LIFE EXTENSION UPDATE EXCLUSIVE SEPTEMBER 28 2001
IN THIS ISSUE, SEPTEMBER 28 2001:
LIFE EXTENSION UPDATE EXCLUSIVE: Blood pressure reduction prevents second
events even in nonhypertensive stroke survivors
WHAT'S HOT: Antioxidant vitamins prevent progression of hypertension in
spontaneously hypertensive rats, Antioxidants may be treatment of choice for
hypertension
PROTOCOL: Hypertension
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Blood pressure reduction prevents second events even in nonhypertensive
stroke survivors
In what has been called a landmark study published in the September 29 2001
issue of the Lancet, 6,105 stroke patients from Europe, Australia and Asia
experienced reductions of 25% to 50% in the risk of a second cardiovascular
event when given blood pressure lowering drugs. The study, known as the
Perindopril Protection Against Recurrent Stroke Study or "PROGRESS", tested
the ability of the ACE inhibitor drug perindropril combined with the
diuretic indapamide to prevent a second stroke or heart attack in this high
risk population. While aspirin has demonstrated success in preventing
second coronary events, it cannot be used by hemorrhagic stroke survivors.
Hemorrhagic stroke is the type of stroke that occurs when a blood vessel in
the vein ruptures and bleeds. In the present study, hemorrhagic stroke
patients experienced three-quarters the risk of stroke than controls.
Although high blood pressure is a strong risk factor factor for stroke, over
two-thirds of strokes occur in people who are not hypertensive. One out of
six stroke surivors suffer from another stroke or a heart attack within five
years of the intial event.
Participants from 172 Asian, Australian and European centers were randomnly
assigned perindorpil and indapamide or a placebo and followed up for four
years. Both hypertensive and nonhypertensive individuals receiving the drug
combination experienced a reduction in blood pressure. Ten percent of those
receiving the drugs experienced a stroke during follow-up compared to 14% of
the placebo group. Major vascular events were also reduced. One in every
eleven participants were able to avoid death or a major cardiovascular event
over the course of the study.
"It was thought that blood pressure lowering drugs were only useful for
patients with high blood pressure, but we have shown that perindopril and
indapamide have beneficial effects, not only for those with high blood
pressure, but also for the much larger number of stroke patients with normal
blood pressure," commented study chairman, Professor John Chalmers of the
University of Sydney.
Chief investigator Dr Stephen McMahon summarized, "The results provide clear
evidence of major health gains for these high risk patients. If the findings
are applied widely, many millions of stroke sufferers worldwide would be
spared unnecessary suffering . . . There is a strong case for making this
treatment available to most stroke patients, irrespective of their age and
blood pressure and irrespective of the other treatments they may be
receiving. The benefits are unusually large and occur in a wide range of
patients. There were very few side-effects."
WHAT'S HOT
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Antioxidant vitamins prevent progression of hypertension in spontaneously
hypertensive rats
In a study published in Hypertension: Journal of the American Heart
Association, researchers from the University of Montreal and Sungkyunkwan
University in Seoul, Korea, demonstrated the ability of vitamins C and E to
prevent the progression of hypertension in rats given a 4% sodium chloride
diet. High sodium diets are notorious for raising blood pressure, and salt
reduction is a frequent recommendation given by physicians to their
hypertensive patients.
Stroke-prone spontaneous hypertensive rats were divided into groups who
received diets containing 1000 mg ascorbic acid per day, 1000 international
units vitamin E per day or a diet supplemented with neither vitamin. The
rats were studied for six weeks and had their blood pressure measured
weekly. At twenty-two weeks of age the animals were euthanized and blood
samples drawn. Small arteries were examined for the ability to relax, and
thoracic aortas were examined for the presence of the pro-oxidant superoxide
and the antioxidant superoxide dismutase (SOD).
While hypertension progressed in the animals receiving the nonsupplemented
high sodium diet, the condition only increased marginally in the animals
receiving vitamin C or E, while body weights of all groups did not differ.
The media to lumen ratio and media thickness of the arteries of the
supplemented rats were significantly lower than that of controls. Vitamins C
and E increased the ability of the arteries to relax, indicating improved
endothelial function. They also lowered superoxide activity by decreasing
the activity of NADPH oxidase, and increasing that of SOD in the vasculature
of the animals studied.
http://www.lef.org/cgi-local/welcome.cgi/id=151066773/sgroup_id=699/welcome.
html
Antioxidants may be treatment of choice for hypertension
The September 2001 issue of International Kidney published an article in
which the hypothesis was submitted that severe regional hypertension may be
due to inactivation of nitric oxide by a type of free radical known as
reactive oxygen species. Nitric oxide is a substance produced in the body
which aids in the relaxation of the blood vessels, helping to maintain
normal blood pressure. The researchers acted on the finding that in rats
with a severe narrowing of the aorta above the renal arteries, nitric oxide
synthase is upregulated in the heart, chest and brain, which may be caused
by nitric oxide inactivation by free radicals.
The researchers in this study banded the aortas of rats above the renal
artery to mimic a condition found in humans in which elevated blood pressure
exists in the vasculature above a narrowed site. Another group of rats were
sham-operated as controls. Nitrotyrosine, a marker of nitric oxide
interaction with reactive oxygen species, and intra-arterial pressure were
measured after three weeks. The banded rats experienced a significant rise
in arterial pressure as well as increases in nitrotyrosine in the aorta
above the band as well as in the heart and brain compared to controls. In
the aorta segment below the bands where there was no change in blood
pressure, nitrotyrosine levels remained the same.
http://www.lef.org/cgi-local/welcome.cgi/id=151066774/sgroup_id=699/welcome.
html
PROTOCOL
Hypertension
A startling statistic in the May 4, 1999, edition of The New York Times
revealed that only 18% of people with high blood pressure (hypertension) are
successfully treated to achieve normotensive ranges. Untreated hypertension
carries enormous health risks, such as increased risk of heart disease,
stroke, kidney disease, and eye disease, yet fear of medication side effects
and improper prescribing by physicians are contributing to an epidemic of
hypertension-induced disease.
"Blood pressure" can be defined as the pressure or force that is applied
against the artery walls as blood is carried through the circulatory system.
It is recorded as a measurement of this force in relation to the heart's
pumping activity, and is measured in millimeters of mercury (mmHg).
The top number, or systolic pressure, is the measurement of the pressure
that occurs when the heart contracts or beats. The bottom number, or
diastolic pressure, is the measurement recorded between beats, while the
heart is at rest. The systolic number is placed over the diastolic number.
For example, 110/70 (read as "110 over 70") means a systolic pressure of 110
mmHg and a diastolic pressure of 70 mmHg. The systolic number is always the
higher of the two numbers.
Coenzyme Q10 (coQ10) and garlic provide aid in the reduction of blood
pressure. These supplements may also mitigate the underlying disease that
may be the cause of hypertension.
In March 1999, the results of a randomized, double-blind trial among
patients receiving antihypertensive medication was published. Patients known
to have essential hypertension and presenting with coronary artery disease
were given 60 mg of CoQ10 twice a day. The doctors conducting the study
stated, "Findings indicate that treatment with Coenzyme Q10 decreases blood
pressure, possibly by decreasing oxidative stress and insulin response in
patients with known hypertension receiving conventional antihypertensive
drugs (Journal of Human Hypertension, 1999 [March], 13 [3]:203-8)
Studies continue in this area, with investigations pointing strongly toward
the benefits of garlic, fish oil, and coQ10 aiding in the treatment of
hypertensive disease. The amount of standardized garlic extract needed to
lower blood pressure is 1500 to 6000 mg per day. The amount of coenzyme Q10
needed to lower blood pressure is 200 to 300 mg per day.
http://www.lef.org/cgi-local/welcome.cgi/id=151066775/sgroup_id=699/welcome.
html
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