Low-cost Alternative Drugs Can Help Lower Blood Pressure

Two inexpensive drugs may help patients who continue to have high blood pressure despite taking standard blood pressure medicine.

Howard Pratt, M.D., of the Indiana University School of Medicine, and his colleagues studied two compounds  amiloride and spironolactone in a group of African-American patients with high blood pressure.

 African-Americans are disproportionately affected by high blood pressure, and tend to retain more sodium in their bodies. 

The retention of sodium is linked to high blood pressure.  Amiloride and Spironolactone are diuretics, and they work by limiting the amount of sodium the kidneys take back into the body during the process of producing urine.

“The kidneys do an incredible job of holding onto sodium, which was important to the survival of our early ancestors who lived in a salt-poor world, but today there’s so much salt in the food we eat that the kidneys end up holding onto too much sodium,” sad Dr. Pratt.  The result, he said, can be high blood pressure.

In a study of 98 patients, some were given one of the two drugs, some were given both, and some were given a placebo.  All of the patients continued to take their standard blood pressure medicine.  On average, blood pressures of the patients taking either amiloride or spironolactone individually, or both drugs, dropped significantly.  There were no side effects.

Dr. Pratt said that physicians with patients for whom standard therapy doesn’t result in a normal blood pressure often prescribe higher doses of the medicine already being used, or add in a new blood pressure drug that could be expensive and often is also ineffective.  He expects that this and additional studies will convince physicians to try the amiloride or spironolactone alternatives instead.

Dr. Pratt said the study was conducted with African-Americans because they are on average more predisposed to retain sodium, but he believes the effectiveness of the two drugs likely would be the same regardless of ethnicity.

The Indiana University School of Medicine study was published in the September issue of the journal Hypertension.

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