Hypertension Silent Killer. What is the most effective treatment in lowering high blood pressure?

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Tanbir Islam 12AS2


What is the most effective treatment in lowering high blood pressure?

The Problem

Research has shown that high blood pressure is the main cause of Strokes and Coronary Heart Disease. It is of the most common disorders in the UK; this can be supported by many sources such as . Hypertension is regarded as a silent killer in many developed countries as statistics show; the “2008 overall death rate from HBP was 18.3%. Death rates were 16.5% for white males, 50.3% for black males, 15.3% for Hispanic males, 13.1% for American Indian/Alaska Native males and 14.5% for Asian/Pacific Islander males”.



Hypertension elevates the blood pressure in the arteries; which damages the artery wall by the high blood pressure exerting an extra strain on the endothelium layer. This causes an inflammatory response as the white blood cells move into the artery wall and accumulate cholesterol from the blood. The cholesterol builds up which lead to the formation of an atheroma, there is also a build up of calcium salts and fibres at the site which lead to a plaque formation on the inner wall of the artery. This causes the artery to become narrower which result in raised blood pressure.  

 Figure 1: Google Images

A blood clot may also form which can block the artery as a whole which reduces the flow of oxygenated blood back to the heart which can result in a heart attack.  A blood clot can also cause stroke, pulmonary embolism and atrial fibrillation. Statistics show “69% of people who have a first heart attack, 77% of people who have a first stroke and 74% of people with chronic heart failure have high blood pressure”.


 Possible Solution – Antihypertensive drugs  

Antihypertensive drugs are possible solutions to lowering blood pressure; these drugs have been tested thoroughly and are only prescribed to patients who suffer from extreme high blood pressure.

Examples of antihypertensive drugs are: ACE inhibitors (ACE stands for angiotensin converting enzyme), Diuretics, Beta blockers and Statins. ACE inhibitors block the production of angiotensin which causes arterial constriction and a rise in blood pressure; however the side effects are cough, dizziness, heart arrhythmia and impaired kidney. A combination of drugs is sometimes used if the blood pressure is not reduced for example: a doctor may prescribe Alpha blockers which reduces nerve impulse to the blood vessel, with ACE inhibitors to help lower the blood pressure.

To see how effective the drugs were, a randomised, double-blind placebo- controlled trial of the antihypertensive drug was conducted during a 4 week period; with “208 moderately hypertensive men aged between 35 to 60 years old, each individual received each of the four monotherapies in random order. Four week of placebo period was included before and between drug treatment periods. Antihypertensive responses were assessed with 24-h ambulatory”. Results show the blood pressure responses to “bisoprolol and losartan did not vary according to the variables. Amlodipine and hydrochlorothiazide responses were positively correlated with age, placebo blood pressure level, and lower night-time dipping on placebo”.                                                     ()

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 The benefit of a double blind study is a “double-blind study is an unbiased experiment which gives an accurate idea of the benefits of a drug. This is especially important when considering drug treatments that may have side effects or be otherwise detrimental to the patient”.


Another randomised drug trial was conducted to investigate how effective antihypertensive drugs are. The placebo-controlled trial of ACE inhibitors “(four trials, 12,124 patients mostly with coronary heart disease) showed a risk reduction of 30% stroke and 20% coronary heart disease, the overview of placebo-controlled trials of calcium antagonists showed 39% risk reduction in stroke ...

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