JUANA SUMMERS, HOST:
More than half of Americans aged 40 and over have high blood pressure. There are typically no symptoms, but left untreated, it can be deadly. NPR's Allison Aubrey reports on new recommendations aimed at prevention and a new experimental drug that experts say has some promising results.
ALLISON AUBREY, BYLINE: When George Solomon was told about the risks of high blood pressure, he was hesitant to take medications because he felt completely fine. Then at age 63, he had a stroke.
GEORGE SOLOMON: I'd been active all day outside. I'd been to the gym. And then at 7:30 that night, I went upstairs to watch a movie, and when I sat down in the chair, I couldn't get back up. I had a sensation that came up across my back.
AUBREY: He lost feeling in his arm and his leg and was rushed to the hospital. After months of recovery, he regained much of his strength, and he's taking medications.
SOLOMON: I am feeling healthier. I think that in combination with the lifestyle and weight reduction, more cardio, still doing the strength training - yes, it makes a big difference.
AUBREY: New guidelines from the American Heart Association focus on early prevention. Dr. Dan Jones, who chaired the committee that wrote the guidelines, says it can be beneficial to start blood pressure medications as soon as blood pressure hits the risky range.
DAN JONES: For all people with a blood pressure over 140 over 90 millimeters of mercury, we recommend beginning with two medications.
AUBREY: The new guidelines also emphasize lifestyle strategies, including a low-sodium diet, exercise and stress reduction in the form of meditation, yoga or deep breathing. For people with systolic blood pressure - that's the upper number in the 130s - the recommendation is to start with these changes, then move to medication if it does not improve.
Dr. Jordy Cohen is a nephrologist and a hypertension specialist at the University of Pennsylvania. She says millions of adults in the U.S. could benefit from medications and lifestyle changes.
JORDY COHEN: There's a really enormous preventive health opportunity in treating hypertension earlier 'cause if you catch it early, you treat it early, you really can end up with many more years of healthy life expectancy where you don't have a stroke, where you don't have a heart attack or heart failure because you've treated this earlier.
AUBREY: Some people don't get enough reduction with current medications, so Jordy Cohen says there's a lot of interest in a new class of medication that works by targeting the hormone aldosterone, which helps regulate fluid and sodium in the body. Too much of the hormone is one cause of high blood pressure. She points to new data.
COHEN: The new study that was released in the New England Journal of Medicine shows that this new class of medications very, very effectively lower blood pressure when used in people who have difficult-to-control hypertension.
AUBREY: It's one of several studies of the drug baxdrostat, which is not yet on the market. Drug makers plan to share data with regulators by the end of the year.
COHEN: In hypertension, we haven't seen anything new since the '90s that was effective.
AUBREY: So she says new treatment options would be very helpful. Dr. Jenifer Brown, a cardiologist at Brigham and Women's Hospital, is one of the researchers behind the new study, which was sponsored by the drug maker AstraZeneca and included about 800 people who were taking two to three medications but still had high blood pressure.
JENIFER BROWN: What we saw is that after 12 weeks of treatment, there was about a 10-point improvement in blood pressure in the patients treated with baxdrostat over the placebo effect.
AUBREY: A 10-point drop is linked to about a 20% reduction in the risk of heart attacks and strokes and also a decreased risk of dementia.
Allison Aubrey, NPR News. Transcript provided by NPR, Copyright NPR.
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