When 52-year-old actor Luke Perry died March 4 after a massive stroke, the response was bewilderment and shock.
While many early deaths come with warning signs, his did not. And the unfortunate statistics over the past decade show a 44 percent increase in young adults hospitalized for strokes.
FILE - In this Jan. 26, 2011 file photo, actor Luke Perry poses for a portrait in New York. Perry, who gained instant heartthrob status as wea…
“What we know now is that he had an ischemic stroke in which a clot is formed blocking blood flow and vital oxygen from getting to the brain and heart,” said cardiologist Keith Ferdinand, M.D., a professor at Tulane University School of Medicine.
“Absent of oxygen, brain and heart cells begin to die within four to six minutes. And, according to the World Health Organization, the No. 1 cause of heart disease and stroke is high blood pressure, and the risk just gets greater as we age, when arteries stiffen and don’t expand.”
Treatment for high blood pressure has involved lifestyle changes such as healthful eating, exercising regularly and meditating, drinking in moderation if at all, and avoiding cigarettes.
For those who discover they already have life-threatening high blood pressure, medications have improved greatly over the past decade. In spite of this, many patients do not respond to traditional medications.
1. Have your blood pressure taken at least once a year.
That's why research is underway to find treatment for those with resistant hypertension.
“Drugs currently on the market to treat hypertension work on the blood vessels by either dilating them, reducing pressure in them by eliminating salt and water or slowing down the heart rate,” said Bruno Besse, M.D., medical director of the French biotech company Quantum Genomics, which developed the drug.
The new drug targets a brain enzyme that is overactive in those with high blood pressure. By limiting its release, blood vessels can expand, keeping pressure low. This is a different mode of action than drugs currently in the marketplace.
“To prove these theories, we began with animals, specifically rats,” said chemist Fabrice Balavoine, Ph.D., director of research and development for Quantum Genomics in Paris. “We modified the genes of some rats to give them hypertension, and left other rats with their normal blood pressure. Then, we introduced the new drug. It only changed the brain chemistry of the rats with hypertension, which is what we were hoping for.”
Knowing it worked on rats, toxicity studies were conducted to make sure there were no adverse side effects. At this point, human trials began, involving hundreds of patients.
At this year’s American College of Cardiology convention, which wrapped up last week in New Orleans, Ferdinand, who helped design the clinical trial with French scientists, reported his Phase II trial findings for the new drug. The investigative drug known as Firibastat, a decade in the making, looks promising in treating those with drug-resistant hypertension.
Since minorities have been underrepresented in many previous clinical trials dealing with hypertension, the French researchers wanted to make sure that those populations were a large part of the study, especially since traditional medications for high blood pressure have been less effective in the black population.
In NEW-HOPE, as the study is called, 54 percent of the studied population is minority, including black, Hispanics and female subjects. Thirty-eight percent of the subjects were black.
The drug had good results across all test subjects, the researchers said.
“We wanted to bring this drug to the U.S. for the trials because of its racial and ethnic diversity,” Besse said. “We found cardiologist Ferdinand, who is known to treat drug-resistant hypertension, and designed the trial in conjunction with him and the FDA."
The trials conducted at 40 centers around the country included 254 patients, all of them obese, making them the most difficult to treat. Normal blood pressure is 120/80, but some of these patients had extremely high numbers, considered to be in stroke territory. After just two months, systolic blood pressure (the top number and the most important one) had come down by 10 millimeters.
For Carolyn Johnson, not part of the study but a resistant-hypertensive patient of Ferdinand’s, pressure had skyrocketed to stroke-risk levels of 190/109 before she decided to see an expert.
Jones had been seeing her primary care physician for three years, taking medication twice a day, but landed in the emergency room twice. She suffered from a constant dull headache.
"I was at my wit’s end,” Johnson said.
“We used to call high blood pressure the silent killer, but many patients do have symptoms,” said Ferdinand. “Those can include headaches, fatigue, shortness of breath, and weakness. But, many asymptomatic patients have strokes. In Ms. Johnson’s case, she needed more than one medication to control her pressure.”
Eliminating stress is a key component to preventing strokes. Cortisol, which is released during stress, causes poor blood flow, increases blood pressure and encourages plaque deposits in the arteries.
Phase III of the clinical trial with larger patient populations will begin soon, but new drugs like Firibastat can take years for FDA approval. Ultimately, the goal is to have one drug that tackles hypertension at a core level, because patients on three or more drugs to control their blood pressure are more than twice as likely to have strokes.
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