Three clinical trials exploring the best ways to treat high blood pressure

A program for prevention and treatment of resistant hypertension with algorithm based therapy (PATHWAY)

One important, unanswered question about treatment of high blood pressure (hypertension) is why many people on therapy still have poorly controlled blood pressure. Professor Morris Brown and colleagues are conducting three important clinical trials – the PATHWAY trials – to find out if we can develop a better approach to treating high blood pressure. The first trial will ask if people with high blood pressure who are started on only one drug respond less well to treatment than people started on a combination of drugs. Another question is whether the drug spironolactone is the best add-on treatment for people with high blood pressure that is resistant to treatment, and if the best drug to use for resistant hypertension can be predicted by measuring renin levels (renin is a hormone in the blood that is linked to high blood pressure). The third trial is investigating if combining a thiazide drug plus a potassium sparing diuretic will be more effective than using thiazide alone to treat high blood pressure, and if this strategy can avoid the risk of diabetes in people with metabolic syndrome who take a thiazide. High blood pressure increases the risk of heart attack and stroke and finding out how to treat the condition more effectively through the PATHWAY trials is of prime importance for improving heart health.