Three tries, no charm in blood pressure care

Josiah Ian Bumagat

Trial-and-error is simple: try once, try again, and repeat. But, when it comes to treatment plans with hundreds of possible prescriptions, the cycle quickly loses appeal.

The process is slow, frustrating, and costly. In health care, time is simply priceless.

In the area of hypertensive care — the treatments for high blood pressure (BP) — delays in finding the right drug combination can be the difference between a stroke and a normal reading. Now, researchers have found a way to make the process be more than guesswork, and it uses a calculator.

Traditionally, hypertension care relied on consecutive blood pressure readings before and after treatment, a trial-and-error approach to gauge how well medications worked.

But BP naturally fluctuates daily due to stress, weather, or other factors, making results unreliable.

Such levels of uncertainty mean that the process of hypertension care is still far from being highly effective. According to Dr. Nelson Wang, a cardiologist and co-author, using repeated trials alone proves difficult to reliably test the efficacy of a prescription.

Hypertension is one of the most common reasons for doctor visits and a leading cause of premature death worldwide, according to the World Health Organization. To address this, the researchers developed the Blood Pressure Treatment Efficacy Calculator, a tool designed to improve treatment precision and efficiency.

Until now, no modern resource had systematically compared the effectiveness of antihypertensive drugs and their combinations, noted study co-author Dr. Anthony Rodgers.

“Using the calculator challenges the traditional ‘start low, go slow, measure and judge’ approach to treatment, which comes with the high probability of being misled by BP readings, inertia setting in or the burden on patients being too much,” Rodgers said.

The calculator analyzes data from over 500 randomized clinical trials involving more than 100,000 participants.

The program works by calculating the average effects of treatments across these trials. This would, in turn, help physicians in estimating how much medications, and which medications, should be used for a specific reduction in BP.  

It uses treatment categories of low, moderate, and high intensity groups according to the amount of blood pressure, measured in millimeters of mercury (mmHg), it reduces.

 “This is really important because every 1mmHg reduction in systolic blood pressure lowers your risk of heart attack or stroke by two percent,” Dr. Wang stated.

The study, published in The Lancet, presents how the tool could allow more “tailor-fit” hypertension care, reducing the need for weeks or months of trial-and-error.

According to Dr. Rodgers, even small improvements in hypertension control could save millions of lives worldwide, with global control rates of just 50 percent making a major impact.

Next, the team plans clinical trials where patient prescriptions will be guided by the calculator’s targets.

Trial-and-error may be simple — but efficiency, once proven, could save more lives.