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Urate-lowering Therapy Does Not Translate Reductions in Blood Pressure in Young Adults with Hypertension, Study Shows

A study has shown that among young adults with hypertension, treatment with urate-lowering drug allopurinol appears to improve endothelial function; however, this does not translate to meaningful reductions in blood pressure (BP) or inflammation levels.

Photo: Urate-lowering Therapy | InStyleHealth

A crossover-clinical-trial, enrolled adults with ages 18 – 40 years old who had hypertension – which is defined as baseline systolic BP > 120 and <160 mm Hg or diastolic BP >80 and <100 mm Hg, and serum urate levels of >5 mg/dL for men or >4 mg/dL for women. However, none of the participants had chronic kidney disease, gout, or previous exposure to urate-lowering therapies.

There was a total of 99 patients were randomized to receive oral allopurinol at 300mg daily or placebo for 1 month then crossed over to the alternative treatment after a 2-4 weeks washout period. Then the efficacy was evaluated based on changes in SBP from baseline, endothelial function which is estimated as flow-mediated dilation (FMD), and high-sensitivity C-reactive protein levels. Safety was also part of the evaluation.

Among patients, 82 was able to complete all the visits. The average population age was 28 years, where 62.6% of them were men, and 40.4% were African American.

For the preliminary intention-to-treat analysis, systolic blood pressure (SBP) did not differ between the two treatment periods. Particularly, there was a mean reduction of 1.39 mm Hg with allopurinol and of 1.06 mm Hg with placebo.

However, urate-lowering therapy yielded an increase in FMD or flow-mediated dilation compared with placebo.

There were no important changes observed in hs-CRP and no serious adverse events recorded.

Current data do not support the use of urate-lowering in the treatment of hypertension in young adults. For complete details of the clinical study, you may click here.


Source: Arthritis Rheumatol 2021;doi:10.1002/art.41749

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