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.
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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