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Dual renin system blocking drug combo provides additional blood pressure-lowering effects

03-26-2007 · EurekAlert!

A combination of two medicines that act against the effects of the enzyme renin are more effective in lowering blood pressure than either of the medicines alone, according to a study presented today at the American College of Cardiology’s 56th Annual Scientific Session.

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  1. Advance in understanding of blood pressure gene could lead to new treatments
    02-04-2007 · EurekAlert!
    Research by scientists at UCL (University College London) has clearly demonstrated for the first time the structure and function of a gene crucial to the regulation of blood pressure. The discovery could be important in the search for new treatments for illnesses such as heart disease, the UK's biggest killer. In a paper published online today in Nature Medicine, the team, led by Professor Patrick Vallance and Dr James Leiper, UCL Department of Medicine, reveal the role of the human gene dimethylarginine dimethylaminohydrolase (DDAH), showing that loss of DDAH activity disrupts nitric oxide (NO) production. NO is critical in the regulation of blood pressure, nervous system functions and the immune system. The role of DDAH is to break down modified amino acids (Asymmetric dimethylarginine (ADMA) and monomethyl arginine (L-NMMA)) that are produced by the body and have been shown to inhibit NO synthase. These molecules accumulate in various disease states including diabetes, renal failure and pulmonary and systemic hypertension, and their concentration in plasma (the fluid component of blood) is strongly predicative of cardiovascular disease and death. In a healthy human body, the majority of ADMA is eliminated through active metabolism by DDAH. Scientists have hypothesised that if DDAH function is impaired, NO production is reduced, and that this could be an important feature of increased cardiovascular risk. To examine this pathway in more detail, the researchers deleted the DDAH gene in mice. These mice went on to develop hypertension, or high blood pressure. They also designed specific inhibitors (small molecules) which bind to the active site of human DDAH. These small molecule inhibitors also induced hypertension in mice, confirming the importance of DDAH in the regulation of blood pressure. Dr Leiper, UCL Medicine, said: “These genetic and chemical approaches to disrupt DDAH showed remarkably consistent results, and provide compelling evidence that loss of DDAH function increases the concentration of ADMA and thereby disrupts vascular NO signalling. “There has been considerable scientific interest in this pathway and the role of ADMA as a novel risk factor, but so far there's been little evidence to support the idea that it's a cause of disease, rather than just a marker. Genes and their pathways are crucial to our understanding of cardiovascular disease and a better understanding of DDAH-1 could lead to important new treatments. “It could help us to establish if genetic variation predisposes certain people to these diseases, or whether environmental factors exert some of their effects through modulation of DDAH activity. “Our research also shows that this pathway could be harnessed therapeutically to limit production of NO in certain situations where too much nitric oxide is a bad thing; for example, hypotension and septic shock. These are some of the biggest problems in intensive care medicine and there is a huge unmet need for drug treatments.” The study, which was carried out at UCL's Rayne Institute, was funded by grants from the British Heart Foundation, the Wellcome Trust and the Medical Research Council. Professor Jeremy Pearson, Associate Medical Director of the British Heart Foundation, said: "The unexpected finding in the 1980s that a simple gas, nitric oxide (NO), is made by cells in the blood vessel wall and is a powerful control of blood vessel relaxation led to the award of the Nobel Prize in 1998 to its discoverers. "More recently, there has been increasing evidence that impairment of NO production is likely to be an important factor in the development of heart and circulatory disease, but the mechanisms responsible are not fully understood. "This study suggests for the first time that the loss of the activity of the enzyme DDAH-1 leads to reduced NO production and may cause heart and circulatory disease. These findings are likely to be important in the search for new ways to optimise the health of our blood vessels." ### Notes for Editors 1. For more information, please contact Ruth Metcalfe in the UCL Media Relations Office on tel: +44 (0)20 7679 9739, mobile: +44 (0)7990 675 947, out of hours: +44 (0)7917 271 364, e-mail: r.metcalfe@ucl.ac.uk2. 'Disruption of methylarginine metabolism impairs vascular homeostasis' is published in the February issue of the journal Nature Medicine. Advance online publication is embargoed to 18.00 GMT (13.00 US Eastern) Sunday 4 February 2007. Journalists can obtain copies of the paper by contacting the UCL Media Relations Office.3. The study was funded by the British Heart Foundation, the Wellcome Trust and the Medical Research Council. About UCL Founded in 1826, UCL was the first English university established after Oxford and Cambridge, the first to admit students regardless of race, class, religion or gender, and the first to provide systematic teaching of law, architecture and medicine. In the government's most recent Research Assessment Exercise, 59 UCL departments achieved top ratings of 5* and 5, indicating research quality of international excellence. UCL is the fourth-ranked UK university in the 2006 league table of the top 500 world universities produced by the Shanghai Jiao Tong University. UCL alumni include Mahatma Gandhi (Laws 1889, Indian political and spiritual leader); Jonathan Dimbleby (Philosophy 1969, writer and television presenter); Junichiro Koizumi (Economics 1969, Prime Minister of Japan); Lord Woolf (Laws 1954, Lord Chief Justice of England & Wales); Alexander Graham Bell (Phonetics 1860s, inventor of the telephone), and members of the band Coldplay.
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  2. New treatment effective in counteracting cocaine-induced symptoms
    08-13-2007 · EurekAlert!
    UT Southwestern Medical Center researchers have discovered a treatment that counteracts the effects of cocaine on the human cardiovascular system, including lowering the elevated heart rate and blood pressure often found in cocaine users.
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  3. Substance in tree bark could lead to new lung-cancer treatment
    08-14-2007 · UT Southwestern Medical Center
    UT Southwestern Medical Center researchers have discovered a treatment that counteracts the effects of cocaine on the human cardiovascular system, including lowering the elevated heart rate and blood pressure often found in cocaine users.
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  4. Effectiveness of first renin inhibitor drug for treating hypertension is limited
    05-09-2007 · EurekAlert!
    Hypertension is a serious condition affecting millions. There are seven classes of drugs used to reduce blood pressure. Aliskiren is the first of a new class of antihypertensive drugs that works by inhibiting renin. A review of six large clinical trials of aliskiren is being published in the May issue of the American Journal of Hypertension. The authors report that, because of reactive renin secretion, this drug has not been any more effective than those already widely available.
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  5. New role in asthma for old drug
    02-01-2007 · EurekAlert!
    Iloprost is an inhaled drug currently used to treat individuals with pulmonary arterial hypertension (raised blood pressure in the blood vessels in the lungs that leads to shortness of breath, dizziness and fainting). However, the results of a new study in mice indicate that iloprost might provide an effective therapeutic for the treatment of individuals with allergic asthma.
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  6. Study finds drug spending caps cause some seniors to quit taking key medicines
    09-11-2007 · EurekAlert!
    Many seniors quit taking drugs for chronic illnesses such as diabetes and high blood pressure when they exceed their drug plan's yearly spending limits, according to a RAND Corp. study. The report, which examines the behavior of seniors enrolled in a private health plan, provides insight into how seniors may act under provisions of Medicare's new drug benefit plan that will leave about one-third of enrollees without drug coverage for some part of each benefit year.
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  7. For treating advanced Parkinson's, new research points to serotonin
    02-04-2008 · EurekAlert!
    Studies in a mouse model of Parkinson's disease show that side effects caused by repeated use of the drug L-DOPA can be minimized by blocking the serotonin 1B receptor. The finding, reported by researchers at Rockefeller University and the Karolinska Institute, suggests that targeting the 1B receptor may provide an alternative approach for treating advanced Parkinson's disease.
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  8. Consumption of small amounts of dark chocolate associated with reduction in blood pressure
    07-03-2007 · EurekAlert!
    Eating about 30 calories a day of dark chocolate was associated with a lowering of blood pressure, without weight gain or other adverse effects, according to a study in the July 4 issue of JAMA.
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  9. Combination HDL/LDL therapy has no effect on plaque build-up
    03-26-2007 · EurekAlert!
    Two RADIANCE studies presented today at the American College of Cardiology's 56th Annual Scientific Session assessed the effects of adding torcetrapib to atorvastatin among patients to improve their cholesterol levels. Although the ILLUMINATE study and other trials involving torcetrapib were recently stopped because of safety concerns, the effect of the drug on carotid intima-media thickness (CIMT) may provide useful information on whether it slows the progression of atherosclerosis.
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  10. One pill may be better than two for treating patients with high blood pressure
    05-11-2007 · EurekAlert!
    Adults with high blood pressure and additional risk factors for heart disease may benefit more from taking one tablet rather than two, if their current treatment combines the lipid-lowering medication atorvastatin with the blood pressure-lowering medication amlodipine.
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