Developments to Watch
HIGH BLOOD PRESSURE MAY NOT BE THE HEART'S REAL ENEMY
For years, doctors have said high blood pressure is a leading culprit in heart disease. To combat hypertension, they prescribed a variety of drugs that lower blood pressure. But although such drugs cut the incidence of strokes by 40%, they failed to lower the rate of heart attacks, a far more common danger.
Now, scientists at the Albert Einstein College of Medicine in New York think they have a new way to identify hypertensive patients who face the greatest risk of heart attacks. In a study published in The New England Journal of Medicine, the researchers found high levels of blood renin, an enzyme known to affect blood pressure, in hypertensive patients who later suffered cardiac arrest. Those with abnormally high renin were five times as likely to have heart attacks as hypertensive patients with low renin.
The study may be controversial. Renin levels are influenced by a number of factors such as salt intake--and even posture. And the researchers, led by Dr. Michael H. Alderman, concede their results may be affected by the relative youth and health of their survey group. But if confirmed, the research could lead to more accurate diagnostic tests--and better treatments.EDITED BY WILLIAM D. MARBACH