Viagra’s Other Uses

Viagra is now being used to treat not only erectile dysfunction (ED) but also pulmonary hypertension. And the drug may have potential for treating several other conditions, reports the August 2007 issue of Harvard Men’s Health Watch.

The three ED medications currently on the market—Viagra, Levitra, and Cialis—all work by the same means, and they have similar side effects. The most common are headaches and facial flushing, which occur in 15% of men. Other reactions include nasal congestion, indigestion, and back pain. These side effects are mild and temporary. The most important worry about ED pills is their ability to widen arteries enough to lower blood pressure. And men who are taking nitrates should never use any of the ED pills.

Although some of the drugs’ side effects may be troublesome, others may be helpful, and scientists are studying whether ED pills might help treat a variety of nonsexual problems. Viagra (sildenafil) has been on the market longest and is most studied. It’s yet not clear if the other ED pills offer similar benefits, but Viagra, at least, may prove useful for some other conditions, including these:

Pulmonary hypertension: Viagra is now marketed under the name Revatio for this uncommon but serious disorder of high pressure in the blood vessels leading to the lungs.

Mountain sickness: Viagra can reduce pulmonary artery pressure at high altitude and improve the ability to exercise in low oxygen conditions.

Raynaud’s phenomenon: In affected individuals, exposure to the cold triggers spasm of the small arteries that supply blood to the fingers, toes, or both, which become pale, cold, and painful. Both Viagra and Levitra have been helpful in clinical trials.

Heart disease: Studies suggest Viagra might help patients with congestive heart failure or diastolic dysfunction.

source:www.newswise.com

Low levels of vitamin D spike blood pressure

As blood levels of vitamin D drop, blood pressure increases, according to findings from the Third National Health and Nutrition Examination Survey (NHANES III).

The analysis involved 12,644 adults in the US aged 20 years and older who had blood pressures recorded and vitamin D levels measured.

As reported in the American Journal of Hypertension, Dr Robert Scragg of the University of Auckland, New Zealand, and colleagues found that patients with the lowest vitamin D levels had blood pressures that were slightly higher than those with the highest levels. This relationship was strongest in subjects who were 50 years of age and older.

source:www.gulfnews.com

Metabolic syndrome increases risk of cardiac harm in those with hypertension

Cardiovascular damage occurs more frequently in hypertensive patients with metabolic syndrome than in hypertensive patients without, according to a study in the July issue of the American Journal of Hypertension. The increased hazard is significantly related to increased levels of inflammation and fibrosis.

"Previous studies have shown that metabolic syndrome is associated with an increased susceptibility to develop cardiovascular damage," write Dr. Andrea Ferrucci and associates at the University of Rome La Sapienza, Italy. "Experimental evidence indicates that inflammation and fibrosis could play a critical role in the development of cardiovascular damage in hypertension," they note. "This issue has not been clarified yet in patients with metabolic syndrome."

The researchers examined the association between markers of inflammation and fibrosis with cardiovascular damage in 128 essential hypertensive patients. Fifty-one had metabolic syndrome and 77 did not.

The team measured clinical and biochemical parameters, and echocardiographic examinations with transmitral Doppler and Doppler imaging (TDI) were performed on all patients.

Patients with metabolic syndrome had significantly worse values documented by echocardiography, including higher left ventricular mass, diastolic function, and interventricular septum thickness.

Results of multiple linear regression analysis adjusting for age, sex, and metabolic syndrome components revealed an association between the metabolic syndrome itself and left ventricular mass.

Serum levels of C reactive protein, tumor necrosis factor-alpha, transforming growth factor-beta, and procollagen type 1 carboxy-terminal propeptide were significantly all higher in patients with metabolic syndrome.

When the authors examined the association between these markers and cardiovascular damage separately in the two groups by multiple linear regression analysis, the relationship was significantly stronger in the metabolic syndrome group, especially in regard to left ventricular mass.

The findings may have "significant implications for management of hypertensives with metabolic syndrome by indicating the need of a more aggressive treatment of hypertension in high-risk patients, starting at the prehypertensive state, as already reported," the authors conclude.

source:www.medicexchange.com

Hypertension Training Company, Disease Management and Training Company for Physicians,

Hypertension Training Company, or HTC, is pleased to announce the official launch of its Web site: www.abcdtool.com.

Hypertension is a major and rapidly growing cost driver for all Health Care Plans.

Hypertension Training Company's main objective is better Hypertension management at lower cost to Health Care.

Hypertension Training Company is the first disease management company specializing in training and education of health care providers (physicians, physician assistants, nurse practitioners, and other health practitioners) in the diagnosis, evaluation, management and treatment of Hypertension and its complications and consequences.

Hypertension Training Company created a unique disease management protocol, ABCD Tool of evaluation and management of Hypertension. ABCD Tool is also an effective training and educational program for health care providers designed to provide them with the state of the art practical approach to patients.

ABCD Tool leads to better Blood Pressure control with fewer and less expensive medications used.

Implementation of the ABCD Tool results in significant improvement in Blood Pressure control, improvement in HEDIS and other performance measures, outcome measures, patient's satisfaction measures, thus giving Health Care Organizations highest industry standards at lowest cost

Hypertension Training Company is founded and operated by practicing physicians with specialty in Clinical Hypertension, Nephrology and Internal Medicine.

source:www.pr.com

Mayo Clinic gets hyperbaric pressure unit

The Mayo Clinic is preparing for the arrival of a 3,800-cubic-foot hyperbaric pressure vessel from Australia.

The rectangular, prefabricated chamber is made of high-strength steel and contains a suite of specialized therapy rooms. Hyperbaric pressure vessels are used to increase atmospheric pressure and deliver high concentrations of oxygen to treat various medical conditions.

The unusual therapy unit is to arrive Saturday and be installed within four hours, lifted by a crane and slid through an opening in the hospital's wall. Rochester Methodist Hospital is one of the two Mayo Clinic hospitals located in the city.

Mayo Clinic physicians are expected to use the chamber primarily to enhance wound healing, a chronic problem for some patients that places them at risk for limb amputation. The hyperbaric vessel will also be used for altitude research relating to health and aerospace transport systems.

source:www.sciencedaily.com

Central command system for pulmonary hypertension discovered

Researchers at the University of Alberta have identified a "central command system" for pulmonary hypertension, a disease that currently has no cure and kills thousands each year.

"We believe this finding opens the door to a new strategy and the development of a new stream of drugs to treat this complex and lethal disease," said Dr. Evangelos Michelakis, director of the U of A pulmonary hypertension program and senior author of the study, which appears today in the Proceedings of the National Academy of Sciences.

Much like cancer, pulmonary hypertension is caused by the uncontrolled proliferation of cells. In the case of pulmonary hypertension, these cells build up in the pulmonary arteries, block blood flow and cause perpetual high-blood pressure in the lungs and, eventually, heart failure.

Pulmonary hypertension is especially dangerous because it is difficult to diagnose, Michelakis said, adding that it can appear in anyone at any age but is most commonly found in females in their 30s. The prime symptom is shortness of breath.

"The current treatments for pulmonary hypertension do not work. At best they might somewhat prolong and improve quality of life, but nothing cures it it usually kills patients within four to five years from diagnosis," said Sebastien Bonnet, a post-doctoral fellow in the U of A Department of Medicine and first author of the paper.

However, the U of A researchers believe they've made a breakthrough in their discovery of the role that nuclear-factor-of-activated-T-lymphocytes (NFAT) play in the cause of the disease. The researchers have identified NFAT as a potential controlling element of pulmonary hypertension in both human tissues and animal models.

When it is working properly, NFAT co-ordinates several cellular functions by regulating the expression of multiple genes. It is normally activated in important health-maintaining functions, such as the regulation of immune cells and the development of the heart. However, it causes havoc when it is activated "inappropriately", such as in the case of pulmonary hypertension.

"You can think of NFAT as a rogue air traffic controller that keeps planes in the air that need to land or sends them to the wrong destinations and causes them to attack places they shouldn't," explained Michelakis, the Canada Research Chair in Pulmonary Hypertension.

Multiple abnormalities have been described in pulmonary hypertension, making the treatment difficult. Most current therapies are designed to attack one abnormality at a time, Michelakis said, adding that this work shows for the first time that several of these abnormalities, so far considered to be unrelated to each other, may in fact be the result of a single problem activation of NFAT.

"Therefore, by attacking NFAT, the 'common denominator' of these abnormalities, you might be able to treat them all at once," he said.

In January this year, the same U of A research team published a paper announcing a possible new treatment for various types of cancer using a molecule called dichloroacetate (DCA). In that study, the team showed that NFAT is also activated in cancer. The team has previously shown that DCA also reverses pulmonary hypertension in animal models.

Michelakis believes that this new approach looking at pulmonary hypertension through a "cancer window" will facilitate the development of effective therapies.

"In both cases, we're taking a novel approach by determining the 'central command centers' for these diseases like NFAT and then trying to come up with ways to attack them at their root causes," he added.

"The development of multidisciplinary programs that focus on pulmonary hypertension all over the world is significantly improving the diagnosis and care of patients with pulmonary hypertension," said Linda Webster, a co-author of the study and manager of the U of A pulmonary hypertension program.

source:www.news-medical.net

Yale Leaders in $6 Million International Effort to Fight Hypertension

Leading researchers in Switzerland, France, Mexico, and at Yale School of Medicine, are pooling efforts under a five-year, $6 million grant from the Leducq Foundation to pinpoint the kidney’s role in high blood pressure.

Hypertension affects more than one billion people worldwide and is one of the most important risk factors for cardiovascular diseases such as stroke, myocardial infarction, sudden death, and kidney disease. The exact causes remain unknown.

The new “Transatlantic Network on Hypertension—Renal Salt Handling in the Control of Blood Pressure” is a collaborative effort to understand how the underlying mechanisms resulting in elevated blood pressure depend upon the role of the kidney in managing the level of salt in the body.

Leading the team at Yale are Steven Hebert, M.D., professor and chair of cellular and molecular physiology and the American coordinator of the project, and Richard Lifton, M.D., professor and chair of genetics.

“Breakthroughs in understanding and treating this complex and often devastating disease will come from collaborations among top scientists from around the world,” Hebert said. “The grant from the Leducq Foundation unites leaders in salt metabolism and hypertension from Europe and North American to understand the role of deranged salt handling by the kidney in causing and maintaining high blood pressure.”

“The Leducq program,” Lifton added, “ uniquely allows us to bring together a ‘dream team’ of investigators around the world with diverse expertise in physiology, genetics, and clinical investigation to combine forces to tackle this important medical problem.”

The European coordinator of the project is Professor Bernard Rossier of the University of Lausanne in Switzerland, who will direct pharmacology and toxicology researchers at Lausanne and Lausanne University Hospital. Also part of the network are researchers from the Instituto de Investigaciones Biomédicas of the Universidad Nacional Autónoma de México, under the direction of Professor Gerardo Gamba, and a team led by Xavier Jeunemaître, M.D., of Hospital Georges Pompidou and the College de France in Paris.

The transatlantic team will study the metabolism of sodium, potassium, and calcium and their influence on blood pressure. They will focus on the ion channels expressed in the kidney and on genetic factors that lead to a sensitivity or resistance to salt related hypertension. The goal is to identify new therapeutic targets for hypertension. In addition, the network will integrate their expertise in areas of population genetics and animal models of hypertension and combine approaches from molecular biology, proteomics, and physiology.

The Leducq Foundation funding will enable the group to develop a network of Ph.D. and postdoctoral researchers within the participating institutions; develop a platform of exchange via the internet for training, videoconferencing, real time laboratory discussions, and other exchanges, and develop a centralized database that will allow easy access to the tools, instruments, materials, and other resources that the various teams will share.

Jean and Sylviane Leducq established the Leducq Foundation in 1996 to support cardiovascular disease research. One of the foundation’s goals is to promote collaboration between researchers in North America and Europe. Toward this end, it began in 2004 to accept applications for its Transatlantic Networks of Excellence in Cardiovascular Research Program.

source:www.webwire.com

Link between obesity, hypertension questioned

The association between body mass index (BMI) and high blood pressure has decreased since 1989, researchers say.

The finding suggests that obesity may not have as much of an impact on heart-related disease as previously thought.

"High blood pressure is a leading cause of the global burden of disease," Dr. Pascal Bovet of the University of Lausanne, Switzerland, and colleagues write in the medical journal Epidemiology. "The prevalence of hypertension, and of several other conditions [including diabetes], is considered to be linked to the worldwide epidemic of obesity."

The researchers examined trends in blood pressure and BMI over a 15-year interval in the Seychelles.

There was a slight decrease in average blood pressure between 1989 and 2004 in both men and women, and the prevalence of high blood pressure changed little during this time.

On the other hand, the percentage of people who were overweight increased from 39 per cent to 60 per cent.

The association between obesity and hypertension decreased "substantially and consistently," Bovet's team writes, and "the impact of the overweight epidemic on cardiovascular disease might be less important than predicted."
© The Vancouver Province 2007

source:www.canada.com

Obesity, arthritis top list of health woes

More than a third of West Virginia’s adults were diagnosed with some form of arthritis in 2005, the highest prevalence in the nation, a new state report says.

The Mountain State also continues to struggle with high rates of obesity, heart disease, diabetes and hypertension, according to the latest Behavioral Risk Factor Survey Report from the state Bureau for Public Health. The report is based on data collected from telephone surveys in 2004 and 2005.

Nearly one-fourth of adults considered their health to be either fair or poor — 23.5 percent in 2004 and 24.7 percent in 2005. That assessment was most common among seniors, those with the least education or those with the lowest household incomes, the report said.

West Virginia’s obesity rate jumped from 27.6 percent in 2004 to 30.6 percent in 2005, and was the third highest rate in the nation both years. Obesity has increased substantially since 1987, the report said.

“Men and women from a wide range of age, education, and income categories contributed to this unhealthy trend,” the report said.

Poor nutrition and lack of exercise are prevalent in the state. Eighty percent of adults don’t eat enough vegetables and fruits, ranking the state seventh in the nation for this risk factor. About one-fourth of adults — 24.5 percent in 2004 and 28.5 percent in 2005 — were not physically active during leisure time.

Tobacco use also persists in West Virginia. More than 26 percent of adults in both 2004 and 2005 smoked cigarettes, the second highest rate in the nation in 2004 and the fourth highest rate in 2005.

However, alcohol consumption is not a big problem. West Virginia ranked 50th in 2004 and 49th in 2005 for heavy drinking. Only 2.9 percent of West Virginia adults reported heavy drinking in 2004. That rate rose slightly to 3.1 percent in 2005, the report said.

More than 22 percent of residents ages 18 to 64 had no health insurance in both 2004 and 2005.

A report released in June by the New-York Based Commonwealth Fund said West Virginia would rank as one of the healthiest states in the country and could save millions a year if it reduced the number of adults without health insurance by about 50 percent.

McDowell County was the unhealthiest county in the state, ranking first in such risk factors as diabetes, asthma, high cholesterol, arthritis, obesity and lack of health insurance, the report said.

“The way of life here throughout the generations was to purchase less expensive foods, and fatty foods are cheaper foods,” said Cheryl Mitchem, program development director at McDowell County’s Tug Valley Health Association, which runs four clinics. “We’ve been looking at all these factors for years.”

Health problems tend to be more severe in the Southern counties. Mingo County is first in the state in hypertension rates and the lowest percentage of people who exercise. Wyoming County leads the state in the percentage of smokers, with 40 percent of adults. Wyoming County also has the highest percentage of residents who have suffered a heart attack or stroke.

The healthiest county overall is probably Monongalia, where 15 percent of residents reported being in fair or poor health. Monongalia also reported rates of obesity, cigarette smoking, diabetes and hypertension that were among the lowest in the state.

www.timeswv.comsource:

High Blood Pressure :: Dark chocolate bite lowers high blood pressure

Daily bite of dark chocolate may reduce high blood pressure in hypertensive patients. Eating about 30 calories a day of dark chocolate was associated with a lowering of blood pressure revealed in a study.
Previous research has indicated that consumption of high amounts of cocoa-containing foods can lower blood pressure (BP), believed to be due to the action of the cocoa polyphenols (a group of chemical substances found in plants, some of which, such as the flavanols, are believed to be beneficial to health).

Dirk Taubert, M.D., Ph.D., of University Hospital of Cologne, Germany, and colleagues assessed the effects of low regular amounts of cocoa on BP. The trial, conducted between January 2005 and December 2006, included 44 adults (age 56 through 73 years; 24 women, 20 men) with untreated upper-range prehypertension (BP 130/85 – 139/89) or stage 1 hypertension (BP 140/90 – 160/100). Participants were randomly assigned to receive for 18 weeks either 6.3 g (30 calories) per day of dark chocolate containing 30 mg polyphenols or matching polyphenol-free white chocolate.

source:www.spiritindia.com

The researchers found that from baseline to 18 weeks, dark chocolate intake reduced average systolic BP by -2.9 (1.6) mm Hg and diastolic BP by -1.9 (1.0) mm Hg without changes in body weight, plasma levels of lipids or glucose. Hypertension prevalence declined from 86 percent to 68 percent. Systolic and diastolic BP remained unchanged throughout the treatment period among those in the white chocolate group. Dark chocolate consumption resulted in the short-term appearance of cocoa phenols in plasma and increased vasodilatory S-nitrosoglutathione. There was no change in plasma biomarkers in the white chocolate group.

“The most intriguing finding of this study is that small amounts of commercial cocoa confectionary convey a similar BP-lowering potential compared with comprehensive dietary modifications that have proven efficacy to reduce cardiovascular event rate. Whereas long-term adherence to complex behavioral changes is often low and requires continuous counseling, adoption of small amounts of flavanol-rich cocoa into the habitual diet is a dietary modification that is easy to adhere to and therefore may be a promising behavioral approach to lower blood pressure in individuals with above-optimal blood pressure. Future studies should evaluate the effects of dark chocolate in other populations and evaluate long-term outcomes,” the authors conclude.

Specific Risk Factors of Hypertension

The following risk factors for hypertension below include age, race, heredity, sex, obesity, stress, smoking, lack of exercise and diabetes:

1. Age: High blood pressure is more likely in men over 35 and in women over 45.

2. Race: African Americans are more likely to develop hypertension than Caucasians and Hispanics develop hypertension more often than Caucasians.

3. Heredity: Hypertension runs in some families. A person is 45% more likely to have high blood pressure if both parents have it; 28% if one parent has it, and 30% if one sibling is affected. When one person has hypertension, everyone in the family should have their blood pressure checked regularly.

4. Sex: Men are more likely to have high blood pressure than women until women become menopausal, when the rate of hypertension exceeds that of men.

5. Obesity: For every 10 pounds of weight gain, blood pressure goes up three to four points. Blood pressure drops when a person loses weight.

6. Stress: Stress raises heart rate and blood pressure, increasing the workload on the heart. People under stress develop more cardiovascular diseases compared to those who are able to manage stress in their lives.

7. Smoking: Cigarette smoking significantly increases the risk of hypertension and blood pressure related illnesses leading to sudden death.

8. Lack of Exercise: Inactivity leads to weight gain and reduced circulation. Exercise helps to strengthen the blood vessels and reduce blood pressure.

9. Diabetes: Approximately half of all diabetics develop hypertension. When a diabetic has high blood pressure their risk of heart attack, stroke. kidney failure
and blindness all increase.

source:weblog.signonsandiego.com

A mother's race for a cure

It took a few years before Martine Rothblatt got used to describing her daughter's chronic lung disease as a lucrative market opportunity. "I choked every time I said it - it sounded so immoral," says Rothblatt, 52. But when she realized that the fastest track to a cure was to launch a biotech firm and then take it public, Rothblatt started United Therapeutics (unither.com).

That was in 1996, and today she is convinced that capitalism is the answer. "I no longer have any doubt about the benefit of using profit motivation to develop cures," she says. "It's the language I need to build the company," she says. "It's the language that Wall Street understands."
After four consecutive years of growing annual revenues by about 40 percent, Rothblatt has proved to be a deft linguist. United Therapeutics (Charts), No. 22 on the FSB 100, reported $159 million in revenues last year. The company, based in Silver Spring, Md.,makes and sells Remodulin, a drug that treats pulmonary hypertension (PPH), abnormally high blood pressure in the arteries that supply the lungs. The rare, incurable, and often fatal ailment causes shortness of breath, fainting spells and fatigue. Most treatment options, ranging from daily pills to intravenous medicines, are fully reimbursable by insurance companies.
FSB 100: See the full list

Sitting beneath bright paintings of DNA strands bursting from planets and stars, commissioned by Rothblatt for her company's headquarters, she describes watching her daughter, Jenesis, battle PPH when she was diagnosed as a little girl. Jenesis survived on a mix of pills, but doctors warned that if her condition worsened, she would have to take Flolan, a GlaxoSmithKline (Charts) drug that stays in the bloodstream for only three minutes. It must be continually administered via a catheter threaded directly into the groin or neck. Unstable at room temperature, Flolan requires patients to carry an ice pack 24 hours a day to ensure that it stays cool.

"The treatment seemed worse than the disease," recalls Rothblatt, stroking one of the three mohawked Labradoodles that roam her offices. "My vision became an inhaled version of the medicine." Her first step was to develop a drug that lasted longer than Flolan.

Rothblatt had no background in biotech: She had started her career as a corporate lawyer and gone on to help launch three successful satellite-communication companies, including Sirius Satellite Radio (Charts). In 1995, Rothblatt sold some of her telecom stock and used the proceeds to fund nonprofit PPH research. But after spending $2 million over two years, she saw little progress and grew discouraged.

She started researching the disease herself and found more than just a potential treatment - she found a business opportunity. The National Institutes of Health estimates that more than 200,000 suffer from PPH worldwide. Each patient pays as much as $150,000 a year for treatment - a $7.5 billion market in the U.S. alone.

After selling her vision of an inhaled PPH therapy to angel investors, Rothblatt tracked down and recruited two scientists who had developed a promising PPH drug at Burroughs Wellcome before it merged with Glaxo in 1995. It took Rothblatt seven months to license the compound, which Glaxo had shelved in favor of Flolan. Rothblatt founded United Therapeutics in 1996 and took the company public three years later.

Reaching her goal of developing an inhaled drug would take years of clinical trials, and Rothblatt had to find a way to keep investors happy in the meantime. "Something I learned from my satellite companies - you have to develop iterations of your products over time, producing real revenues incrementally," she says.

In 2002 the FDA approved the company's first version of Remodulin, the compound she licensed from Glaxo. Remodulin, which patients inject under their skin, lasts as long as three hours in a patient's bloodstream and doesn't have to be cooled. The drug, say some pulmonologists, is easier and safer to administer than Flolan. spokesman for Glaxo nor one for the drug's U.S. distributor would comment on the ease and safety of the use of Flolan.

United Therapeutics in 2004 introduced the drug in an IV form that is less painful to inject than the original version. Later this year the company hopes to complete clinical trials on the inhaled and tablet forms of Remodulin, which are expected to hit the market in late 2008 and 2009, respectively. But Rothblatt faces a lot more competition today. At least four companies now offer PPH drugs. One, Ventavis, is an inhaled medication produced by Actelion (actelion. com), a San Francisco biotech firm.

Ironically, the young girl who inspired Rothblatt to found United Therapeutics has not benefited from the company's work. Jenesis Rothblatt is 22 today and still takes pills for her PPH (her condition never became severe enough to require Flolan or Remodulin).

Rothblatt, a transsexual, pursues many interests outside biotech. She has published four books, including "The Apartheid of Sex: A Manifesto on the Freedom of Gender" (Rivers Oram Press, 1996) and "Two Stars for Peace" (iUniverse, 2003), in which she argues that the U.S. could bring peace to the Middle East by granting U.S. statehood to Israel and Palestine. She also sits on the boards of several organizations that study the use of technology to extend human life.

Yet her primary goal is to grow United Therapeutics by finding treatments for other chronic illnesses neglected by big pharmaceutical companies. The firm's first drug outside the pulmonary market, OvaRex, promises to help keep ovarian cancer in remission (it is in the last phase of clinical trials). Says Rothblatt: "In an industry dominated by dinosaurs, we're going to concentrate on carving out our own little niches, helping the chronically sick live an easier life.
source:money.cnn.com

Rasilez, An Important New Treatment for High Blood Pressure, Receives Positive Opinion Recommending European Union Approval

Novartis has received a positive opinion recommending European Union approval of Rasilez® (aliskiren) as the first new type of high blood pressure treatment in more than a decade.

The Committee for Medicinal Products for Human Use (CHMP), which reviews medicines for the European Commission, issued the positive opinion for Rasilez based on data from more than 7,800 patients in 44 clinical studies. The Commission generally follows the CHMP's recommendations and is expected to issue a decision within three months.

The clinical trial program showed that Rasilez provided significant blood pressure reductions for 24 hours and beyond3. Furthermore, Rasilez provided added efficacy when used in combination with other commonly used blood pressure medications[4],[5].

Studies estimate that nearly one billion people may have high blood pressure and that nearly 70% of patients with high blood pressure never reach healthy blood pressure levels. As a result, they live at risk of complications like heart attack, stroke, blindness and premature death, creating a strong need for new therapies like Rasilez[1],[2],[3].

"This important milestone for Rasilez comes just days after the US approval of Exforge as our new fixed combination therapy. Following the anticipated EU approval of Rasilez, our new antihypertensive medicines will be made available to patients in the US, Europe and elsewhere as quickly as possible. We have made significant progress in developing a broad and complementary portfolio of medicines to help physicians worldwide treat patients with high blood pressure," said Thomas Ebeling, CEO of Novartis Pharma.

Rasilez is the first in a new class of drugs called direct renin inhibitors. It acts by directly inhibiting renin, an enzyme that triggers a process leading to high blood pressure. The medication received its first approval in March 2007 from the US Food and Drug Administration under the trade name Tekturna®.

"If approved, Rasilez will offer millions of Europeans an important new treatment option for high blood pressure," said James Shannon, MD, Global Head of Development at Novartis Pharma AG. "This positive opinion is highly encouraging since Rasilez has been shown to help a wide variety of people by providing long-lasting blood pressure control."

In clinical trials, the approved doses of Rasilez demonstrated a placebo-like tolerability profile4. Rasilez was developed in collaboration with Speedel.

Blood pressure measurements consist of two values: the first represents the pressure within blood vessels when the heart contracts, while the second represents the pressure when the heart is at rest between beats. Blood pressure is measured in millimeters of mercury (mmHg), with normal blood pressure levels between 120/80 mmHg and 140/90 mmHg.


Disclaimer
The foregoing release contains forward-looking statements which can be identified by the use of terminology such as "generally follows," "anticipated," "will," "expected," "may," "estimate" or similar expressions, or by express or implied discussions regarding the potential regulatory approval of Rasilez or future sales of Rasilez. Such forward-looking statements reflect the current views of Novartis regarding future events and involve known and unknown risks, uncertainties and other factors that may cause actual results to be materially different from any future results, performance or achievements expressed or implied by such statements. There can be no guarantee that Rasilez will be approved for any indications or brought to market in the European Union or in any other market or that Rasilez will reach any particular sales levels. In particular, management's expectations regarding the approval and commercialization of Rasilez could be affected by, among other things, additional analysis of clinical data; new clinical data; unexpected clinical trial results; unexpected regulatory actions or delays or government regulation generally; our ability to obtain or maintain patent or other proprietary intellectual property protection; competition in general; increased government, industry, and general public pricing pressures; as well as other risks and factors referred to in Novartis AG's Form 20-F on file with the U.S. Securities and Exchange Commission. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those anticipated, believed, estimated or expected. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of new information, future events or otherwise.


About Novartis
Novartis AG (NYSE: NVS) is a world leader in offering medicines to protect health, cure disease and improve well-being. Our goal is to discover, develop and successfully market innovative products to treat patients, ease suffering and enhance the quality of life. We are strengthening our medicine-based portfolio, which is focused on strategic growth platforms in innovation-driven pharmaceuticals, high-quality and low-cost generics, human vaccines and leading self-medication OTC brands. Novartis is the only company with leadership positions in these areas. In 2006, the Group's businesses achieved net sales of USD 37.0 billion and net income of USD 7.2 billion. Approximately USD 5.4 billion was invested in R&D. Headquartered in Basel, Switzerland, Novartis Group companies employ approximately 100,000 associates and operate in over 140 countries around the world. For more information, please visit http://www.novartis.com.

References
1. Ong KL, Cheung BMY, Man YB, et al. Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004. Hypertension. 2007; 49:69-75.
2. Chobanian AV, Bakris GL, Black HR, et al. and the National High Blood Pressure Education Program Coordinating Committee. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206-1252.
3. American Heart Association. International Cardiovascular Disease Statistics fact sheet. www.americanheart.org.
4. Mitchell B, Oh J, Chung J, et al. Once-Daily Aliskiren Provides Effective, Smooth 24-Hour Blood Pressure Control in Patients with Hypertension. Presented at the American Society of Hypertension 21st Scientific Meeting & Exposition, May 17, 2006
5. Oparil S, Yarows S, Patel S, et al. "The Direct Renin Inhibitor Aliskiren in Combination With the Angiotensin Receptor Blocker Valsartan Provides Additional Blood Pressure-Lowering Effects Compared With Either Agent Alone in Patients With Hypertension." Poster presented at American College of Cardiology 56th Annual Scientific Session, March 2007.
6. Uresin Y, Taylor A, Kilo C, Tschope D, Santonastaso M, Ibram G, Fang H, Satlin A. Aliskiren, a novel renin inhibitor, has greater BP lowering than ramipril and additional BP lowering when combined with ramipril in patients with diabetes and hypertension. Poster to be presented at the 16th Scientific Meeting of the European Society of Hypertension. 2006.
source:www.pharmalive.com

New European Guidelines on Treatment of Hypertension

New guidelines for the management of arterial hypertension have been issued at the European Society of Hypertension (ESH) meeting in Milan, Italy. The recommendations, which were drawn up jointly by task forces from ESH and the European Society of Cardiology, also appear in the Journal of Hypertension.

Co-chair of the task forces, Dr Guy de Backer (University Hospital, Ghent, Belgium) told heartwire the guidelines are essentially an update to 2003 recommendations. The new document is 82 pages long, and lists 825 references, reflecting the vast amount of data published on the subject of hypertension in the past 4 years, he noted.

Asked to pick out highlights for heartwire, de Backer said this was a difficult task, "as there has been no one dramatic change, rather small changes in each area. The most important thing is that this is an update and the numerous references have been critically evaluated. We have kept the general framework and added what we think is most important from the literature."

For the clinician, the main messages can be found in a number of boxes in the paper, which contain position statements, he noted. "All you need to do is look at the position statements in the boxes, and only read the text if you want more detail." The task forces are working hard to produce a pocket version of the new guidelines for release at the ESC meeting in Vienna in September, he added.
source:www.medscape.com

Rasilez, An Important New Treatment For High Blood Pressure, Receives Positive Opinion Recommending European Union Approval

Novartis has received a positive opinion recommending European Union approval of Rasilez (aliskiren) as the first new type of high blood pressure treatment in more than a decade.

The Committee for Medicinal Products for Human Use (CHMP), which reviews medicines for the European Commission, issued the positive opinion for Rasilez based on data from more than 7,800 patients in 44 clinical studies. The Commission generally follows the CHMP's recommendations and is expected to issue a decision within three months.

The clinical trial program showed that Rasilez provided significant blood pressure reductions for 24 hours and beyond3. Furthermore, Rasilez provided added efficacy when used in combination with other commonly used blood pressure medications[4],[5].

Studies estimate that nearly one billion people may have high blood pressure and that nearly 70% of patients with high blood pressure never reach healthy blood pressure levels. As a result, they live at risk of complications like heart attack, stroke, blindness and premature death, creating a strong need for new therapies like Rasilez[1],[2],[3].

"This important milestone for Rasilez comes just days after the US approval of Exforge as our new fixed combination therapy. Following the anticipated EU approval of Rasilez, our new antihypertensive medicines will be made available to patients in the US, Europe and elsewhere as quickly as possible. We have made significant progress in developing a broad and complementary portfolio of medicines to help physicians worldwide treat patients with high blood pressure," said Thomas Ebeling, CEO of Novartis Pharma.

Rasilez is the first in a new class of drugs called direct renin inhibitors. It acts by directly inhibiting renin, an enzyme that triggers a process leading to high blood pressure. The medication received its first approval in March 2007 from the US Food and Drug Administration under the trade name Tekturna.

"If approved, Rasilez will offer millions of Europeans an important new treatment option for high blood pressure," said James Shannon, MD, Global Head of Development at Novartis Pharma AG. "This positive opinion is highly encouraging since Rasilez has been shown to help a wide variety of people by providing long-lasting blood pressure control."

In clinical trials, the approved doses of Rasilez demonstrated a placebo-like tolerability profile4. Rasilez was developed in collaboration with Speedel.

Blood pressure measurements consist of two values: the first represents the pressure within blood vessels when the heart contracts, while the second represents the pressure when the heart is at rest between beats. Blood pressure is measured in millimeters of mercury (mmHg), with normal blood pressure levels between 120/80 mmHg and 140/90 mmHg.

Disclaimer

The foregoing release contains forward-looking statements which can be identified by the use of terminology such as "generally follows," "anticipated," "will," "expected," "may," "estimate" or similar expressions, or by express or implied discussions regarding the potential regulatory approval of Rasilez or future sales of Rasilez. Such forward-looking statements reflect the current views of Novartis regarding future events and involve known and unknown risks, uncertainties and other factors that may cause actual results to be materially different from any future results, performance or achievements expressed or implied by such statements. There can be no guarantee that Rasilez will be approved for any indications or brought to market in the European Union or in any other market or that Rasilez will reach any particular sales levels. In particular, management's expectations regarding the approval and commercialization of Rasilez could be affected by, among other things, additional analysis of clinical data; new clinical data; unexpected clinical trial results; unexpected regulatory actions or delays or government regulation generally; our ability to obtain or maintain patent or other proprietary intellectual property protection; competition in general; increased government, industry, and general public pricing pressures; as well as other risks and factors referred to in Novartis AG's Form 20-F on file with the U.S. Securities and Exchange Commission. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those anticipated, believed, estimated or expected. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of new information, future events or otherwise.

About Novartis

Novartis AG (NYSE: NVS) is a world leader in offering medicines to protect health, cure disease and improve well-being. Our goal is to discover, develop and successfully market innovative products to treat patients, ease suffering and enhance the quality of life. We are strengthening our medicine-based portfolio, which is focused on strategic growth platforms in innovation-driven pharmaceuticals, high-quality and low-cost generics, human vaccines and leading self-medication OTC brands. Novartis is the only company with leadership positions in these areas. In 2006, the Group's businesses achieved net sales of USD 37.0 billion and net income of USD 7.2 billion. Approximately USD 5.4 billion was invested in R&D. Headquartered in Basel, Switzerland, Novartis Group companies employ approximately 100,000 associates and operate in over 140 countries around the world. For more information, please visit http://www.novartis.com.

References

1. Ong KL, Cheung BMY, Man YB, et al. Prevalence, awareness, treatment, and control of hypertension among United States adults 1999-2004. Hypertension. 2007; 49:69-75.

2. Chobanian AV, Bakris GL, Black HR, et al. and the National High Blood Pressure Education Program Coordinating Committee. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206-1252.

3. American Heart Association. International Cardiovascular Disease Statistics fact sheet. http://www.americanheart.org.

4. Mitchell B, Oh J, Chung J, et al. Once-Daily Aliskiren Provides Effective, Smooth 24-Hour Blood Pressure Control in Patients with Hypertension. Presented at the American Society of Hypertension 21st Scientific Meeting & Exposition, May 17, 2006

5. Oparil S, Yarows S, Patel S, et al. "The Direct Renin Inhibitor Aliskiren in Combination With the Angiotensin Receptor Blocker Valsartan Provides Additional Blood Pressure-Lowering Effects Compared With Either Agent Alone in Patients With Hypertension." Poster presented at American College of Cardiology 56th Annual Scientific Session, March 2007.

6. Uresin Y, Taylor A, Kilo C, Tschope D, Santonastaso M, Ibram G, Fang H, Satlin A. Aliskiren, a novel renin inhibitor, has greater BP lowering than ramipril and additional BP lowering when combined with ramipril in patients with diabetes and hypertension. Poster to be presented at the 16th Scientific Meeting of the European Society of Hypertension. 2006.
source:www.medicalnewstoday.com

Ranbaxy gets tentative FDA nod to make, market hypertension treatment drug

MUMBAI (Thomson Financial) - India's Ranbaxy Laboratories Ltd said it received tentative approval from the US Food and Drug Administration to manufacture and market amlodipine besylate tablets of 2.5 mg, 5 mg and 10 mg strengths.

Amlodipine besylate tablets treat hypertension, which can be used either alone or in combination with other anti-hypertensive agents. They are marketed in the US by Pfizer (nyse: PFE - news - people ) as Norvasc.

Total annual market sales for amlodipine besylate tablets were 2.79 bln usd, as per data from IMS in March, Ranbaxy said in a release to the Bombay Stock Exchange.
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source:www.forbes.com

High Blood Pressure

What is high blood pressure?

High blood pressure or hypertension means high pressure (tension) in the arteries. The arteries are the vessels that carry blood from the pumping heart to all of the tissues and organs of the body. High blood pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase the blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called “pre-hypertension”, and a blood pressure of 140/90 or above is considered high blood pressure. The systolic blood pressure, which is the top number, represents the pressure in the arteries as the heart contracts and pumps blood into the arteries. The diastolic pressure, which is the bottom number, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure, therefore, reflects the minimum pressure to which the arteries are exposed.

An elevation of the systolic and/or diastolic blood pressure increases the risk of developing heart (cardiac) disease, kidney (renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke (brain damage). These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure. Accordingly, the diagnosis of high blood pressure in an individual is important so that efforts can be made to normalize the blood pressure and, thereby, prevent the complications. Since hypertension affects approximately 1 in 4 adults in the United States, it is clearly a major public health problem.

Whereas it was previously thought that diastolic blood pressure elevations were a more important risk factor than systolic elevations, it is now known that for individuals older than 50 years of age systolic hypertension represents a greater risk.
source:www.medicinenet.com

Hypertension: The DASH Diet

One step to lower high blood pressure -- incorporate the DASH diet into your lifestyle. Doctors recommend:

* Eating more fruits, vegetables, and low-fat dairy foods
* Cutting back on foods that are high in saturated fat, cholesterol, and total fat
* Eating more whole grain products, fish, poultry, and nuts
* Eating less red meat and sweets
* Eating foods that are rich in magnesium, potassium, and calcium

The DASH diet, which stands for Dietary Approaches to Stop Hypertension, is an example of such an eating plan. In studies, patients who were on the DASH diet reduced their blood pressure within two weeks. Another diet -- DASH-Sodium -- calls for reducing sodium (salt) to 1,500 mg a day (about 2/3 teaspoon). Studies of patients on the DASH-Sodium plan significantly lowered their blood pressure.
Implementing the DASH Diet

The DASH diet calls for a certain number of servings daily from various food groups. The number of servings you require may vary, depending on your caloric need. When beginning the diet, start slowly and make gradual changes. Consider adopting a diet plan that allows 2,400 milligrams of salt per day (about 1 teaspoon) and then once your body has adjusted to the diet further lower your salt intake to 1,500 mg per day (about 2/3 teaspoon). These amounts include all salt consumed, including that in food products, used in cooking, and added at the table.

Here are some tips to get you started:

* Add a serving of vegetables at lunch and at dinner.
* Add a serving of fruit to your meals or as a snack. Canned and dried fruits are easy to use.
* Use only half the butter, margarine, or salad dressing, and use low-fat or fat-free condiments.
* Drink low-fat or skim dairy products three times a day.
* Limit meat to six ounces a day. Try eating some vegetarian meals.
* Add more vegetables, rice, pasta, and dry beans to your diet.
* Instead of typical snacks (chips, etc.), eat unsalted pretzels or nuts, raisins, graham crackers, low-fat and fat-free yogurt and frozen yogurt; unsalted plain popcorn with no butter, and raw vegetables.
* Read food labels carefully to choose products that are lower in sodium.

Staying on the DASH Diet

The following is a list of food groups and suggested serving amounts for the DASH diet:

* Grains: 7-8 daily servings
* Vegetables: 4-5 daily servings
* Fruits: 4-5 daily servings
* Low-fat or fat-free dairy products: 2-3 daily servings
* Meat, poultry and fish: 2 or less daily servings
* Nuts, seeds, and dry beans: 4-5 servings per week
* Fats and oils: 2-3 daily servings
* Sweets: try to limit to less than 5 servings per week
source:www.webmd.com

Cholesterol Management Health Center

High cholesterol is a major risk factor for heart disease. But do you know what “high” cholesterol means and how to prevent it? We’ve compiled the best information you need to understand what’s at stake. You’ll learn how to make sense of your cholesterol test results. We’ll also give you advice on getting them under control.
Overview & Facts
What Is Cholesterol?

* Cholesterol Basics

Are You At Risk?

* Who Gets High Cholesterol?
* High Cholesterol in Children

Prevention

* Lower Cholesterol to Reduce Heart Disease Risk
* Cholesterol-Lowering Foods
* Cholesterol Control: The Alternatives
* Tool: Do You Know How to Lower Your Cholesterol?

Symptoms & Types
Complications

* Cholesterol, Heart Disease, and Other Health Problems

Diagnosis & Tests
Diagnosis

* 10 Questions to Ask Your Doctor About Cholesterol
* Making the Diagnosis

Tests

* Know Your Cholesterol Levels

Treatment & Care
Treatment

* Get Heart-Healthy: Here’s a Diet to Lower Cholesterol
* Low-Cholesterol Diets
* Take Steps to Reduce Cholesterol
* Statin Drugs
* The Alternatives: Herbs and Supplements That Could Help
* Video: Controlling Cholesterol With Exercise

Living & Managing
Living and Coping

* Eating Out: Look For Low-Cholesterol Foods

Personal Stories

* Cholesterol Management: Personal Stories

Support & Resources
Finding Help

* Cholesterol Management: Finding Help

Resources

* Cholesterol Management: Resources

source:www.webmd.com

Diagnosis & Tests

Diagnosing hypertension is important. Learn how doctors test for high blood pressure and even see a photo of how the test is done.
Diagnosis
Diagnosing High Blood Pressure

High blood pressure is often called a "silent disease" because you usually don't know you have it; there may be no outward symptoms or signs, so monitoring your blood pressure is critical.
Tests
Tests for High Blood Pressure

The only way to tell whether you have high blood pressure is to have your blood pressure measured with a blood pressure cuff (sphygmomanometer). Learn just what that entails, what your results mean, and other tests your doctor may perform.
How Is Blood Pressure Measured?

Want to know how blood pressure is measured and what a blood pressure cuff looks like? Click on the photo in this article and you'll have an idea what to expect when you get your blood pressure taken.
source:www.webmd.com