Correction appended
A research team from Northwestern’s Feinberg School of Medicine is pioneering an alternative way for patients to effectively treat hypertension, a condition affecting about one in three American adults.
Hypertension, more commonly known as high blood pressure, contributes to a myriad of health problems like stroke, diabetes and heart failure. The current hypertension therapeutics, which also manage kidney disease and congestive heart failure, treat millions of people. But they may not be the ideal solution for a sizable portion of patients, said Jan Wysocki, lead author of the study and a Feinberg postdoctoral fellow in nephrology.
The current therapeutics target a chemical called Angiotensin-converting enzyme, or ACE, which produces a hormone, Angiotensin II, that causes blood vessels to constrict and blood pressure to spike. To counteract these effects, current medications work to inhibit the enzyme and block the hormone to keep patients’ blood pressures in check, said Dr. Daniel Batlle, Earle, del Greco, Levin Professor of Nephrology and Hyptertension and Professor of Medicine at Feinberg.
“One could conceptualize that ACE is a ‘bad’ enzyme in the sense that it promotes the formation of a hormone that may have undesirable effects whereas ACE2 is a good enzyme because it promotes its destruction,” Dr. Batlle said.
Current treatments lose their effectiveness over time in some patients, Wysocki said.
“There is a response from some organisms to counter-regulate the effects of (ACE inhibitors),” he said. “Through this, (the hormone) levels rise again.”
To provide another choice for hypertensive patients, Wysocki and his colleagues tested the effects of a different enzyme, ACE2, on a sample of laboratory mice. The current ACE-inhibitor drugs focus on preventing the hormone from forming. In this approach, the beneficial enzyme works to break down the hormone already in the body, said Minghao Ye, a research associate in Feinberg’s Division of Nephrology.
“This is a different therapy in the sense that it tackles the same hormone but from a different angle,” Batlle said.
A combination of the current inhibitors and the new therapeutics could also be used in the future to deliver an even more effective remedy for high blood pressure, Batlle said.
While it remains to be seen whether the new ways to amplify ACE2 activity that we are now testing in mice in my laboratory will be more effective than the current interventions used currently, our research offers the promise of new tools to be developed clinically for patients to handle some types of hypertension, Batlle said.[email protected]
Correction: In a previous version of this article, Dr. Daniel Batlle’s name was misspelled. The headline referenced a group of “NU students.” It was in fact a group of NU researchers. Jan Wysocki’s was referenced as “she,” but the article should have read “he.” Dr. Batlle was referred to as the chief of the division of nephrology and hypertension. He is no longer the chief, but a professor of medicine at Feinberg.
