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Aug. 26, 2008 -- The drug allopurinol (Zyloprim), often prescribed to lower uric acid levels in adults who suffer the painful arthritic condition known as gout, also appears to help lower high blood pressure in teens, according to a new study.
However, the researcher emphasizes, he is not suggesting that the powerful drug, which can have serious side effects, be used in teens with high blood pressure. He conducted the study to test the hypothesis that lowering uric acid levels can lower blood pressure in teens.
"I really don’t want this to be taken to suggest that allopurinol is a good alternative for treatment of blood pressure in children or adults," says Daniel I. Feig, MD, PhD, associate professor of pediatrics at the Baylor College of Medicine, Houston and the lead author. The drug is too potent, he and other experts say, and the risk of serious side effects make it unattractive to use long-term in teens.
If future, larger studies also find that lowering uric acid in teens with high blood pressure normalizes their pressure, Feig says, "the impetus will be… to find better ways to lower uric acid, whether by dietary means or by medications."
The study is published in Wednesday's Journal of the American Medical Association.
Build-up of uric acid, a natural waste product, can lead to a painful inflammation of the joints called gout, a form of arthritis that typically occurs in middle-aged men. Uric acid levels can increase if the body produces more of it or if the body has problems getting rid of it.
Uric acid also has been discussed as a possible factor in high blood pressure since the 1870s, Feig says. But the concept fell out of favor in recent times, until laboratory studies on animals beginning in the late 1990's found that inducing a rise in uric acid in animals raises their blood pressure. Other studies have found that lowering uric acid levels can improve blood vessel functioning, he says.
Feig's team randomly assigned 30 teens, aged 11 to 17, with newly diagnosed stage I essential hypertension, the mildest kind, to take either 200 milligrams of allopurinol twice daily for four weeks or placebo twice daily for four weeks. The teens didn't know which they were taking.
Next, everyone then got switched to the other group, so that teens taking placebo took the drug and teens taking the drug took placebo.
All the teens had levels of uric acid associated, in previous studies, with high blood pressure. Most of the participants were overweight or obese.
All had blood pressure that was considered stage 1 hypertension in teens.
They had blood pressure taken at the clinic and via an ambulatory monitoring system.