Last November, the American College of Cardiology and American Heart Association jointly lowered their definition of hypertension from the previous 140/90 blood pressure reading down to 130/80. Unfortunately, there isn’t necessarily a “one size fits all” standard due to an array of factors associated with high blood pressure, but there certainly is a well-known correlation between hypertension and subsequent cardiovascular problems. To that end, the new guidelines of the ACA and AHA – the first comprehensive set in nearly 15 years – are certainly with merit as a means to try and get in front of cardiovascular disease, the leading cause of death in both men and women in the U.S. The fact is that even with all the advancements made in medicine, one in every four American deaths annually is the result of heart disease.
The decision to lower the BP benchmark was underpinned by the landmark SPRINT trial that found a target below 120 for the systolic reading decreased incidences of heart attack, stroke and death in older patients that were at higher risk. While optimistic, the study researchers cautioned that the patients were meticulously followed and treated and only patients within specific risk parameters were enrolled, meaning that concluding a direct translation to general populations may be in inappropriate assumption.
Based upon the new threshold, it is estimated that 45.6% of American adults will be diagnosed with hypertension, instead of 31.9% with the old guidelines. That will raise total prevalence to an astonishing 103.3 million citizens. As with most other diseases, early intervention is critical to help these patients and that is where the new standards are directed.
Our strategies at Lexington Biosciences are aligned with the ACA, AHA and all the other groups that assert more needs to be done to tackle cardiovascular disease sooner in its pathogenesis. We believe that a more meaningful impact is certainly attainable, but additional easy-to-use diagnostics needs to be in the physician’s tool chest. Right now, blood pressure and cholesterol tests are the standards of care and, while important, are insufficient.
We think that there is the potential to bring endothelial function monitoring to the forefront of cardiovascular care to improve patient outcomes. It is well documented that endothelial dysfunction is a hallmark of subclinical atherosclerosis, the first signs of the narrowing of arteries due to plaque buildup on the artery walls. Think of subclinical atherosclerosis as the first whisper from the nearly silent killer of cardiovascular disease that often goes unnoticed until a heart attack happens. It would be great to hear that whisper before such an event.
There are ways today to test endothelial function, which provide quantifiable metrics, but have limitations in availability so that they frequently aren’t ordered until other symptoms present, resulting in late identification of the disease after it has progressed.
These are motivating factors for us at Lexington Biosciences and HeartSentry, our product in development that is designed to easily and inexpensively monitor endothelial function as part of a routine check-up or eventually for home use pending FDA approval. We applaud the proactive approach by the ACA and AHA and are optimistic that in future we will have the technology and protocol in place to see not just a reduction in blood pressure guidance, but a meaningful reduction in cardiovascular disease as well.
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