Principle Investigator PURE-UAE. Dr. Afzal Hussein Yusufali, Consultant Cardiologist, Dubai Heart Centre, Dubai Hospital

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Dubai, United Arab Emirates: up to 75 percent of the UAE’s local population with high blood pressure have uncontrolled disease dramatically increasing their risk of suffering stroke and heart disease, according to new results from the local-arm of an international study (1) .

Presenting the findings of the PURE study to the media today, UAE researchers revealed that just 25 percent of Emiratis aged 35 to 70 years with hypertension (diagnosed and undiagnosed) have their blood pressure controlled within the recommended target of less than 140/90 mmHg – leaving 75 percent with uncontrolled disease.   

In total, 41 percent of the Emirati population aged 35 to 70 years suffers from hypertension and 19 percent have pre-hypertension, causing locally-based doctors to warn that unless the situation is tackled the numbers suffering from stroke and heart disease will rise dramatically over the next 10 years. Globally, raised blood pressure is responsible for 62 percent of all strokes and 49 percent of all heart disease and is the biggest single cause of death (2). 

The study of 1,505 UAE nationals also showed that of those who were receiving treatment for hypertension only 38 percent had lowered their blood pressure to within normal levels – meaning that 62 percent remained hypertensive despite being prescribed antihypertensive drugs, raising the issue of insufficient blood pressure reduction and poor medication compliance.

“Hypertension, including pre-hypertension, is a huge problem in the UAE in terms of the number of people affected and the impact the disease will have on future rates of stroke and heart disease,” warned the principle investigator of the study Dr. Afzal Hussein Yusufali, Consultant Cardiologist, Dubai Heart Centre, Dubai Hospital. 

“One of the worrying statistics we found was that only 66 percent of the study group with hypertension knew they had the disease, and just 60 percent were receiving treatment, of which only 38 percent were benefitting from the medications and had seen their blood pressure lowered to within target levels,” he added.     

“The reason why tackling raised blood pressure is so important is because it is the number one factor that will cause death. There are various aspects to dealing with the UAE situation; we need to screen more people, and make them aware that they have hypertension or pre-hypertension, and we need to educate them and the wider public to make healthier lifestyle choices and get them on effective medications if required,” Dr. Yusufali concluded   

One of the key issues to improving blood pressure control is ensuring that patients take individually selected blood pressure reducing agents and comply with their medication regimen. Compliance can be a major problem for hypertensive patients as many of them also suffer from diabetes and have to take several pills a day.   

Doctors are hoping that a new triple combination single pill for uncontrolled hypertension, which was licensed by the UAE Ministry of Health in October 2010 but has only just become available at local pharmacies, will provide more powerful blood pressure reduction and at the same time boost medication compliance by removing the need for patients to take several pills at one time.

The drug called Exforge HCT combines the antihypertensive medications; amlodipine, valsartan and hydrochlorothiazide in one preparation and is especially designed for patients whose blood pressure remains above the recommended target of 140/90 mmHg, even when two different classes of medication are already being used.

“Many patients with hypertension suffer no symptoms which is why it is known as the ‘silent killer’. Because of this patients do not always understand the importance of taking their medications as prescribed, on top of this patients may be prescribed up to seven drugs at the same time which can all lead to issues of non-compliance,” explained Dr. Azan Binbrek, Consultant Cardiologist, Rashid Hospital, Dubai.

“Having three drugs combined as a more powerful single pill medication will provide better blood pressure control and should improve patient’s compliance, reducing their risk of developing cardiovascular disease,” he added.

“We are very pleased to be launching Exforge HCT in the UAE which will assist hypertensive patients to reach and retain target blood pressure, so helping to reduce their risk of developing cardiovascular disease. Providing innovate treatments such as Exforge HCT is part of Novartis’ commitment to delivering quality healthcare across the UAE and the Middle East,” said Dr. Mohamed Ibrahim Soliman, Regional Medical Advisor, Novartis Middle East Cluster.    

The PURE trial is a worldwide epidemiological study that looks at the impact of social influences on chronic non-communicable diseases in low, middle and high income countries. in total 154,000 individuals took part in the research across 17 countries. the UAE findings were included in the overall results but have yet to be made public as a separate study.

Exforge HCT:

Exforge HCT is the first modern triple single-pill combination for treatment of high blood pressure. it combine the most studied and commonly prescribed branded high blood pressure medicines in their respective classes – the calcium channel blocker (CCB) amlodipine besylate and the angiotensin receptor blocker (ARB) Valsartan along with HCTZ the widely prescribed antihypertensive worldwide

Exforge HCT has been shown in clinical trials to provide powerful blood pressure control with excellent safety and tolerability (3). Exforge HCT is expected to help patients who  struggle with multiple medications to reach their blood pressure goals and find difficult to comply to their current  therapy. Significant reductions in both systolic and diastolic blood pressure were observed during the clinical trials (4).

Exforge HCT: Indications/Potential uses:

For the treatment of essential hypertension; Exforge HCT is indicated in patients whose blood pressure is not adequately controlled by dual therapy. Exforge HCT is indicated as alternative treatment in patients already taking equivalent doses of valsartan, amlodipine and hydrochlorothiazide as separate tablets. 

References:

[1] Prospective Urban Epidemiology (PURE) study.  American Heart Journal, 2009; 158: 1-7.

[2] The World Health Report 2002 – Reducing Risks, Promoting Healthy Life. World Health Organisation, who.int/whr/2002.

[3] Calhoun et al. Triple Antihypertensive Therapy with Amlodipine, Valsartan and Hydrochlorothiazide; a Randomized Clinical Trial. Hypertension 2009; 54:32-39

[4] Calhoun et al.  Amlodipine / Valsartan / Hydrochlorothiazide Triple Combination Therapy in Moderate/Severe Hypertension Secondary Analyses Evaluating Efficacy and Safety. Adv Ther 2009; 26 (11).

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© Press Release 2011