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Published: Monday, 11/18/2013 - Updated: 1 year ago

UT-led study alters treatment

Surgery not always needed for hypertensive patients

BY MARLENE HARRIS-TAYLOR
BLADE STAFF WRITER
Dr. Christopher Cooper, center, with Holly Burtch, left, and Pamela Brewster stand on the University of Toledo Health Science Campus, the former Medical College of Ohio. His team’s findings were revealed in Dallas at a national meeting of scientists sponsored by the American Heart Association. Dr. Christopher Cooper, center, with Holly Burtch, left, and Pamela Brewster stand on the University of Toledo Health Science Campus, the former Medical College of Ohio. His team’s findings were revealed in Dallas at a national meeting of scientists sponsored by the American Heart Association.
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The results of a nearly 10-year-long study on hypertension, led by researchers at the University of Toledo Medical Center, concluded that there is no need for patients with a particular form of hypertension to have surgery to unclog a blocked artery.

The study results were announced Monday in Dallas at a national meeting of scientists sponsored by the American Heart Association. The findings will also be published in the New England Journal of Medicine, a widely read and influential medical periodical.

Dr. Christopher Cooper, chairman of the department of medicine at the former Medical College of Ohio, led a team of global researchers who were trying to determine the best therapy for people whose high blood pressure is caused by a blockage in the artery that feeds the kidneys.

Hypertension is the most common chronic medical condition in the United States. It is closely linked to heart attack, and congestive heart failure and kidney failure. The people who suffer from this particular form of hypertension are truly a high-risk group with difficult-to-control high blood-pressure, Dr. Cooper said.

More than 100 hospitals in seven countries enrolled nearly 1,000 patients in the study, including about 34 from the Toledo area. One group was treated with medication, while the second group received medication plus surgery to insert a stent to clear the blocked artery.

“What we found after following folks for an average of almost four years is that there was no real difference in the outcome with or without the stent. The bottom line is if we treat people with good medicines they do as well as if they had a stent,” Dr. Cooper said.

In 2004, the Medical College of Ohio received a $25 million grant from the National Institutes of Health National Heart, Lung, and Blood Institute to design, lead, and coordinate this study. At that time, it was the largest grant the institution had ever received.

Dr. Cooper, who was chief of cardiology at the time, coordinated the grant and the research with medical centers across the United States, and in Canada, South America, Europe, Australia, New Zealand, and South Africa. They screened more than 5,000 patients with this very specific condition in order to find the 947 who became participants in the study, Dr. Cooper said.

“It was a huge effort and took a lot of dedication mostly on the part of our patients,” he said. “It’s really a great feeling. I’ve been able to work with a great group of folks here at the university. It’s been a long-term investment, and to see it come to a really solid conclusion is very gratifying.”

About half of the participants were women, and the researchers tried to actively recruit African-Americans. “The African-American community is disproportionately affected by kidney disease and high-blood pressure, and so we worked pretty hard to get a representative sample. We ended up with seven percent of the patients in the study who were African-American,” Dr. Cooper said.

And most importantly, he said, the results were the same for everybody.

“I saw a patient in the office this morning who has a blocked kidney artery and who’s on medication, and a year ago I might have thought about putting a stent in that patient. And now this morning, I looked through their list of medications, and I said you are good to go. You don’t need any other treatment,” Dr. Cooper said.

The results of this research will save patients time and money and protect them from the risks associated with surgery, he said.

Contact Marlene Harris-Taylor at: mtaylor@theblade.com or 419-724-6091.



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