SEPTEMBER 14 2019 LISTENER 19
be done about blood pressure in patients
who undergo emergency clot retrieval to
remove the blockage? McBryde hopes to
address those questions in future research
for which she is seeking grant funding.
It is vital that researchers understand
the condition of the blood vessels that are
feeding the brain in the first place, says
Paton. “What we have found in animals
and humans with hypertension is that
there is a narrowing of the cerebral arteries
to start with so their capacity to get more
blood into the brain is restricted and that
could be a cause of their hypertension.”
In some patients, the cerebral arteries are
missing, tiny or twisted. Says McBryde:
“It’s like the brain trying to drink through
a curly straw.”
Paton, who chairs the steering group
for Manaaki Mānawa, says the centre, and
the hoped-for national centre of research
excellence, will be game changers for car-
diovascular research in New Zealand, with
novel findings that can be readily translated
into clinical use. “Of all the centres in the
world, we have a unique opportunity here
because of the pioneering history in heart
research and treatment at Green Lane Hospi-
tal and the multidisciplinary team we have
assembled,” says Paton. “Auckland is at the
forefront of many research disciplines, butpeople here don’t realise it. Many research-
ers from around the world are looking at
New Zealand, and they’re impressed.”DRUG DISCORD
Hypertension specialist Dr Walter van der
Merwe has a number of beefs about the way
New Zealand deals with hypertension. He
says the condition doesn’t get the attentionit deserves, and we don’t have the right com-
binations of drugs to treat it.
“You don’t hear about blood pressure
much these days. People talk about cardio-
vascular risk, cholesterol and statins, but
high blood pressure doesn’t get very much
profile. You don’t see public-health posters
saying, ‘Have you had your blood pressure
checked?’”
Control of the condition here is poor,
says van der Merwe. The most commonly
prescribed drug for hypertension is the
angiotensin converting enzyme (ACE)
inhibitor cilazapril combined with a
diuretic, hydrochlorothiazide. Last year,
nearly 67,000 people took the drug. ACE
inhibitors relax and dilate the blood vessels,
making it easier for blood to flow through.
Imagine your blood circulation as a garden
hose. We’ve all put our thumb over the
end to create more resistance, increasing
the pressure and pushing the water further- but the amount of water coming out is a
lot less when we apply our thumb. Diuretics
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“Many researchers from
around the world are
looking at New Zealand,
and they’re impressed.”
Fiona McBryde: “We
can look at the effect
of blood pressure on
stroke size.”