Repurposed Hypertension Drug Showed Multiple Benefits in Adults With Obesity

Obesity is closely intertwined with high blood pressure and diabetes, often putting patients at greater risk for either of these health conditions. It’s also associated with arterial stiffening – when the walls of the artery become more rigid, forcing the heart to work harder to pump blood. This can lead to an increased risk of heart disease.

Researchers at the University of Missouri School of Medicine are exploring whether a common drug used to treat high blood pressure, amiloride, could help arteries become more flexible in patients with obesity, providing more protection against cardiovascular disease. From a Phase II clinical study of 116 participants, they found that amiloride not only lowered blood pressure but also improved blood sugar levels and artery flexibility.

“Interestingly, older individuals showed greater improvements in their vital signs than other participants,” said study author Camila Manrique-Acevedo. “This may be because older adults are typically at higher risk for these conditions and often have more difficulty with dysregulation in their bodies. As a result, they may have more room to benefit from treatment. However, more research is needed to confirm this.”

Amiloride helps prevent the body from losing too much potassium, an essential mineral for maintaining muscle contraction and fluid balance in the body. In other studies, an increased concentration of potassium has been associated with improved blood vessel function and a better bodily response to insulin.

In the trial, potassium concentration increased, as was expected, and it’s possible it contributed to the reduction in blood pressure, blood sugar and arterial stiffness. Further, the data suggests that the arteries improved because of the drop in blood pressure, and not because of any structural changes in the blood vessel walls.

“Amiloride is a drug that is already FDA-approved, proven to treat high blood pressure and familiar to physicians,” Manrique-Acevedo said. “We did not observe any severe adverse health events during this study, which positions this medication as a potential strategy to reduce arterial stiffening in patients with obesity and high blood pressure.”

Camila Manrique-Acevedo, MD is an MU Health Care endocrinologist and a professor of medicine at the Mizzou School of Medicine. She holds the Thomas W. Burns, MD Distinguished Professorship in Diabetes and is also a NextGen Precision Health Investigator.

"ENAC blockade reduces blood pressure and arterial stiffness in adults with obesity and insulin resistance" was recently published in the American Journal of Physiology. In addition to Manrique-Acevedo, study authors include Francisco Ramirez-Perez, post-doctoral fellow.