New vaccine brings the pressure down

HYPERTENSION
The usual treatments for high blood pressure include a class of medications called ACE inhibitors, which block production of a pressure-raising protein called angiotensin II. While ACE inhibitors have proven effective, sticking with the drug long term has posed problems for many patients, because of side effects. Now, research led by Martin Bachmann from Cytos Biotechnology in Switzerland suggests a new form of vaccination therapy that overcomes some of the barriers of traditional medications. To create the vaccine, researchers designed a modified form of angiotensin II that mimics a virus, so that the body's immune system attacks angiotensin II and thereby lowers blood pressure. Researchers tested this vaccine on 72 patients, with three vaccinations over a period of four months, and found that people who received the injected drug did just as well as patients who might have otherwise been on ACE inhibitors. "This is the first time a vaccine has worked so well at lowering blood pressure," says Bachmann.

BOTTOM LINE: Patients with high blood pressure may someday get a vaccine instead of popping pills.

CAUTIONS: The research was conducted by a company that would likely produce the vaccine. Also, the findings need to be repeated on a much larger scale to confirm the effectiveness of the vaccine.

WHAT'S NEXT: Bachmann said researchers will test different doses of the vaccine to make sure the most effective is given.

WHERE TO FIND IT: The Lancet, March 8.

SUSHRUT JANGI

HUMAN BEHAVIOR

The cost of a medicine appears to affect a patient's expectations of its effectiveness. Researchers divided 82 volunteers into two groups: One was told they would receive a pain medication with a cost of $2.50 per pill, while the second was told their medication had been discounted to 10 cents per pill. The researchers administered a series of electrical shocks to each participant at varying voltages, based on an earlier determination of each individual's pain tolerance. The participants were then given the pill they had been told about, which was actually a placebo, and once again received a series of electrical shocks. The researchers judged the apparent effectiveness of the pills by comparing the participants' pain ratings before and after they took the pill. More than 85 percent of those receiving the "expensive" pill said it had helped their pain, compared to only 61 percent of those who received the "discounted" medication. "The simple conclusion is that our expectations change our reality," said Dan Ariely, a professor of behavioral economics at MIT's Sloan School of Management and one of the study's authors.

BOTTOM LINE: Our expectations of a drug's effectiveness are influenced by its cost; so much so that an expensive sugar pill relieves pain better than a cheap one.

CAUTIONS: Ariely cautions that the study must be replicated in a wider range of settings to determine how other factors, such as the method of drug delivery or the brand of the medication, may affect a person's response.

WHAT'S NEXT: The researchers plan to study the effects of providing medication for no cost, as well as whether patients will stick better to a drug regimen that is expensive.

WHERE TO FIND IT: Journal of the American Medical Association, March 5.

MICHELLE SIPICS