High blood pressure, or hypertension, affects millions of people worldwide and is a major risk factor for heart disease and stroke. A new study delves into the concept of personalized drug therapy for hypertension, investigating whether individualized treatment choices could lead to better blood pressure control. By exploring the variability in patients’ responses to different blood pressure medications, this research aims to shed light on the potential benefits of tailoring treatments to individual needs, ultimately improving patient outcomes and reducing the global burden of hypertension-related health issues.
Personalized Drug Therapy
A study published in the Journal of the American Medical Association (JAMA) investigated whether personalized drug therapy could be beneficial for treating high blood pressure, and if so, how significant the benefits of this approach would be. The authors wanted to explore if different individuals have varying responses to different blood pressure-lowering medications.
The study was conducted as a randomized, double-blind, repeated crossover trial. This means that participants were randomly assigned to different groups and were given various blood pressure-lowering drugs in a specific order, without the participants or researchers knowing which drug was being administered. This type of study design helps to minimize biases and increase the reliability of the results.
The findings showed that people had significantly different responses to the various blood pressure medications. Based on these results, the researchers estimated that personalizing treatment choices for high blood pressure patients could potentially lower their systolic blood pressure (the top number in a blood pressure reading) by an average of 4.4 mm Hg more than if they were given a fixed, one-size-fits-all treatment.
In conclusion, this study highlights the existence of individual differences in how people respond to blood pressure-lowering medications. The potential benefits of personalizing drug therapy for hypertension are significant enough to warrant further research into this area. By tailoring treatment to individual needs, healthcare professionals could potentially achieve better blood pressure control and improve the overall health of patients with high blood pressure.
Maximizing the Benefits of Hypertension Treatment: A Study on Personalized Drug Targeting
There are several blood pressure-lowering medications available, but it is not clear whether selecting specific drugs for specific individuals can lead to better results. The objective of this study was to explore and quantify the potential benefits of matching the right drug to the right person to maximize the effects on blood pressure. To achieve this, a randomized, double-blind, repeated crossover trial was conducted on men and women with mild hypertension who were at low risk for heart-related events.
The trial took place at an outpatient research clinic in Sweden, and the researchers used mixed-effects models to analyze the results. Participants were given four different types of blood pressure medications in a random order, with two of the medications being repeated. The study aimed to estimate the additional blood pressure reduction that could be achieved by personalizing treatment choices.
Results
The main outcome of this study focused on measuring ambulatory daytime systolic blood pressure at the end of each treatment period. A total of 1468 completed treatment periods were recorded among 270 participants, with a median length of 56 days. The participants were 54% men and had a mean age of 64 years. The results showed significant variability in individual blood pressure responses to different treatments, particularly when comparing lisinopril to hydrochlorothiazide, lisinopril to amlodipine, candesartan to hydrochlorothiazide, and candesartan to amlodipine.
Large differences were not observed when comparing lisinopril to candesartan and hydrochlorothiazide to amlodipine. The study concluded that, on average, personalized treatment could potentially lower systolic blood pressure by an additional 4.4 mm Hg. These findings highlight the considerable variation in blood pressure response to hypertension medications, which may have significant implications for tailoring drug therapy to individual needs.
Bibliography
Sundström, J., Lind, L., Nowrouzi, S., Hagström, E., Held, C., Lytsy, P., Neal, B., Marttala, K., & Östlund, O. (2023). Heterogeneity in Blood Pressure Response to 4 Antihypertensive Drugs: A Randomized Clinical Trial. JAMA, 329(14), 1160-1169. doi: 10.1001/jama.2023.3322
- Materson, B. J., Reda, D. J., Cushman, W. C., Massie, B. M., Freis, E. D., Kochar, M. S., Hamburger, R. J., Fye, C., Lakshman, R., Gottdiener, J., & et al. (1993). Single-drug therapy for hypertension in men. A comparison of six antihypertensive agents with placebo. The Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents. New England Journal of Medicine, 328(13), 914-921. doi:10.1056/NEJM199304013281303
- Wald, D. S., Law, M., & Morris, J. K. (2002). Homogeneous assay of high-sensitivity C-reactive protein and its distribution in British men and women in the general population. Annals of Clinical Biochemistry, 39(2), 114-119. doi:10.1258/0004563021901842
- Parati, G., Ochoa, J. E., Bilo, G., Agarwal, R., Covic, A., Dekker, F. W., Fliser, D., Heine, G. H., Jager, K. J., Gargani, L., Kanbay, M., Mallamaci, F., Massy, Z. A., Ortiz, A., Picano, E., Rossignol, P., Vanholder, R., Wiecek, A., Zoccali, C., & London, G. M. (2016). Hypertension in Chronic Kidney Disease Part 2: Role of Ambulatory and Home Blood Pressure Monitoring for Assessing Alterations in Blood Pressure Variability and Blood Pressure Profiles. Hypertension, 67(6), 1102-1110. doi:10.1161/HYPERTENSIONAHA.116.07112
- Turner, J. R., & Viera, A. J. (2014). Ambulatory blood pressure monitoring in clinical practice: A review. American Journal of Medicine, 127(1), 3-10. doi:10.1016/j.amjmed.2013.08.024
- Johnson, J. A., & Boerwinkle, E. (2017). Pharmacogenomics of antihypertensive drugs: past, present and future. Pharmacogenomics, 18(3), 251-264. doi:10.2217/pgs-2016-0170