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. 2022 Oct;12(5):635-645.
doi: 10.21037/cdt-22-154.

Personalized antihypertensive treatment guided by pharmacogenomics in China

Zhi-Lin Xiao  1 , Mei Yang  1 , Xiao-Bin Chen  2 , Xiu-Mei Xie  1 , Mei-Fang Chen  1
Affiliations

Personalized antihypertensive treatment guided by pharmacogenomics in China

Zhi-Lin Xiao et al. Cardiovasc Diagn Ther. 2022 Oct.

Abstract

Background: The implementation of genotyping for anti-hypertensive drugs in clinical practice remains a challenge. We conducted this study to analyze the distribution of polymorphisms of antihypertensive drug-related genes in Changsha County in China and compare the clinical effectiveness of genotype-guided and clinical experience-guided antihypertensive therapy in hypertensive individuals.

Methods: A total of 9,933 essential hypertensive participants from Changsha County were consecutively enrolled in our study, and 7 genetic polymorphic loci (CYP2D6*10, ADRB1, CYP2C9*3, AGTR1, ACE, CYP3A5*3 and NPPA) were detected by a polymerase chain reaction (PCR)-fluorescence probe. From an available sample of 660 hypertensive participants, 495 cases were randomly identified by genotype-guided therapy and 165 cases by clinical experience-guided therapy. We performed 24-hour ambulatory blood pressure (BP) monitoring on each of these cases, pre- and post-intervention.

Results: In the enrolled 9,933 cases, the mutation frequencies of CYP2C9*3, ADRB1(1165G>C), AGTR1(1166A>C), CYP2D6*10, ACE(I/D), CYP3A5*3 and NPPA(2238T>C) were 4.41%, 74.60%, 5.55%, 57.08%, 30.94%, 69.03% and 1.19%, respectively. In both genotype-guided and clinical experience-guided groups, the comparisons of intra-group pre-and post-treatments showed significant decreases in diastolic blood pressure (DBP) (P<0.01) and significant increases in the control rate of BP (47.1% vs. 38.6% and 37.5% vs. 33.9%, P<0.05) in response to adjusted antihypertensive agents. Correspondingly, the extent of the reduction of systolic blood pressure (SBP; 3.52±11.72 vs. 0.92±9.14 mmHg), the extent of the increase in the rate of BP control (8.5% vs. 3.6%) and the percentage rate of decrease of grades 2 and 3 hypertensive individuals were more significant in the genotype-guided group than that in the clinical experience-guided group (P<0.01).

Conclusions: While prescribing anti-hypertensive drugs, appropriate dosage and type adjustments should be made according to the gene mutation frequency and individual circumstances. Pharmacogenomics-guided personalized treatment of hypertensive patients is likely to be a more effective strategy, especially in those with significantly elevated SBP.

Keywords: Hypertension; ambulatory blood pressure monitoring (ABPM); genetic polymorphic loci; personalized treatment; pharmacogenomics.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cdt.amegroups.com/article/view/10.21037/cdt-22-154/coif). MFC reports that the study materials of this manuscript were provided by Changsha County Government. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow diagram of the study. ABPM, ambulatory blood pressure monitoring; PCR, polymerase chain reaction.
See this image and copyright information in PMC

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References

    1. Ma LY, Chen WW, Gao RL, et al. China cardiovascular diseases report 2018: an updated summary. J Geriatr Cardiol 2020;17:1-8. - PMC - PubMed
    1. Melville S, Byrd JB. Personalized Medicine and the Treatment of Hypertension. Curr Hypertens Rep 2019;21:13. 10.1007/s11906-019-0921-3 - DOI - PMC - PubMed
    1. Rysz J, Franczyk B, Rysz-Górzyńska M, et al. Pharmacogenomics of Hypertension Treatment. Int J Mol Sci 2020;21:4709. 10.3390/ijms21134709 - DOI - PMC - PubMed
    1. Luizon MR, Pereira DA, Sandrim VC. Pharmacogenomics of Hypertension and Preeclampsia: Focus on Gene-Gene Interactions. Front Pharmacol 2018;9:168. 10.3389/fphar.2018.00168 - DOI - PMC - PubMed
    1. Pinheiro DS, Santos RS, Jardim PCBV, et al. The combination of ACE I/D and ACE2 G8790A polymorphisms revels susceptibility to hypertension: A genetic association study in Brazilian patients. PLoS One 2019;14:e0221248. 10.1371/journal.pone.0221248 - DOI - PMC - PubMed