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The IDEAL study : towards personalized drug treatment of hypertension
Theodora Bejan-Angoulvant1, Jean-Philippe Baguet, Sylvie Erpeldinger
1Department of Clinical Pharmacology, Hospices Civils de Lyon, Lyon, France; UMR 5558, CNRS, Villeurbanne, France; Claude Bernard Lyon 1 University, Lyon, France.
Objective:
To identify markers (phenotypic, genetic, or environmental) of blood pressure (BP) response profiles to angiotensin converting enzyme inhibitors (ACEIs) and diuretics.
Methods:
IDEAL was a crossover (two active and two wash out phases), double-blind, placebo-controlled trial. Eligible patients were untreated hypertensive, aged 25 to 70. After two visits, patients were randomized to one of four sequences. The main outcome was BP differences between the active treatment and placebo.
Results:
One hundred and twenty-four patients were randomised: mean age 53, men 65%, family history of hypertension 60%. Average BP fall at each visit before randomisation was about 2% of the initial level reflecting both a regression to the mean and a placebo effect.
Conclusion:
The results are expected to improve knowledge in drug's mechanisms of action and pathophysiology of hypertension, and to help in personalizing treatment. The estimation of BP responses to each drug in standardized conditions provided a benefit to each participant.
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