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Genome-wide response to antihypertensive medication using home blood pressure measurements: a pilot study nested

Kei Kamide1, Kei Asayama, Tomohiro Katsuya

  • 1Department of Geriatric Medicine & Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan and Department of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan and Research Institute, National Cerebro & Cardiovascular Research Center, Osaka, Japan and Studies Coordinating Centre, Research Unit Hypertension & Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.

Pharmacogenomics
|November 7, 2013
PubMed

Insights

This study identified genetic markers associated with responses to calcium channel blockers and angiotensin II receptor blockers in hypertension patients. These findings may advance personalized hypertension treatment strategies.

Area of Science:

  • Pharmacogenomics
  • Cardiovascular Medicine
  • Genetics

Background:

  • Essential hypertension is a common cardiovascular condition.
  • Treatment decisions for hypertension often involve calcium channel blockers (CCB), angiotensin-converting enzyme inhibitors (ACEI), or angiotensin II receptor blockers (ARB).
  • Individual responses to antihypertensive medications can vary significantly.

Purpose of the Study:

  • To investigate the genetic basis of blood pressure response to first-line antihypertensive treatments.
  • To identify single nucleotide polymorphisms (SNPs) associated with differential drug responses in hypertension.
  • To explore the potential for personalized medicine in hypertension management.

Main Methods:

  • A genomic study (HOMED-BP trial) involving 265 patients with mild-to-moderate essential hypertension.
  • Randomized allocation to first-line treatment with CCB, ACEI, or ARB.
  • High-fidelity phenotyping using 5-day home blood pressure measurements before and after treatment.
  • Genotyping using 500K DNA microarray chips and statistical analysis of blood pressure response as a quantitative trait.
  • Replication of significant findings using the multicenter GEANE study.

Main Results:

  • Single nucleotide polymorphisms (SNPs) in PICALM, TANC2, NUMA1, and APCDD1 were associated with CCB response.
  • SNPs in ABCC9 and YIPF1 were associated with ARB response, with findings replicated in an independent study.
  • No specific SNPs were reported as associated with ACEI response in the abstract.

Conclusions:

  • The study highlights specific genetic variations influencing patient response to CCBs and ARBs.
  • The use of high-fidelity phenotyping through home blood pressure monitoring is a valuable approach.
  • This research represents a step towards personalized treatment strategies for hypertension.
Abstract

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