Related Experiment Video
Updated: Aug 6, 2026
04:37
Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
Published on: June 6, 2025
Personalised approach to hypertension treatment: protocol for the HYPERMARKER randomised controlled trial
Matthew Chapman1,2, Jonathan E Knikman3, Alastair Mobley1,2
1Department of Cardiovascular Sciences, University of Birmingham, Birmingham, England, UK.
BMJ Open
|July 16, 2026
Summary
This study investigates personalized hypertension treatment using a digital tool combining patient data and metabolomics. The goal is to improve blood pressure management and reduce health burdens.
Area of Science:
- Cardiovascular Medicine
- Digital Health
- Metabolomics
Background:
- Individual blood pressure treatment response varies significantly, often relying on clinician experience.
- Personalized medicine approaches, including patient empowerment and metabolomic profiles augmented by machine learning, show promise but lack robust evaluation.
- The HYPERMARKER trial aims to address the global health and economic burdens of hypertension by evaluating an individualized medication class selection.
Purpose of the Study:
- To evaluate the effectiveness of a digital portal for shared decision-making in hypertension therapy selection.
- To assess the impact of combining clinical features and metabolomic profiles for personalized antihypertensive medication class choice.
- To determine if an individualized approach enhances clinical effectiveness in managing hypertension.
Main Methods:
- A pragmatic, multicentre, adaptive, open-label strategy trial with stratified randomization.
- An intervention utilizing a digital portal for shared decision-making, incorporating clinical features and metabolomic profiles (liquid chromatography-mass spectrometry).
- 400 participants randomized to standard care or the intervention group, with remote follow-up via smartphone app and linked blood pressure monitor to assess home systolic blood pressure changes over 4 weeks.
Main Results:
- Primary outcome: Change in home systolic blood pressure during a 4-week period after medication changes.
- Secondary outcomes: Patient-reported adverse effects, quality of life, treatment withdrawal, healthcare utilization, and health economic analysis.
- Trial design includes a second phase where all participants receive the updated intervention.
Conclusions:
- The HYPERMARKER trial will provide crucial data on the clinical effectiveness of a novel, personalized approach to hypertension management.
- Findings are expected to inform future strategies for optimizing antihypertensive therapy and reducing the global burden of hypertension.
- The study emphasizes patient empowerment and the integration of advanced diagnostics (metabolomics) in routine clinical practice.
Related Concept Videos
01:28Hypertension IV: Drug Therapy and Lifestyle Modifications
Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
01:23Hypertension V: Nursing Management
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
01:28Hypertension I: Introduction
Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
01:18Hypertension and Regulation of Blood Pressure
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...