A Pharmacogenomics-Guided Antihypertensive Strategy for Blood Pressure Reduction in Rural China: A Cluster-Randomized...

Area of Science:

• Genetics and Genomics
• Cardiovascular Medicine
• Primary Healthcare

Background:

• Limited evidence exists for pharmacogenomics in guiding antihypertensive treatment within low-resource primary care settings.
• This study addresses the need for real-world data on pharmacogenomic applications in underserved populations.

Purpose of the Study:

• To evaluate the effectiveness and safety of a pharmacogenomic-guided antihypertensive strategy in low-resource primary care.
• To compare pharmacogenomic guidance against physician experience and routine care for blood pressure management.

Main Methods:

• A randomized controlled trial involving 1031 hypertensive patients across 90 villages.
• Intervention groups received medication adjustments based on pharmacogenomics or physician experience; a control group received routine care.
• Blood pressure control after 4 weeks was the primary outcome, assessed using regression analyses and considering intracluster correlation.

Main Results:

• Pharmacogenomic guidance resulted in significantly higher blood pressure control rates (98.4%) compared to physician experience (74.2%) and routine care (75.1%).
• The between-group net differences in blood pressure control were substantial, favoring the pharmacogenomic approach.
• No significant differences in adverse events were observed among the three groups, indicating similar safety.

Conclusions:

• A pharmacogenomic-guided antihypertensive strategy offers a significant advantage in blood pressure control within low-resource primary care settings.
• This approach maintains a comparable safety profile to traditional methods, making it a viable option for improving cardiovascular health in underserved areas.