Preliminary Application of Antihypertensive Gene Detection in the Treatment of Hypertension.

Six loci (CYP2D6, CYP2C9, AGTR1, ACE, NPPA, CYP3A5) linked to five antihypertensive drug classes guide treatment choice and dosing.

This prospective randomized controlled trial evaluated whether pharmacogenomics-guided therapy improves blood pressure control in 900 hypertensive patients, allocated to conventional care (n = 450) or guided therapy (n = 450) with testing of six loci (CYP2D6, CYP2C9, AGTR1, ACE, NPPA, CYP3A5) linked to five antihypertensive drug classes. The guided group achieved higher blood pressure control rates at 3 months (80.7 % vs 70.2 %, P < 0.001) and 6 months (78.4 % vs 65.1 %, P < 0.001), and better adherence (98.0 % vs 74.0 %, P < 0.001). ACE-inhibitor-related dry cough incidence was lower (1.6 % vs 8.3 %, P < 0.001), with fewer drug adjustments and a reduced 6-month readmission rate (2.4 % vs 8.9 %, P < 0.001).

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

With 900 randomized patients, this trial provides robust evidence that panel-based pharmacogenomics-guided antihypertensive prescribing improves blood pressure control, adherence and reduces adverse effects such as ACE-inhibitor cough. The panel mixes established pharmacokinetic genes (CYP2C9, CYP2D6, CYP3A5) with pharmacodynamic genes of weaker evidence (AGTR1, ACE, NPPA), and the single-center origin limits generalizability. An encouraging result for preemptive genotyping, pending confirmation in larger populations.

Analysis by Dr Thibaut Benquey