Pharmacogenomic studies of hypertension: Paving the way for personalized antihypertensive treatment

Michael T. Eadon, Sri H. Kanuri, Arlene B. Chapman

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Introduction: Increasing clinical evidence supports the implementation of genotyping for anti-hypertensive drug dosing and selection. Despite robust evidence gleaned from clinical trials, the translation of genotype guided therapy into clinical practice faces significant challenges. Challenges to implementation include the small effect size of individual variants and the polygenetic nature of antihypertensive drug response, a lack of expert consensus on dosing guidelines even without genetic information, and proper definition of major antihypertensive drug toxicities. Balancing clinical benefit with cost, while overcoming these challenges, remains crucial. Areas covered: This review presents the most impactful clinical trials and cohorts which continue to inform and guide future investigation. Variants were selected from among those identified in the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR), the Genetic Epidemiology of Responses to Antihypertensives study (GERA), the Genetics of Drug Responsiveness in Essential Hypertension (GENRES) study, the SOPHIA study, the Milan Hypertension Pharmacogenomics of hydrochlorothiazide (MIHYPHCTZ), the Campania Salute Network, the International Verapamil SR Trandolapril Study (INVEST), the Nordic Diltiazem (NORDIL) Study, GenHAT, and others. Expert Commentary: The polygenic nature of antihypertensive drug response is a major barrier to clinical implementation. Further studies examining clinical effectiveness are required to support broadbased implementation of genotype-based prescribing in medical practice.

Original languageEnglish (US)
Pages (from-to)33-47
Number of pages15
JournalExpert Review of Precision Medicine and Drug Development
Volume3
Issue number1
DOIs
StatePublished - Jan 3 2018

Keywords

  • Antihypertensive
  • Blood pressure
  • Implementation
  • Pharmacogenomics
  • Precision medicine

ASJC Scopus subject areas

  • Molecular Medicine
  • Genetics
  • Pharmacology
  • Drug Discovery

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