Glasgow University. UK: Scientists are investigating whether treatment for high blood
pressure can be improved by taking a person’s ethnic heritage into
account. High blood pressure, or hypertension, is common in the general
population. A healthy lifestyle alone is not enough to control blood
pressure, and drug treatment is required.
There are a wide variety of drugs available and although these are
effective and safe, it is often necessary to try different types of
drugs and often to use a combination of two or more drugs.
Delay in choosing the right kind of tablet or combination of tablets
through ‘trial and error’ is a major problem and, in a large proportion
of people with hypertension, blood pressure is not adequately
controlled. Relatively little is known about why some people respond
better to one kind of tablet or combination of tablets than others.
It is know that response to treatment differs in different ethnic
groups in the UK and may differ between populations in Europe, Asia and
Africa.
Now scientists at the University of Glasgow are working, with a
consortium led by King’s College London, to see if genetic markers of
ancestry, combined with a detailed measure of chemical ‘metabolites’
circulating in the blood that characterise the biochemical processes in
each person can predict the best type of drug that person.
This is the goal of the £3.4m AIM HY study, funded by the Medical Research Council and the British Heart Foundation.
Professor Sandosh Padmanabhan, the lead investigator at Glasgow,
said: “High blood pressure is currently treated using a range of
generic, low cost drugs which are not always effective.
“We plan to use 21st century high-throughput genomics and
metabolomics to try and explain the mechanism for the known differences
in drug response observed in different ethnic groups and see if we can
use this knowledge to improve hypertension treatment.
“This project seeks evidence for selecting the drug treatments in an
ethnically-diverse population like the UK. This may involve using
non-standard combinations of existing drugs and/or new drugs. If a
combination of drugs is required we can use a new technology to put
these into a single tablet.
“The ultimate aim is to deliver personalised treatment for high blood
pressure, based on a single blood test that captures the genetic and
other biological factors that determine how an individual will respond.
“This should reduce the number of consultations, the time required to
achieve optimal blood pressure control and contribute to better
hypertension control in the UK.”
High blood pressure is extremely common within the general population
in the UK and worldwide and is a major cause of heart disease, kidney
disease and stroke.
One in three of the UK population will require treatment for
hypertension at some point in their lives. It’s the biggest contributor
to the global burden of disease, a burden that is particularly great in
ethnic minorities in the UK and in lower and middle income countries. It
is also the commonest reason for people to be prescribed long-term
medication by their GP.
The consortium also comprises: Universities of Cambridge, Nottingham,
Manchester; UCL, Queen Mary, MRC Biostatistics Unit, Mayo Clinic and
Foundation, University of Florida.