Uppsala/Berlin.
High blood pressure can be lowered in a number of ways. Not everyone helps everyone equally well. Is personalized therapy the solution?
The effectiveness of blood pressure medication can differ greatly from person to person. For many patients with high blood pressure, switching medications could apparently have a greater impact than increasing the dosage of the current medication. This shows a study by medical professionals from Uppsala University in Sweden.
Based on the results of their investigations in the specialist journal “JAMA”, the scientists advocate the treatment of high blood pressure to focus more on personalized therapy approaches and to test them. It remains to be seen how well this can actually be implemented in everyday practice.
Markus van der Giet, hypertensiologist at the Charité in Berlin, considers the personalized treatment approach to be desirable, but currently difficult to implement. He suspects that it might be more appropriate therapies increasingly tailored to specific groups of people.
High blood pressure has long been a widespread disease
High blood pressure, known in professional circles as hypertension, is global common disease, which if left untreated can lead to kidney damage, heart disease and stroke. A study by the World Health Organization (WHO) in 2021 showed that only 25 percent of sick women and 20 percent of men are able to achieve their therapy goals with the effective medication available.
The number of those affected had grown loud WHO-Studie in 200 countries surveyed doubled to almost 1.3 billion people from 1990 to 2019. According to the German Hypertension League, there are between 20 and 30 million people in Germany.
Also interesting: New study: High blood pressure between 30 and 40 increases dementia risk in old age
The scientists at Uppsala University are now investigating why only very few people – despite treatment – can be properly adjusted. Specifically, the team led by cardiologist Johan Sundström was concerned with the extent to which the effectiveness of different blood pressure medication differs from person to person.
Optimal blood pressure medication wanted for everyone
The doctors examined 280 participants to see whether there was an optimal blood pressure medication for each individual patient and thus whether there was potential for a personalized blood pressure treatment gives. For a total of one year, the subjects alternately took four common medications from different drug classes: thiazide diuretics, ACE inhibitors, angiotensin II antagonists and calcium antagonists.
The effects of the drugs varied greatly from person to person, and certain patients achieved lower blood pressure with one drug than another. In addition, had an impact medication change for many subjects more than doubling the dose of the current drug.
According to the authors, this result calls into question the treatment guidelines in numerous countries, according to which the four drug groups examined are all hypertension patients are equally recommended. “This study provides evidence that widely used antihypertensive drugs vary in effectiveness across individuals, offering the potential for greater blood pressure reduction through personalized therapy,” it said.
In a statement, Sundström specifies: “If we customize each patient’s medication, we can better effect than if we randomly select a drug from one of these four drug groups.”
Personalization could be “frustrating experience”.
For Charité physician van der Giet would mean “patients one after the other medication trying out what would not work in everyday clinical practice and would probably also be a frustrating experience for the patients.”
However, the “scientifically fascinating” study shows that some drugs may be more beneficial for some patients than others. “However, you don’t know in advance which patient will react to which drug,” emphasizes van der Giet, who is also President of the German Hypertension League.
In fact, the authors themselves concede that for a personalized therapy biomarkers would have to be researched that would enable such predictions. “However, such biomarkers are by no means as stable as one might think, but can vary in the context of blood collection conditions, as a result of daily fluctuations and temperature changes,” points out van der Giet.
His approach with regard to the health of those affected: “We know, for example, that certain groups – whether women or men, older or younger people – react differently medication react,” says van der Giet: “Such a personalization, which does not include the individual but larger clusters, could definitely make sense.” (fmg)
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