Medication can play a huge role in reducing high blood pressure, a major cause of stroke, heart attack and other serious health problems. However, given the wide selection of drugs doctors choose, finding out which drug works best for someone is difficult.
But researchers may have found a better way to predict the efficacy and side effects of blood pressure medications, and it does not involve taking a single pill. Instead, it depends on genetics.
In a new study published Tuesday in the American Heart Association CirculationResearchers have discovered a large genetic database in the UK to look for specific genes that contain instructions for producing proteins targeted by three commonly used blood pressure medications – ACE inhibitors, beta-blockers and calcium channel blockers.
They then used people's genes to assess what a drug would do – benefits and harms.
The researchers were able to combine certain variations in genes with the effect of the drug class in reducing heart disease and the risk of stroke. But they found a possible complication of a particular category of blood pressure drugs examined in the study.
Genetic variants targeted by calcium channel blockers had "a possible side effect not previously reported". Specifically, they were linked to an increased risk of developing diverticulosis, a condition in which small pouches develop along the walls of the large intestine. When the pockets become infected or tear, these complications can lead to hospitalization.
"As far as we know, this effect is not related to blood pressure, and this is a new insight generated by the study," said lead author Dr. Dipender Gill, a clinical researcher at Imperial College. College of London.
Neither ACE inhibitors nor beta-blockers showed previously unknown side effects.
Researchers corroborated the association between calcium channel blockers and diverticulosis by accessing another genetic database of DNA samples available through a biobank operated by Vanderbilt University in Tennessee.
It is estimated that 874 million adults worldwide have high blood pressure, often called "the silent killer," because it rarely shows obvious symptoms as it wreaks havoc on the body. Also called hypertension, high blood pressure is usually treated through lifestyle changes – specifically changes in diet and levels of physical activity – and the use of one or more medications.
But most high blood pressure drugs are tested in older or high-risk populations for a relatively short period of time, and the tests rarely capture side effects other than the obvious ones.
"The real strength of the study is that it was able to assess the unexpected effects of medications on human health in an unbiased way," said Kiran Musunuru, an associate professor of cardiovascular and genetic medicine at the University of Pennsylvania. not involved in the research.
"There is no obvious connection that would lead the medical community to suspect a link between calcium channel blockers and diverticulosis, but it looks like there may be one, after all," he said. "The idea of using genetic variants that mimic the effects of drugs to get a better idea that drugs will be effective and safe before drugs are used in people will be an important element of drug development going forward. "
But Musunuru warned that the connection between calcium channel blockers and diverticulosis is still preliminary and it is not enough for doctors and their patients to stop using calcium channel blockers alone for that reason.
"These drugs are very useful and the doctor prescribes them for a very important reason. What we highlight is the information that should inform more studies and investigations," he said.
Gill said that although the study offers an "innovative view" of the possible side effects of calcium channel blockers, the greatest implication is for future research.
"In the current era, the vastness of genetic data makes it possible to do very advanced and sophisticated analyzes very quickly," he said.
Ioanna Tzoulaki, a senior author of the study and an epidemiologist at Imperial College London, added, "This approach is evolving as a powerful cost and time-efficient tool to help prioritize or design trials that are most likely to succeed."
Blood pressure drugs help keep heart problems away, says FDA
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Genetics May Help Predict the Right Medicine for You (2019, June 25)
recovered on June 25, 2019
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