Relationship between a Weighted Multi-Gene Algorithm and Blood Pressure Controlin Hypertension

• Published in: Journal of clinical medicine Vol. 8; no. 3
• Main Authors: Phelps, Pamela K, Kelley, Eli F, Walla, Danielle M, Ross, Jennifer K, Simmons, Jerad J, Bulock, Emma K, Ayres, Audrie, Akre, Monica K, Sprissler, Ryan, Olson, Thomas P, Snyder, Eric M
• Format: Journal Article
• Language: English
• Published: Switzerland 01-03-2019
• Subjects: blood pressure; treatment; genetics; hypertension; pharmacotherapy; pharmacogenetics
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm8030289

Hypertension (HTN) is a complex disease with interactions among multiple organ systems, including the heart, vasculature, and kidney with a strong heritable component. Despite the multifactorial nature of HTN, no clinical guidelines utilize a multi-gene approach to guide blood pressure (BP) therapy. Non-smokers with a family history of HTN were included in the analysis (
= 384; age = 61.0 ± 0.9, 11% non-white). A total of 17 functional genotypes were weighted according to the previous effect size in the literature and entered into an algorithm. Pharmacotherapy was ranked from 1⁻4 as most to least likely to respond based on the algorithmic assessment of individual patient's genotypes. Three-years of data were assessed at six-month intervals for BP and medication history. There was no difference in BP at diagnosis between groups matching the top drug recommendation using the multi-gene weighted algorithm (
= 92) vs. those who did not match (
= 292). However, from diagnosis to nadir, patients who matched the primary recommendation had a significantly greater drop in BP when compared to patients who did not. Further, the difference between diagnosis to current 1-year average BP was lower in the group that matched the top recommendation. These data suggest an association between a weighted multi-gene algorithm on the BP response to pharmacotherapy.