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基于药物遗传学检测的个性化抗高血压治疗的实施与结果:一项关于血压控制和药物耐受性的回顾性研究

The Implementation and Outcomes of Personalized Antihypertensive Therapy Based on Pharmacogenetic Testing: A Retrospective Study Examining Blood Pressure Control and Medication Tolerability.

作者信息

Khan Youksal, Shanmugar Suriya Bala, Ahmad Urooj Fatima, Mansoor Amna, Gbamgbola Taiwo Asanat, Farooq Waqas, Anene Jennifer Ifeoma, Bedros Adees Wirtan Sarkees, Gulfam Muhammad

机构信息

Oncology Department, Jinnah Postgraduate Medical Centre, Karachi, PAK.

Internal Medicine Department, ACS Medical College and Hospital, Chennai, IND.

出版信息

Cureus. 2024 Nov 23;16(11):e74288. doi: 10.7759/cureus.74288. eCollection 2024 Nov.

Abstract

BACKGROUND

Hypertension management typically relies on standardized treatment regimens, which may not account for individual genetic variations that affect drug metabolism and response.

OBJECTIVE

The objective of this study was to evaluate the effectiveness of personalized antihypertensive therapy, guided by pharmacogenetic testing, in terms of blood pressure (BP) control and medication tolerability.

MATERIALS AND METHODS

A retrospective cohort study was conducted at Jinnah Postgraduate Medical Centre, Karachi, from January 2023 to December 2023. The study included 330 hypertensive patients who received either conventional care (n = 165) or personalized therapy directed by pharmacogenetic testing (n = 165). Data on patient demographics, genetic test results, antihypertensive drug prescriptions, and blood pressure readings at baseline, three months, and six months were extracted from electronic health records. Reports of adverse effects were used to assess medication tolerability. Independent t-tests were employed for statistical analysis (SPSS version 25 (IBM Corp., Armonk, NY)) to evaluate changes in blood pressure and adverse effects between the two groups, with a significance level set at p < 0.05.

RESULTS

Among the 330 hypertensive patients, the Personalized Therapy group (n = 165) showed a significant reduction in systolic blood pressure by 17.8 mmHg (±6.4) and diastolic blood pressure by 11.3 mmHg (±5.7) over six months, compared to reductions of 8.7 mmHg (±6.7) and 5.7 mmHg (±4.8), respectively, in the Standard Therapy group (n = 165) (p < 0.001). Additionally, the Personalized Therapy group experienced fewer adverse effects, with 15 patients reporting dizziness and five reporting gastrointestinal issues, compared to 30 patients with dizziness and 10 with gastrointestinal issues in the Standard Therapy group.

CONCLUSION

Personalized antihypertensive therapy based on pharmacogenetic testing significantly improves blood pressure control and medication tolerability compared to standard treatment, supporting its broader implementation in hypertension management.

摘要

背景

高血压管理通常依赖标准化治疗方案,而这些方案可能未考虑影响药物代谢和反应的个体基因变异。

目的

本研究的目的是评估在药物遗传学检测指导下的个性化抗高血压治疗在血压控制和药物耐受性方面的有效性。

材料与方法

2023年1月至2023年12月在卡拉奇真纳研究生医学中心进行了一项回顾性队列研究。该研究纳入了330例高血压患者,他们接受了常规护理(n = 165)或由药物遗传学检测指导的个性化治疗(n = 165)。从电子健康记录中提取了患者人口统计学数据、基因检测结果、抗高血压药物处方以及基线、三个月和六个月时的血压读数。使用不良反应报告来评估药物耐受性。采用独立t检验进行统计分析(SPSS 25版(IBM公司,纽约州阿蒙克)),以评估两组之间血压和不良反应的变化,显著性水平设定为p < 0.05。

结果

在330例高血压患者中,个性化治疗组(n = 165)在六个月内收缩压显著降低了17.8 mmHg(±6.4),舒张压显著降低了11.3 mmHg(±5.7),相比之下,标准治疗组(n = 165)的收缩压和舒张压分别降低了8.7 mmHg(±6.7)和5.7 mmHg(±4.8)(p < 0.001)。此外,个性化治疗组的不良反应较少,有15例患者报告头晕,5例报告胃肠道问题,而标准治疗组有30例患者头晕,10例患者有胃肠道问题。

结论

与标准治疗相比,基于药物遗传学检测的个性化抗高血压治疗显著改善了血压控制和药物耐受性,支持其在高血压管理中更广泛的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b7f/11664490/cb9eb4bf8d9a/cureus-0016-00000074288-i01.jpg

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