A new study out of Sweden shows that people with hypertension can respond significantly better to some treatments than others, suggesting that hypertension medicine decisions might become far more personalized in the future.
It’s traditionally been challenging to get hypertension under control, in part because a single antihypertensive drug often doesn’t achieve sufficient BP reduction and many patients don’t want to add a second medication.
- However, this new study suggests that hypertension control might be far less of a challenge if each patient was prescribed the optimal medication for them the first time around.
In the randomized, double-blind, repeated crossover trial, 280 Swedish people with grade 1 hypertension and low CV event risks were treated with four different blood pressure medications in random order (lisinopril, candesartan, hydrochlorothiazide, amlodipine).
Data from 1,468 two-month treatment periods and 270 patients showed “substantial” variations in treatment responses between individuals (P < .001), finding that each participant’s optimal antihypertensive drug could reduce their systolic blood pressure by an additional 4.4 mm Hg compared to the study’s other treatment options.
Each individual’s optimal antihypertensive drug also improved systolic blood pressure by…
- 3.1 mm Hg compared the group’s most effective overall treatment (lisinopril)
- 2-times compared to doubling the dosage of another antihypertensive option
- Over 50% compared to combining two different antihypertensive options
This new evidence that antihypertensive drugs have different effects on different patients could set the stage for larger RCTs to see if these findings can be replicated and to identify what factors influence treatment response variations. If successful, those trials might lead to big changes in hypertension treatment decisions.
The Takeaway
Although it might not be surprising that different patients respond better or worse to different medications, this study reframes what some might have historically described as standard deviation into an opportunity to start making hypertension treatment far more precise.
