A simple test can detect genetic variants associated with hypertension and create individualized treatments that can improve blood pressure control.
The fluorescent assay uses conjugated polymers and can detect two single nucleotide polymorphisms (SNPs) associated with hypertension in a single reaction.
Personalized therapeutic schedules based on the test results dramatically improved rates of blood pressure control among 100 patients with hypertension.
Treatment based on test results also tended to shorten the time to blood pressure control compared with conventional treatment.
“Our system has the advantages of simple operation and high throughput detection, providing a potentially useful tool to aid in management of hypertension,” the researchers note, reporting their findings in Science Translational Medicine.
“This system could be applied to maximize the efficacy of antihypertensive medication and reduce rates of uncontrolled hypertension, particularly in resource-limited settings.”
Essential hypertension has several genetic risk factors that can affect both its incidence and the response to medication.
Attempting to incorporate this information into treatment, the researchers developed a cationic conjugated polymer-based multistep fluorescence resonance energy transfer (MS-FRET) technique to rapidly detect DNA genotypes associated with hypertension.
The polychromatic fluorescent technique was used to assess 10 genetic loci known to be associated with hypertension or adverse effects from antihypertensive medications in a retrospective study of blood samples from 150 Chinese patients hospitalized with hypertension.
The team identified several known hypertensive risk alleles, with most of the patients studied carrying at least one variant allele within selected genes.
The researchers then applied their results in a prospective clinical trial of 100 patients with hypertension.
Participants were divided into a precision treatment group based on the results of allele analysis and a conventional group whose standard antihypertensive treatment was guided by medical experience.
Those treated with the precision medicine approach had significantly better blood pressure control over the course of a week compared with those treated according to standard guidelines, at 94.0 versus 54.0 percent, the investigators report.
There was also a trend towards faster blood pressure control, at 4.06 versus 5.82 days, respectively.
Qi Shen, from the University of Chinese Academy of Sciences in Beijing, and colleagues note that the genetic detection system requires only 1 to 2 ml of blood from the patient and provides the results within five to six hours.
They suggest: “This polychromatic fluorescent detection system may be useful for identifying risk alleles in patients with hypertension to guide optimal antihypertensive medication selection and dosing.”