Future hypertension treatment will include targeted, and earlier, treatment

A.F. Dominiczak, UK

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Although not ready for clinical practice, these methods are proving effective in the research setting, according to Professor Anna F. Dominiczak, Director of the BHF Cardiovascular Research Centre at the University of Glasgow and Secretary of the Scientific Committee of the European Society of Hypertension. She spoke today in a session on the future of arterial hypertension at the 16th European Meeting on Hypertension held in Madrid, Spain.

Dominiczak stated that the future is preventive medicine, which requires biomarkers, and that systems biology, i.e., genomics, proteomics, and metabolomics provide this information. “Knowledge of the molecular mechanisms of pathological processes will mean more accurate diagnosis and better preventative techniques and treatment,” she stated.

Pharmacogenomics is using DNA chip technology for so-called drug targeting, and can predict the best response to drug treatment and side effects. Side effects can be prevented by adjusting the drug dose in the setting of certain polymorphisms, for example. SNPs have the biggest future and look at multiple pathways simultaneously. Using non-commercial technology, it is possible to predict by about 50% the blood pressure response to antihypertensive drugs currently. As the technology develops, the costs are decreasing and in the future it will be available at the bedside, much like cholesterol testing today.

The real cost savings will be the prevention of late complication and disability, with this type of prediction returning the drug cost by about 3-fold. “…antihypertensive prevention and treatment is really a way of saving money, as it reduces the possibility of the patient developing chronic cardiovascular pathological conditions which have a significant impact economically speaking on public health, said Dominiczak. She noted that treatment must include lifestyle changes made by patients, as well as early detection and more aggressive treatment.