Currently, in conventional medical practice, the term “personalized medicine” routinely refers to identifying the genetics of some cancerous tumor so as to “tune” chemotherapy. Of course, I’ve been using genetic evaluations from a wide variety of providers depending on specific needs, none of which involves a cancerous tumor. The attached abstract hints at the value that an appropriate genetic evaluation could have for both individuals and populations. By running patients with high blood pressure through a genetic test panel (only 10 genes) that then translated into much more effective high blood pressure treatment in a much shorter time than in the population receiving usual care. Since about 45% of strokes occur in patients with hypertension who aren’t adequately controlled, controlling blood pressure more quickly through genetic could easily pay for itself in better outcomes (and it real dollars!).
One could ask why we don’t do this… but that would just be a silly question, right?
FROM SCIENCE TRANSLATIONAL MEDICINE / BY QI SHEN HONGHONG ZHANG, YIMING HUANG, MINGYU LI, HAO ZHAO, ZHIWEN YANG, HAIJING ZHAO, QI LIU, ZIHAO FU, SHU WANG
Genetic variants among individuals have been associated with ineffective control of hypertension. Previous work has shown that hypertension has a polygenic nature, and interactions between these loci have been associated with variations in drug response. Rapid detection of multiple genetic loci with high sensitivity and specificity is needed for the effective implementation of personalized medicine for the treatment of hypertension. Here, we used a cationic conjugated polymer (CCP)–based multistep fluorescence resonance energy transfer (MS-FRET) technique to qualitatively analyze DNA genotypes associated with hypertension in the Chinese population. Assessment of 10 genetic loci using this technique successfully identified known hypertensive risk alleles in a retrospective study of whole-blood samples from 150 patients hospitalized with hypertension. We then applied our detection method in a prospective clinical trial of 100 patients with essential hypertension and found that personalized treatment of patients with hypertension based on results from the MS-FRET technique could effectively improve blood pressure control rate (94.0% versus 54.0%) and shorten the time duration to controlling blood pressure (4.06 ± 2.10 versus 5.82 ± 1.84 days) as compared with conventional treatment. These results suggest that CCP-based MS-FRET genetic variant detection may assist clinicians in rapid and accurate classification of risk in patients with hypertension and improve treatment outcomes.
SNPing out hypertension
Essential hypertension has multiple genetic risk factors that can affect both its incidence and response to treatment. Here, Shen and colleagues developed a simple, high-throughput fluorescent assay for detection of two different single nucleotide polymorphisms (SNPs) in a single reaction. They applied this method in a prospective study to screen for variants at a total of 10 loci associated with hypertension and guide medication use based on drug class-associated risks. Patients treated according to this precision medicine approach had improved blood pressure control over a 7-day period compared with those treated using standard guidelines. These results suggest that this assay should be further studied and may be useful in resource-limited settings.