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The clinical impact of anti-hypertensive treatment drug-gene pairs in the asian population: a systematic review of publications in the past decade

Journal of Human Hypertension volume 37, pages 170–180 (2023)Cite this article

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Abstract

Pharmacogenetics play an important role in determining the anti-hypertensive effects of blood pressure-lowering medications and have the potential to improve future patient care. Current literature on the topic, however, has a heavy focus on Caucasians and may not be generalisable to the Asian populations. Therefore, we have conducted this systematic review to summarise and evaluate the literature of the past decade. PubMed, Embase, and the Cochrane Register of Controlled Trials were searched for relevant studies from 1 January 2011 to 23 July 2021. The outcome of interest was the response to anti-hypertensive treatment in Asians according to each genetic polymorphism. A total of 26 studies with a total of 8837 patients were included in our review, covering five classes of anti-hypertensive agents—namely, angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta-blockers (BB), calcium channel blockers (CCB), and thiazide-like diuretics. Response to ACEI therapy was most susceptible to genotypic variations, while the efficacy of ARB and CCB were affected by pharmacogenetic differences to varying extent. For BB, only variations in the ADRB1 genotype significantly affects therapeutic response, while the therapeutic efficacy of thiazide-like diuretics was correlated with genotypic variations in the REN and ACE. This systematic review evaluated the impact of pharmacogenetic variations on the therapeutic efficacy of anti-hypertensive treatment in Asians and has described numerous drug-gene pairs that are potentially clinically important. Future prospective studies with larger sample sizes and longer follow-up periods are needed to better elucidate the impact of these drug-gene pairs.

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Fig. 1: PRISMA flow diagram.
Fig. 2: Distribution of included studies across drug classes.

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Authors and Affiliations

  1. Department of Pharmacy, National University of Singapore, Singapore, Singapore

    Sarah Wai Yee Tang & Doreen Su-Yin Tan

  2. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Aaron Shengting Mai

  3. Department of Cardiology, National University Heart Centre, Singapore, Singapore

    Nicholas W. S. Chew

  4. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Wilson Wai San Tam

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DT, WT and NC conceived of the presented idea. ST and AM carried out the study. ST and AM contributed equally to the final version of the manuscript as first authors. DT, WT and NC helped supervise the project.

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Correspondence to Doreen Su-Yin Tan.

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Tang, S.W.Y., Mai, A.S., Chew, N.W.S. et al. The clinical impact of anti-hypertensive treatment drug-gene pairs in the asian population: a systematic review of publications in the past decade. J Hum Hypertens 37, 170–180 (2023). https://doi.org/10.1038/s41371-022-00765-y

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