Ethnicity may significantly affect how patients respond to hypertension medication, a research study has found, highlighting the critical importance of personalised medicine in blood pressure management.
Results from the AIM-HY INFORM trial, presented at the recent European Society of Cardiology Congress in Madrid and coinciding with preparations for the 2025 Know your numbers campaign (8-14 September), show clear differences in blood pressure responses among Black, South Asian, and White patients for both single-drug and dual-combination therapies.
The results could transform health outcomes for over seven million people of Black and South Asian heritage in the UK, including at least two million who currently need treatment, the King’s College London (KCL) researchers predicted.
The study investigated whether ethnicity and the chemical composition of blood can predict the most effective type of drug or combination of medications for treating hypertension in an individual. The ultimate aim of the trial is to deliver personalised treatment for high blood pressure, based on knowledge of how an individual will respond, reducing the number of appointments a patient has and providing faster, more effective treatment.
Potential to tailor treatment to ethnicity
Funded by the British Heart Foundation and the Medical Research Council, the study involved 829 participants from Black, South Asian and White ethnic backgrounds. The participants each received multiple blood pressure treatments, allowing for direct comparisons of individual responses to be made.
The researchers found significantly different responses to treatment across the different ethnicities for both single-drug and dual-combination antihypertensive therapies. They also discovered evidence of lower plasma renin levels in Black patients, suggesting that ethnicity-related differences in drug response have clear biological foundations.
Professor Ian Wilkinson, of the University of Cambridge Division of Experimental Medicine and Immunotherapeutics, chief investigator of the AIM-HY INFORM trial and president of the British and Irish Hypertension Society (BIHS), said: ‘These important findings could influence treatment choices for millions with high blood pressure.
‘They confirm NICE is right to base initial single-drug therapy on ethnicity but reveal that the most effective two-drug diuretic combination (water tablets) is not currently recommended, regardless of ethnicity. Overall, these drugs were well tolerated, and the BIHS will urge NICE to review its guidance in light of these results.’
Professor Philip Chowienczyk, lead primary investigator in the AIM-HY programme and professor of clinical cardiovascular pharmacology at KCL, added: ‘The AIM-HY trial will help us give everybody in the UK the best treatment for hypertension by tailoring treatment according to ethnicity.
‘The next challenge is to be able to use biological markers to predict the best treatments and to develop treatments that are equally effective in all ethnic groups.’
Earlier this year, research uncovered clear differences in the development of hypertension between South Asian and East Asian adults.
In 2023, a genetic study revealed clopidogrel to be ineffective for myocardial infarction prevention in the majority of British south Asians when compared to those of European descent.
A version of this article was originally published by our sister publication Nursing in Practice.