New groundbreaking results from a clinical trial reinforce the critical importance of personalised medicine in hypertension care.
Results from the AIM-HY INFORM trial, presented today at the European Society of Cardiology Congress in Madrid, confirm that ethnicity is a relevant consideration in hypertension drug response.
The trial is the first of its kind in the UK and is part of a wider programme of work led by King's that seeks to understand whether ethnicity and the chemical makeup of blood can predict the best type of drug or combination of drugs to treat hypertension in a person.
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."
Professor Philip Chowienczyk, Lead Primary Investigator in the AIM-HY programme, King's College London
Hypertension, also known as high blood pressure, is a leading risk factor for heart attacks, strokes, kidney failure, dementia, and premature death. It affects one in three adults yet often goes undetected because it has no symptoms.
Unlike many chronic conditions, hypertension can be easily identified and controlled, with regular monitoring, healthier lifestyles, and effective medication transforming outcomes.
The AIM-HY INFORM trial, part of the wider AIM-HY programme led by King's, was funded by the British Heart Foundation and the Medical Research Council. The trial involved 829 participants from Black, South Asian and White backgrounds. Each participant received multiple blood pressure treatments, allowing for precise comparisons within each person. The trial results confirm significant differences between Black, South Asian and White patients in response to both single-drug and dual-combination antihypertensive therapies among different ethnic groups in the UK.
The results could inform more tailored and effective treatments and offer potential cost savings as well as significantly enhance patient outcomes through more targeted therapies. The trial also highlighted biological mechanisms underlying these variations, such as notably lower plasma renin levels in Black patients, providing crucial insights into why certain medications perform differently across groups. They demonstrate that ethnicity-related differences in drug response have clear biological foundations and could transform outcomes for the more than 7 million people of Black and South Asian heritage in the UK, of which at least 2 million require treatment for hypertension.
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 Ian Wilkinson, of the University of Cambridge Division of Experimental Medicine and Immunotherapeutics, Chief Investigator of the AIM-HY INFORM trial and Chief and President of the British & Irish Hypertension Society
