BACKGROUND
Hypertension management is often suboptimal due to interindividual variability in drug response. Pharmacogenomics testing may guide personalized therapy by identifying genetic polymorphisms affecting drug efficacy and safety. This study aimed to evaluate whether pharmacogenomics-guided therapy improves blood pressure control and treatment compliance and reduces rehospitalization in patients with hypertension.
MATERIAL AND METHODS
In this prospective randomized controlled trial, 900 patients with hypertension were assigned to a control group (CG, n=450) receiving conventional care or a study group (SG, n=450) receiving pharmacogenomic-guided therapy. Six gene loci (CYP2D6, CYP2C9, AGTR1, ACE, NPPA, CYP3A5) related to 5 antihypertensive drug classes were tested. Outcomes included blood pressure control rate, compliance, adverse reactions, drug adjustments, and 6-month readmission rate.
RESULTS
The SG achieved significantly higher blood pressure control rates at 3 months (80.7% vs 70.2%, P<0.001) and 6 months (78.4% vs 65.1%, P<0.001) compared with the CG. Treatment compliance was also higher in the SG (98.0% vs 74.0%, P<0.001). angiotensin-converting enzyme inhibitor–related dry cough incidence was lower in the SG (1.6% vs 8.3%, P<0.001). The SG required fewer drug adjustments during hospitalization and had a lower 6-month readmission rate (2.4% vs 8.9%, P<0.001).
CONCLUSIONS
Pharmacogenomic-guided individualized therapy improves blood pressure control, enhances treatment adherence, reduces specific adverse reactions, and decreases rehospitalization. These findings support integrating pharmacogenomic testing into personalized hypertension management.

Keywords: Antihypertensive Agents; Cardio-Renal Syndrome; Hypertension; Polymorphism, Single Nucleotide; Randomized Controlled Trial; src Homology Domains