“Blood Pressure” by Bernard Goldbach is licensed under CC BY 2.0

Hypertension: Personalized Treatment May Reduce Need for Higher Doses and Multiple Medications

MedicalResearch.com Interview with:

Johan Sundström, MD, PhDProfessor of Epidemiology at Uppsala University Professorial Fellow at The George Institute for Global Health Cardiologist at Uppsala University Hospital

Dr. Sundström

Johan Sundström, MD, PhD
Professor of Epidemiology at Uppsala University
Professorial Fellow at The George Institute for Global Health
Cardiologist at Uppsala University Hospital

MedicalResearch.com: What is the background for this study?

Response: High blood pressure, hypertension, is a growing global health challenge. Over the last 30 years, the number of people with hypertension has doubled, and it is estimated that around a third of adults aged 30-79 have the condition – a total of 1.28 billion people worldwide. Untreated hypertension can lead to kidney disease, heart disease, and stroke, accounting for 11.3 million deaths in 2021 alone. A small minority get their blood pressure under control with drug therapy, and some studies indicate that as little as half are taking their blood pressure medications as intended. Is this because the drugs’ effectiveness and side effects differ between different individuals? If so, there would be a substantial risk that patients will not get their optimal medication on the first try, with poor blood pressure lowering and unnecessary side effects as a result.

In a new clinical trial in Sweden, it was studied whether there is an optimal blood pressure medication for each person, and thus a potential for personalized blood pressure treatment. In the study, 280 people with high blood pressure tried out four different blood pressure drugs on several different occasions over a total of one year.

MedicalResearch.com: What are the main findings? Were there gender or ethnic differences in responses?

Response:       The study showed that the treatment effect varied greatly by medication and by individual. By finding the optimal treatment for an individual, blood pressure levels could be reduced to twice the levels capable of doubling the dose of a sub-optimal treatment. Optimizing treatment by personalization also has more than half the effect of adding a second blood pressure medication.

MedicalResearch.com: What should readers take away from your report?

Response: With these findings, we have evidence that existing blood pressure treatments can be optimised for maximum patient benefit. Personalized treatment may reduce the need for higher doses and multiple medications, with the potential to improve treatment adherence, patient outcomes, and cost efficacy.

MedicalResearch.com: What recommendations do you have for future research as a results of this study?

Response: Given the size of the likely benefits, additional studies to confirm these findings, to test for the potential of personalization of combination antihypertensive therapy, and to identify mechanisms to enable the personalization of antihypertensive therapy in routine clinical practice should be a priority.

Disclosures: This study was supported by the Swedish Research Council (grant 921-2014-7126), The Kjell and Märta Beijer Foundation, and Anders Wiklöf.


Sundström J, Lind L, Nowrouzi S, et al. Heterogeneity in Blood Pressure Response to 4 Antihypertensive DrugsA Randomized Clinical TrialJAMA. 2023;329(14):1160–1169. doi:10.1001/jama.2023.3322

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Last Updated on April 11, 2023 by Marie Benz