A widely used diuretic, torasemide, may offer a more effective treatment option for individuals with uncontrolled high blood pressure, particularly those carrying a common variant of the uromodulin (UMOD) gene. The British Heart Foundation (BHF) study, published in Hypertension, found that patients with two copies of this genetic variation experienced a significant reduction in blood pressure after treatment with torasemide.
Genetic Link to Blood Pressure Response
The study, led by the University of Glasgow, involved 174 participants with uncontrolled hypertension. Genetic testing revealed that approximately two-thirds of the participants had two copies of a specific UMOD gene variant, previously linked to an increased risk of high blood pressure. After 16 weeks of torasemide treatment, this group experienced an average blood pressure reduction of nearly 5%, a change researchers believe could substantially improve long-term cardiovascular health.
Torasemide's Impact on Hypertension
Torasemide, a loop diuretic typically used to manage fluid overload associated with conditions like heart failure and kidney disease, has not been commonly used to treat high blood pressure. The trial results indicated that individuals with two copies of the UMOD variant not only experienced a greater reduction in blood pressure but also demonstrated a more sustained response compared to those with one or no copies of the variant, who experienced a rebound in blood pressure after an initial drop.
Precision Medicine Approach
Professor Sandosh Padmanabhan, Pontecorvo Chair of Pharmacogenomics at the University of Glasgow, emphasized the potential of a precision medicine approach. "By doing a simple genetic test using saliva or blood from the patient, we can predict how effectively this commonly used drug will control hypertension in individual patients," he stated. This personalized approach could significantly improve treatment outcomes, especially for patients who have struggled to manage their hypertension effectively.
Implications for Hypertension Management
With at least 11 million people in the UK diagnosed with high blood pressure and an estimated 3 million still experiencing uncontrolled hypertension, this research offers a promising avenue for improved management. Uncontrolled hypertension is a major health concern, contributing to a significant proportion of heart attacks and strokes and costing the NHS over £2.1 billion annually.
Future Research
Professor James Leiper, Associate Medical Director at the British Heart Foundation, noted the need for larger trials to validate these findings. "This promising research has used the latest findings in genetic science to investigate how we could in future tailor treatment for many of these patients," he said. Further studies are essential to confirm whether torasemide and other loop diuretics could become a significant tool in combating uncontrolled hypertension on a broader scale.
