Guiding hypertension treatment with pharmacogenomics: the role of the community pharmacist

摘要

Hypertension is a major risk factor for heart disease and stroke, which are theleading causes of death worldwide. Anti-hypertensive drugs account for the major drug classused in the treatment and prevention of cardiovascular diseases, although their use is basedon a trial-and-error rationale. For anti-hypertensive drugs the percentage of non-responderscan reach 20% of the patients under treatment, and non-compliance due to adverse drugresponses is frequent.Among the causes known which account for differences in drug response are theinterindividual genetic differences - the focus of study in Pharmacogenomics. Being able toprovide Pharmacogenomic tests in a community pharmacy setting gives the pharmacist anopportunity to individualize drug therapy, maximising efficacy and minimising toxicity, basedon patients’ genetic data.Given the number of hypertensive patients (circa 30% of global population), theexpenditure with cardiovascular drugs (one million euros per day in reimbursements inPortugal) and the difficulty in finding the right drug for each patient, being able to offerPharmacogenomic tests to hypertensive patients in a community pharmacy setting is anopportunity that should be seized.