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

Abstract

Hypertension is a major risk factor for heart disease and stroke, which are the leading causes of death worldwide. Anti-hypertensive drugs account for the major drug class used in the treatment and prevention of cardiovascular diseases, although their use is based on a trial-and-error rationale. For anti-hypertensive drugs the percentage of non-responders can reach 20% of the patients under treatment, and non-compliance due to adverse drug responses is frequent. Among the causes known which account for differences in drug response are the interindividual genetic differences - the focus of study in Pharmacogenomics. Being able to provide Pharmacogenomic tests in a community pharmacy setting gives the pharmacist an opportunity to individualize drug therapy, maximising efficacy and minimising toxicity, based on patients’ genetic data. Given the number of hypertensive patients (circa 30% of global population), the expenditure with cardiovascular drugs (one million euros per day in reimbursements in Portugal) and the difficulty in finding the right drug for each patient, being able to offer Pharmacogenomic tests to hypertensive patients in a community pharmacy setting is an opportunity that should be seized.