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World Hypertension Day: Genetic Studies, Precision Medicine – Science Advances Toward A Cure

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World Hypertension Day: Hypertension, or high blood pressure, is the leading risk factor for cardiovascular diseases. About 220 million people in India are estimated to have hypertension, and only 12 per cent of them have their blood pressure under control, according to the World Health Organization (WHO). Primary hypertension cannot be cured, but secondary hypertension can be treated, if the cause is reversible. 

However, certain scientific advances can lead to a cure for primary hypertension too.

Scientific research and advances that can lead to a cure for primary hypertension 

The scientific advances which can lead to a cure for hypertension include genetic studies, precision medicines and RNA therapeutics, among others.

“Ongoing scientific research and advancements offer hope for potential breakthroughs that may lead to a cure or more effective management of hypertension in the future. Some scientific advances that hold promise in the quest for a cure for hypertension include genetic studies, precision medicine, novel drug therapeutics, RNA therapeutics, stell cell research, and artificial intelligence, among others,” Dr Preet Pal Thakur, Co-Founder, Glamyo Health, told ABP Live.

Genetic studies

It is important to understand the genetic factors associated with hypertension to obtain valuable insights for developing targeted therapies against high blood pressure.

“Genome-wide association studies (GWAS) have identified several genetic variants linked to blood pressure regulation. By deciphering the genetic basis of hypertension, researchers can potentially identify new drug targets and develop personalised treatment approaches,” Dr Thakur said.

Precision Medicine

Precision medicine, or personalised medicine, is an innovative approach to tailoring disease prevention and treatment. The technique takes into account differences in people’s genes, environments, lifestyles and other unique characteristics. 

“With advances in technologies like genomics, metabolomics, and wearable devices, researchers can gather comprehensive data and develop personalised treatment plans for patients with hypertension. This approach may lead to more effective interventions and better control of blood pressure,” Dr Thakur said.

Novel Drug Targets

Dr Thakur also suggested that exploring new drug targets beyond the traditional mechanisms of blood pressure regulation may offer novel treatment options for hypertension. 

“Researchers are investigating various pathways involved in vascular function, sodium balance, renin-angiotensin system, and endothelial dysfunction to identify potential targets for drug development. These discoveries may pave the way for more targeted and effective therapies,” he explained. 

The renin-angiotensin system, or the renin-angiotensin-aldosterone system, regulates blood pressure, blood volume, electrolyte and fluid balance, and systemic vascular resistance, which refers to the resistance in the circulatory system used to create blood pressure, facilitate the flow of blood, and is a component of cardiac function, according to the United States’ National Institutes of Health (NIH). 

Endothelial dysfunction is a condition in which there are no blockages in the heart arteries, but the vessels constrict, instead of dilating, because of the lack of nitric oxide, which acts as a vasodilator.

RNA Therapeutics

Small interfering RNA (siRNA) and antisense oligonucleotides are some advances in RNA-based therapeutics which hold promise for treating hypertension, according to Dr Thakur.

Small interfering RNA (siRNA), also known as silencing RNA, is a double-stranded RNA molecule that is non-coding, and is a powerful tool in drug targeting and therapeutics. They are used to silence genes of interest in molecular biology. 

Antisense oligonucleotides are small pieces of DNA or RNA that can bind to specific molecules of RNA, and block the ability of the RNA to make a protein or work, according to the NIH.

“Advances in RNA-based therapeutics, such as small interfering RNA (siRNA) and antisense oligonucleotides, hold promise for treating hypertension. These therapies can target specific genes or gene products involved in blood pressure regulation and potentially correct underlying molecular abnormalities associated with hypertension. RNA therapeutics have shown success in other disease areas and may offer innovative treatment options for hypertension in the future,” Dr Thakur said.

Stem Cell Research

Normal blood pressure can be restored with the help of stem cell research.

“Stem cell research offers the potential for regenerative therapies to repair damaged blood vessels and restore normal blood pressure. Scientists are exploring the use of various types of stem cells, including induced pluripotent stem cells (iPSCs), to generate functional blood vessels and replace dysfunctional or damaged cells in hypertensive individuals. While this area of research is still in its early stages, it holds promise for the development of regenerative treatments for hypertension,” Dr Thakur said.

Induced pluripotent stem cells are stem cells derived from skin or blood cells that have been reprogrammed back into an embryonic-like pluripotent state that enables  the development of an unlimited source of any type of human cell required for therapeutic purposes, according to the University of California Los Angeles. A pluripotent cell is a cell capable of developing into different types of cells or tissues in the body.

Artificial Intelligence and Machine Learning

Artificial intelligence and machine learning are being increasingly used in the field of healthcare. 

“These technologies can analyse large volumes of patient data, including medical records, genetic information, and lifestyle factors, to identify patterns and develop predictive models for hypertension. AI-driven algorithms may help in early detection, risk assessment, and personalised treatment strategies, leading to improved management of hypertension and potentially preventing its progression,” Dr Thakur said.

He also said that while a definitive cure for hypertension is yet to be discovered, these scientific advances offer promising avenues for future breakthroughs.

Dr Thakur concluded that as researchers continue to unravel the complexities of hypertension, collaborations between scientists, clinicians, and pharmaceutical companies will be crucial in translating scientific discoveries into effective treatments.

In order to maintain a healthy life and avoid hypertension, one should adopt a low-salt diet, and adopt the “Dietary Approaches to Stop Hypertension (DASH) diet”, Dr Pradeep Khandavalli, MBBS, DNB General Medicine, DM & DNB Nephrology, told ABP Live.

One should emphasise on protein, potassium, and water intake, he said. “Alongside these dietary changes, regular exercise and adherence to antihypertensive medication are essential.”

Dr Khandavalli also said that hypertension poses risks to multiple organs, including the brain and kidneys. He explained that by managing it effectively, one will not only control morbidity and mortality but also unlock a healthier and happier life.

“It is concerning that only 50% of hypertensive patients consistently take prescribed medication, leaving a significant gap between those who take action to control their blood pressure and those who neglect it,” he said.

Dr Khandavalli has said that people should prioritise following their doctor’s advice and taking proactive steps to manage their blood pressure.

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