{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T15:03:54Z","timestamp":1789743834713,"version":"4.0.1"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The advent of pharmacogenomics-guided antihypertensive therapy represents a paradigm shift in hypertension management. This study aimed to investigate the prevalence of relevant genetic variants among hypertensive patients in Hunan Province, China, and evaluate the efficacy of genotype-directed vs. clinically guided therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 2,702 patients with essential hypertension from 14 hospitals were enrolled and evenly randomized to either a control group receiving standard care or an experimental group receiving pharmacogenomics-tailored medication. Genetic variants in seven gene loci (\n                      <jats:italic>ADRB1<\/jats:italic>\n                      ,\n                      <jats:italic>CYP2D6<\/jats:italic>\n                      ,\n                      <jats:italic>CYP3A5<\/jats:italic>\n                      ,\n                      <jats:italic>CACNA1C<\/jats:italic>\n                      ,\n                      <jats:italic>CYP2C9<\/jats:italic>\n                      ,\n                      <jats:italic>ACE<\/jats:italic>\n                      ,\n                      <jats:italic>ADD1<\/jats:italic>\n                      ) associated with five major drug classes were analyzed. Blood pressure and biochemical parameters were assessed at baseline and 4 weeks post-intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The frequencies of the risk allele frequencies for\n                      <jats:italic>ACE<\/jats:italic>\n                      ,\n                      <jats:italic>CYP2C9<\/jats:italic>\n                      ,\n                      <jats:italic>ADRB1<\/jats:italic>\n                      ,\n                      <jats:italic>CYP2D6<\/jats:italic>\n                      ,\n                      <jats:italic>CYP3A5<\/jats:italic>\n                      ,\n                      <jats:italic>CACNA1C<\/jats:italic>\n                      , and\n                      <jats:italic>ADD1<\/jats:italic>\n                      were 34.3%, 4.8%, 74.8%, 57.3%, 69.8%, 11.9%, and 46.3%, respectively. After 4 weeks, blood pressure significantly decreased in both groups (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), with a more pronounced reduction observed in the experimental group (from 155.45\/92.12\u2005mmHg to 129.03\/76.96\u2005mmHg) compared to the control group (from 156.52\/91.75\u2005mmHg to 143.74\/82.73\u2005mmHg). The genotype-guided group also achieved a significantly higher blood pressure control rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings highlight the critical role of genetic profiling in antihypertensive drug selection. Personalized treatment based on pharmacogenomics offers a more effective strategy for hypertension management. In the studied Hunan population, angiotensin II receptor blockers and beta-blockers emerged as particularly efficacious options under genotype guidance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1842597","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:11:16Z","timestamp":1789740676000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacogenomics-guided therapy for essential hypertension: a multi-center randomized controlled open-label trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Sha","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Research Institute of Blood Lipids and Atherosclerosis, The Second Xiangya Hospital of Central South University","place":["Changsha, 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