MICA: Ancestry and biological Informative Markers for stratification of HYpertension: The AIM HY study

高血压在英国和全世界的普通人群中极为常见，是心脏病、肾病和中风的主要原因。它被认为是造成全球疾病负担的最大单一因素。对于大多数高血压患者来说，仅靠健康的生活方式是不足以控制血压的，需要药物治疗。有各种各样的药物可供选择，虽然这些是有效和安全的，但经常有必要尝试不同类型的药物，经常使用两种或两种以上药物的组合。通过“反复试验”来选择正确的片剂或片剂组合的延迟是一个主要问题，而且在很大一部分高血压患者中，血压没有得到充分控制。关于为什么有些人对一种药片或药片组合的反应比其他药片更好，人们知之甚少。众所周知，在英国不同的种族群体对治疗的反应不同，在欧洲、亚洲和非洲的人群之间也可能存在差异。这项研究计划的目的是确定我们是否可以使用祖先的遗传标记（预测一个人来自欧洲、亚洲和非洲的祖先的比例）和血液中循环的化学“代谢物”的详细测量，描述每个人的生化过程，以预测最适合那个人的药物类型或药物组合。如果需要联合用药，我们可以使用一种新技术将这些药物放入一片药片中。我们希望这将为英国和其他国家的高血压单片治疗提供一种更有效、更简单的方法。

High blood pressure (hypertension) is extremely common within the general population in the UK and worldwide and is a major cause of heart disease, kidney disease and stroke. It is recognised to be the single biggest contributor to the global burden of disease. In most people with hypertension, a healthy lifestyle alone is not enough to control blood pressure, and drug treatment is required. There are a wide variety of drugs available and although these are effective and safe, it is often necessary to try different types of drugs and often to use a combination of two or more drugs. Delay in choosing the right kind of tablet or combination of tablets through "trial and error" is a major problem and, in a large proportion of people with hypertension, blood pressure is not adequately controlled. Relatively little is known about why some people respond better to one kind of tablet or combination of tablets than others. It is know that response to treatment differs in different ethnic groups in the UK and may differ between populations in Europe, Asia and Africa. The objective of this research proposal is to determine if we can use genetic markers of ancestry (which predict the proportion of a person's ancestors from Europe, Asia and Africa) and a detailed measure of chemical "metabolites" circulating in the blood that characterise the biochemical processes in each person to predict the best type of drug or combination of drugs for that person. If a combination of drugs is required we can use a new technology to put these into a single tablet. We hope that this will provide a more effective simpler approach to single tablet treatment of hypertension both in the UK and in other countries.