Genetic Passports for Hypertension Patients: Sechenov University Researchers Learn to Match Medication to DNA
One patient takes a blood pressure pill and improves. Another one takes the same medication and faints because of a sharp drop in blood pressure. Why? The answer lies in genetics. Russian researchers have developed an algorithm that uses DNA analysis to select both medication and dosage on an individual basis.
Protecting Patients From the “Silent Killer”
Hypertension is one of the most common cardiovascular diseases. It is often called a “silent killer” because it may show no symptoms while remaining one of the leading causes of heart attacks and strokes. That makes long-term medication a lifelong necessity. There are many drugs used to treat high blood pressure, but they do not work equally well for every patient. Researchers at Sechenov University found that the explanation lies in genetic differences.
Researchers from the Department of Clinical Pharmacology studied why patients with arterial hypertension respond differently to standard treatment regimens. They identified individual genetic characteristics as the key factor. Based on those findings, the team developed and patented an algorithm.
The process is relatively straightforward. A patient undergoes genetic testing for several key markers – CYP2C9, AGT, CYP11B2 and ACE. The physician then receives the results and selects both the medication and dosage regimen best suited to that individual. The entire approach is based on genetics and clinical pharmacology.
The study results were published in the scientific journal Pharmacy and Pharmacology. The developers now plan to expand the algorithm to cover additional classes of antihypertensive drugs.
Science-Based Effectiveness
The study involved 179 people with newly diagnosed hypertension who had not previously received treatment. Researchers prescribed therapy, conducted genetic testing and monitored both blood pressure and drug concentrations in patients’ bloodstreams over a three-month period.
The study identified an important pattern: carriers of a specific CYP2C9 gene variant faced a significantly higher risk of sudden blood pressure drops while taking irbesartan, a medication from the angiotensin II receptor blocker class commonly prescribed for hypertension.
Associated side effects included dizziness, weakness and even fainting. For such patients, researchers recommend alternative medications, including valsartan.
Researchers also found that irbesartan’s effectiveness depends on its concentration in the bloodstream. However, that effect was only noticeable during the first three weeks of treatment, after which sensitivity decreased in some patients. No such relationship was identified for valsartan.
Doctors who know a patient’s genetic profile can now prescribe the medication most likely to work immediately while avoiding drugs that could trigger adverse side effects. That removes the traditional “let’s try this first and switch later if needed” approach. Hypertension medications are often expensive. If a drug proves ineffective, patients may have to discard it entirely. Genetic-guided therapy selection helps save time, money and stress.
Important for Russia
Sechenov University’s development is already becoming part of the broader expansion of pharmacogenetics in Russia. The Russian Scientific Center of Surgery has established a Center for Predictive Genetics, Pharmacogenetics and Personalized Therapy. The center currently works with 11 key groups of medications. By 2030, Russia plans to deploy more than 20 domestic pharmacogenetic testing systems.
A federal trend is also taking shape through the Scientific and Technological Program for the Development of Genetic Technologies for 2019–2030. The initiative is aimed at creating technological foundations for medicine, agriculture and industry. In September 2024, the Russian Health Ministry’s Scientific and Practical Council approved updated clinical guidelines for arterial hypertension in adults.
Important for the World
The scale of the problem is enormous. According to WHO data released in 2025, the number of people living with hypertension worldwide reached 1.4 billion in 2024. Blood pressure control remains insufficient globally. Any technology that improves treatment effectiveness represents not simply a scientific breakthrough, but potentially lives saved.
The algorithm also has export potential. Countries with high rates of cardiovascular disease – which includes nearly all developed and developing economies – are actively seeking ways to reduce mortality from strokes and heart attacks. If the Russian methodology proves effective at scale, demand for it is likely to emerge internationally.
Russian developers are now planning to expand the algorithm to cover additional groups of antihypertensive drugs. More broadly, pharmacogenetic testing is becoming a growing trend not only in cardiology, but also in oncology, psychiatry and the treatment of autoimmune diseases.
