Precision Medicine - Enhancing hypertension treatment outcomes through biomarker driven adherence assessment

• Applicant: Dr. Selina Hemmer
• Subject Area: Toxicology, Laboratory Medicine ; Pharmacy
• Term: since 2025
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 564577882

Hypertension is one of the most common chronic diseases worldwide. Despite the existence of numerous treatment options, non-adherence remains a significant problem. Many patients do not take their antihypertensive medication as prescribed. This leads to inadequate treatment outcomes, an increased risk of cardiovascular disease and a significant burden on the healthcare system. The aim of this project is to identify and validate biomarkers that can reliably detect both the use of angiotensin-converting enzyme inhibitors (ACEi) and their therapeutic effect. ACEi represent an important group of drugs in the treatment of hypertension. Their mode of action is based on the inhibition of the angiotensin-converting enzyme, which inhibits the formation of the vasoconstrictor hormone angiotensin II. In the first step, a method is being developed to analyze biomarker profiles based on the analysis of angiotensin II concentrations and therapeutic ACEi levels in the blood plasma of ACEi-treated and non-treated patients. Non-targeted pharmacometabolomic approaches are used to identify additional biomarkers in blood and urine that are influenced by ACEi therapy. These approaches allow a deeper insight into the biochemical changes associated with the treatment. The identified biomarkers will then be correlated with angiotensin II concentrations and blood pressure values. Particular attention will be paid to the clear distinction between non-adherence and true treatment resistance. This differentiation is crucial for adapting the treatment. If blood pressure cannot be adequately controlled despite ACEi therapy, the biomarkers can help to identify the cause of the inadequate effect. Furthermore, the investigation is ongoing to ascertain the potential of the detection of these biomarkers in alternative sample matrices, such as oral fluid, dried blood spots, and exhaled breath. The use of such less invasive sample matrices has the capacity to significantly facilitate the monitoring of drug intake and enable its application in non-clinical settings. The identification of specific biomarkers allows a more precise assessment of adherence and treatment success, thereby supporting individualized treatment decisions. Precision medicine approaches can not only increase the effectiveness of therapy but also reduce the incidence of secondary diseases and relieve the burden on the healthcare system. The results of this project have the potential to fundamentally change the management of hypertension. In the long term, this research will help to sustainably improve the care of patients with chronic high blood pressure and establish personalized treatment strategies based on individual patient profiles.

• DFG Programme: Research Grants
• Co-Investigator: Professor Dr. Markus R. Meyer