High blood pressure is one of the most important preventable causes of heart disease and stroke.
It happens when blood pushes against the walls of the arteries with too much force over time, making the heart and blood vessels work harder.
Doctors often recommend exercise, a healthy diet, weight control and less salt to help lower blood pressure. Many people also need medicine, especially when lifestyle changes alone are not enough to bring their blood pressure into a safer range.
Several types of drugs are used to treat high blood pressure. These include ACE inhibitors, beta-blockers and calcium channel blockers, which lower blood pressure in different ways and have helped prevent many heart attacks and strokes.
However, medicines can sometimes affect parts of the body beyond the problem they are designed to treat. Finding uncommon or unexpected side effects can be difficult because traditional clinical trials may require large numbers of people and years of follow-up.
Researchers led by Imperial College London used genetics to look for possible effects of common blood pressure medicines. Instead of giving drugs to hundreds of thousands of people, they studied naturally occurring genetic differences that can imitate some of the biological effects of the medicines.
The team first identified proteins targeted by ACE inhibitors, beta-blockers and calcium channel blockers. They then examined genetic information from around 750,000 people to find gene variants connected with these drug targets.
This approach allowed the researchers to ask whether people whose genes naturally produced drug-like effects also had different risks of disease. As expected, genetic patterns that represented lower blood pressure were linked with lower risks of coronary heart disease and stroke.
The researchers then searched for less obvious effects. Using UK Biobank data, they examined links with nearly 900 diseases and health conditions, looking for signals that might reveal possible side effects or new uses for the medicines.
One result attracted particular attention. Genetic changes that mimicked the effects of calcium channel blockers were associated with a higher risk of diverticulosis, a condition in which small pouches form in the wall of the intestine.
Diverticulosis becomes much more common with age and often causes no symptoms. In some people, however, the pouches can be linked with abdominal pain or bleeding, and they can sometimes become inflamed or infected, leading to a condition called diverticulitis.
Further analysis suggested that the possible association was mainly connected with non-dihydropyridine calcium channel blockers, a subgroup that includes medicines such as verapamil and diltiazem. The researchers said the reason for the link was uncertain, but one possibility is that these drugs affect the muscles that move food through the intestine.
The finding does not prove that these medicines directly cause diverticulosis. Genetic studies can provide useful clues about cause and effect, but they cannot replace clinical trials or careful studies of patients actually taking the drugs.
For that reason, the researchers stressed that the results should not change current treatment. People taking blood pressure medicine should not stop it or change their dose because of this study without first speaking with a doctor.
The research shows how large genetic databases may help scientists discover unexpected effects of widely used medicines more quickly. Such clues can help researchers decide which possible risks deserve closer testing in future clinical studies.
The study, titled “Use of Genetic Variants Related to Antihypertensive Drugs to Inform on Efficacy and Side Effects,” was published in the American Heart Association journal Circulation. The researchers said the possible link between non-dihydropyridine calcium channel blockers and diverticulosis needs further investigation before it can guide medical care.
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