Algorithm for selecting drugs for antihypertensive therapy in dorsopathy patients

P450 (CYP 2C8, CYP 2C9) is involved in the biotransformation of antihypertensive drugs and NSAIDs. For individuals with known cytochrome P450 enzyme activity, it is possible to select a drug and its dosage regimen to achieve a clinical effect [Zhestovskaya A. S., Kukes V. G., Sychev D. A. 2013]. In studies by foreign authors [Jang J. H., Jeong S. H., Lee Y. B. 2023], it has been found that the pharmacokinetics of meloxicam depends on the allelic variant of CYP2C9*1/*1 and CYP2C9*1/*3. In the work by Boyarko A.V. et al. 2021, the detection of CYP2C9*2 and CYP2C9*3 in a patient is associated with an increase in the dose of losartan, in contrast to that in patients with the CYP2C9*1/*1 genotype. In contrast, according to studies, the CYP2C9*2 and CYP2C9*3 alleles do not affect the antihypertensive effect of losartan [Yasar Ü. et al. 2002]. With regard to drugs from the calcium channel blocker (CCB) group, a previously conducted study revealed a dependence of the activity of the 3A4 and 3A5 isoenzyme in patients receiving amlodipine [M.N. Dorofeeva, E.V. Shikh, 2020]. For further research, it is essential to determine the activity of CYP2C9 and 3A4 enzymes when prescribing drugs of various pharmacological groups (ARB, CCB, NSAID) in patients with a combination of hypertension and pain syndrome. The development of algorithms for personalized selection of antihypertensive therapy in patients with a combination of hypertension and chronic pain syndrome against the back ground of dorsopathy is of current importance.