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Background: Genome-wide association studies identified the major A allele of SNP rs13333226 to be associated with increased BP and uromodulin excretion. Observational studies indicate those with rs13333226-AA genotype have greater BP lowering in response to loop diuretics.

Methods: This genotype blinded multi-centre trial (NCT03354897) enrolled hypertensive participants without diabetes aged ≥18 years with home SBP >135 mmHg and/or DBP >85 mmHg despite treatment with ≥1 non diuretic antihypertensive drug for ≥3 months. Participants were prescribed torasemide 5mg daily for 16 weeks with ABPM BP measured at baseline, 8 and 16 weeks. Primary endpoint was change in 24h ABPM SBP between baseline and end of treatment by genotype (AA vs AG/GG).

Results: We screened 251 patients, with 222 prescribed torasemide; 174 had genotype data and took ≥80% of dispensed torasemide …