Pharmacogenetics of the response to antihypertensive drugs

In the United States, only about one third of hypertensive individuals successfully control their blood pressure. One reason for this is the unpredictable response individuals have to treatment. Clinicians often rely on empirical methods to match patients with effective treatment. Hypertension pharmacogenetics seeks to find genetic predictors of response to drugs that reduce blood pressure or unfavorable cardiovascular outcomes. For more than a decade, investigators have been assessing associations between genetic polymorphisms and response to antihypertensive drugs. This article reviews 29 studies published since 2008. Although inconsistent findings remain common, trends are emerging for several gene-treatment combinations. Nevertheless, researchers continue to cite differences in study design, variable methods for assessing pharmacologic exposures, and small sample sizes as explanations for these inconsistencies. Assuming that common genetic variation plays a role in response to antihypertensive drugs, disciplinary progress hinges on our ability to launch large studies using high-fidelity phenotyping with multiple drugs and ethnic groups.