Drugs

, Volume 64, Issue 16, pp 1801–1816

Drug-Gene Interactions between Genetic Polymorphisms and Antihypertensive Therapy

Authors

  • Hedi Schelleman
    • Department of Epidemiology & BiostatisticsErasmus MC
    • Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute of Pharmaceutical Sciences (UIPS)Utrecht University
    • Department of Epidemiology & BiostatisticsErasmus MC
  • Anthonius de Boer
    • Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute of Pharmaceutical Sciences (UIPS)Utrecht University
  • Abraham A. Kroon
    • Department of Internal MedicineUniversity Hospital of Maastricht and Cardiovascular Research Institute Maastricht (CARIM)
  • Monique W. M. Verschuren
    • Centre for Prevention and Health Services ResearchNational Institute of Public Health and the Environment (RIVM)
  • Cornelia M. van Duijn
    • Department of Epidemiology & BiostatisticsErasmus MC
  • Bruce M. Psaty
    • Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health ServicesUniversity of Washington
  • Olaf H. Klungel
    • Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute of Pharmaceutical Sciences (UIPS)Utrecht University
Review Article

DOI: 10.2165/00003495-200464160-00006

Cite this article as:
Schelleman, H., Stricker, B.H.C., de Boer, A. et al. Drugs (2004) 64: 1801. doi:10.2165/00003495-200464160-00006
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Abstract

Genetic factors may influence the response to antihypertensive medication. A number of studies have investigated genetic polymorphisms as determinants of cardiovascular response to antihypertensive drug therapy. In most candidate gene studies, no such drug-gene interactions were found. However, there is observational evidence that hypertensive patients with the 460W allele of the α-adducin gene have a lower risk of myocardial infarction and stroke when treated with diuretics compared with other antihypertensive therapies. With regard to blood pressure response, interactions were found between genetic polymorphisms for endothelial nitric oxide synthase and diuretics, the α-adducin gene and diuretics, the α-subunit of G protein and β-adrenoceptor antagonists, and the ACE gene and angiotensin II type 1 (AT1) receptor antagonists. Other studies found an interaction between ACE inhibitors and the ACE insertion/deletion (I/D) polymorphism, which resulted in differences in AT1 receptor mRNA expression, left ventricular hypertrophy and arterial stiffness between different genetic variants. Also, drug-gene interactions between calcium channel antagonists and ACE I/D polymorphism regarding arterial stiffness have been reported. Unfortunately, the quality of these studies is quite variable. Given the methodological problems, the results from the candidate gene studies are still inconclusive and further research is necessary.

Copyright information

© Adis Data Information BV 2004