Benefits of Pharmacogenetics in the Management of Hypertension

Abstract

This alarming situation, linked to a great extent with the pharmacological treatment of this disorder of a habitually chronic nature, augments the need to take caution to extremes when prescribing antihypertensives, and encouraging strict adjustment to prescriptive

Pharmacogenetic Considerations in the Treatment of Alzheimer’s Disease

“…Both requirements are necessary in dementia, to cope with efficacy and safety issues associated with current antidementia drugs (Table 1) and other medications (antidiabetics, statins, cardiotonic agents, antihypertensive drugs, antiParkinsonian drugs, psychotropics) of common use [2,3]. A practical example of the importance of the use of pharmacogenetics for a correct drug prescrip tion is the fact that by trialanderror, neglecting the pharmacogenetic profile of patients, the prescription error rate of psychotropic drugs or antihypertensive agents in the community is over 50% [168,169]. These numbers are not surprising if we assume that over 70% of the Caucasian population is defective for the CYP2D6/2C9/2C19/3A4 genetic cluster through which 60-80% of common drugs are metabolized [19].…”

Pharmacogenomics of Hypertension Treatment

“…Within the next 20 years, the number of individuals suffering from hypertension is believed to rise by 60% to a total of more than 1.5 billion individuals [ 1 , 3 ]. Currently, 46 percent of U.S. adults are estimated to have hypertension, among whom only 80 percent are aware of their condition, and even fewer follow pharmacological treatment [ 4 , 5 ]. Adequate blood pressure control is reported in approximately 53% of these individuals [ 4 , 5 ].…”

“…Currently, 46 percent of U.S. adults are estimated to have hypertension, among whom only 80 percent are aware of their condition, and even fewer follow pharmacological treatment [ 4 , 5 ]. Adequate blood pressure control is reported in approximately 53% of these individuals [ 4 , 5 ]. The high prevalence of undiagnosed and uncontrolled hypertension is associated with a frequent lack of specific clinical manifestations of hypertension (it is also called a “silent killer”), poor efficacy of treatments, and low adherence resulting from possible adverse reactions to active ingredients, despite increasing public awareness of hypertension and its complications [ 4 , 5 , 6 ].…”

“…Adequate blood pressure control is reported in approximately 53% of these individuals [ 4 , 5 ]. The high prevalence of undiagnosed and uncontrolled hypertension is associated with a frequent lack of specific clinical manifestations of hypertension (it is also called a “silent killer”), poor efficacy of treatments, and low adherence resulting from possible adverse reactions to active ingredients, despite increasing public awareness of hypertension and its complications [ 4 , 5 , 6 ]. The low efficacy of some therapies could be related to inter-individual genetic variability.…”

“…Genetic variability may modulate the drug response via genes that are engaged in the pathomechanisms of hypertension development and alter the effects of drugs, modifications of mechanistic interactions between drugs and genes, and the polymorphisms in genes related to drug transporters. Moreover, drug responses can be affected by genetic polymorphisms in genes encoding drug-metabolizing enzymes and pleiotropic genes participating in metabolic reactions and complex cascades [ 4 , 14 ]. Genome-wide association studies (GWASs) have led to the discovery of variants associated with drug efficacy and adverse drug reactions.…”