Essential Hypertension: Translating Pathophysiology into Pharmacogenomics

Abstract

This paper will review the literature on the most recent advances of pharmacogenomics of essential hypertension. Specifically, the hypotheses regarding the responsibility of gene polymorphisms in hypertension and whether the pathophysiological mechanisms underlying hypertension can be translated in pharmacogenomic evidence will be analyzed. In particular, the present review will cover the role of genes in blood pressure regulation (mostly, sodiumsensitivity and vasoconstriction) as well as in the antihypertensive response to drugs: associations, lack of associations and contradictory results will be evaluated, and the reasons for discrepancies examined. Emphasis will be placed on the methodologies used so far to conceive and develop pharmacogenomic hypotheses to improve our capability to achieve solid, unequivocal results to be translated in the day-by-day clinical practice.

Integrating the Pathophysiology and Pharmacogenomics of Essential Hypertension

“…as in this case) hypertension. Nevertheless, as discussed in our A multidisciplinary approach to EH will modify 'old-fashrecent review, the results originating from pharmacogenomic studioned' pathophysiology to provide cause and effect relationships ies are frequently biased by important methodological flaws in for a clustering of phenomenology that is logical but still insuffistudy design, patient selection and statistical analysis, [74] which are cient to improve understanding of the disease. Determinants of summarised in table II. disease are not the same as determinants of response to treatment.…”