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Genetics Influence Blood Pressure Medications
Date:1/22/2008

attack and stroke.

Previous studies have shown that the presence of certain gene characteristics can predict response to treatments such as ACE inhibitors, which are drugs used to control hypertension. But this information hasn't been adopted widely by doctors.

The new study focused on the NPPA (atrial natriuretic precursor A) gene, which is involved in forming atrial natriuretic polypeptide, which acts as a diuretic.

Specifically, the study authors wanted to see if people with hypertension and two different NPPA genotypes (known as NPPA G664A and NPPA T2238C) responded differently to different medications.

In all, 38,462 people with hypertension underwent genotyping [genetic testing] and were randomly assigned to receive a diuretic (chlorthalidone) or one of the following three drugs: a calcium channel blocker (amlodipine); an angiotensin converting enzyme inhibitor (lisinopril); or an alpha-blocker (doxazosin).

People with the more common subtype of the NPPA gene responded better to the calcium channel blocker than the diuretic. There were no differences in response between the diuretic and the other two drugs studied, the researchers said.

People with the other genotype fared better on the diuretic.

"Eventually we should be able to utilize prescreening for treatment to determine which drug you may respond best to," Arnett said. "This is a small but important step towards personalized medicine."

More information

The American Heart Association has more on high blood pressure.



SOURCES: Joshua M. Hare, M.D., chief of cardiology, University of Miami Miller School of Medicine; Jeffery Vance, M.D., Ph.D., professor, Miami Institute for Human Genomics; Donna K. Arnett, Ph.D., chair and professor, department of epidemiology, University of Alaba
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