El Cheikh Jana, Hamed Fouad, Rifi Hana, Dakroub Ali H, Eid Ali Hussein
Faculty of Medicine, University of Balamand, Al Koura, Tripoli, Lebanon.
Blavatnik Family Research Institute, Departments of Cardiology and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Br J Pharmacol. 2025 Feb;182(4):929-950. doi: 10.1111/bph.17414. Epub 2024 Dec 3.
Hypertension is a major contributor to cardiovascular disease and its associated morbidity and mortality. The low efficacy observed with some anti-hypertensive therapies has been attributed partly to inter-individual genetic variability. This paper reviews the major findings regarding these genetic variabilities that modulate responses to anti-hypertensive therapies such as angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), diuretics, calcium channel blockers (CCBs) and β-adrenoceptor blockers. The importance of studying these genetic polymorphisms stems from the goal to optimise anti-hypertensive therapy for each individual patient, aiming for the highest efficacy and lowest risk of adverse effects. It is important to recognise that environmental and epigenetic factors can contribute to the observed variations in drug responses. Owing to the multigenic and multifactorial nature of drug responses, further research is crucial for translating these findings into clinical practice and the establishment of reliable recommendations.
高血压是心血管疾病及其相关发病率和死亡率的主要促成因素。一些抗高血压疗法疗效欠佳,部分原因是个体间的基因变异。本文综述了有关这些基因变异的主要研究结果,这些变异调节了对诸如血管紧张素转换酶(ACE)抑制剂、血管紧张素受体阻滞剂(ARB)、利尿剂、钙通道阻滞剂(CCB)和β-肾上腺素能受体阻滞剂等抗高血压疗法的反应。研究这些基因多态性的重要性源于为每个患者优化抗高血压治疗的目标,即追求最高疗效和最低不良反应风险。必须认识到,环境和表观遗传因素可能导致所观察到的药物反应差异。由于药物反应具有多基因和多因素性质,进一步研究对于将这些研究结果转化为临床实践并制定可靠建议至关重要。