Drug Resistant Hypertension in African Americans' Exome

Resistant hypertension is defined as blood pressure that remains above goal in spite of the concurrent use of 3 antihypertensive agents of different classes or the concurrent use of 4 or more antihypertensive agents regardless of control. Its diagnosis is important for the identification of patients who are at high risk of having reversible causes of hypertension and/or patients who, because of persistently high blood pressure levels, may benefit from special diagnostic and therapeutic considerations. Resistant hypertension represents an extreme phenotype, thus, it has been predicted that genetic factors could play a larger role than for the general hypertensive population. Genetic assessments of patients with resistant hypertension have been limited. The current study assayed the exome of 91 African American patients with treatment resistant hypertension.]]>
Our sample of 91 affected resistant hypertensive African Americans represents an extreme sampling approach from the upper tail of the distribution of blood pressure response to antihypertensive drugs from a large RCT. We have defined our phenotype as a more extreme version of resistant hypertension: our 91 subjects were all taking 4 or more medications to lower blood pressure and had blood pressure values greater than 140/90 mmHg after four years in the RCT. ]]>
Data are derived from a completed randomized clinical trial wherein patients were randomized to one of four treatment arms and followed prospectively for an average of 4.2 years. About 35% of the trial participants were African American. ]]>