The heterogeneity of hypertension: why doesn't every patient respond to every antihypertensive drug?
Hypertension is a multifactorial disease, and there is growing evidence that implicates a range of environmental factors in its aetiology. These include dietary sodium, obesity, alcohol and stress. Additionally, several genetic abnormalities may predispose an individual to hypertension. The number of hypertensive phenotypes resulting from different environmental-genetic interactions may explain, therefore, why there is marked heterogeneity in response to treatment and why any single antihypertensive agent would be unlikely to control BP in more than 25-50% of patients. This is one rationale for combination therapies in which the component drugs affect different pathophysiological mechanisms.
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Department of Clinical Pharmacology and Therapeutics, St Mary's Hospital Medical School, London, UK.
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D008957:Models, Genetic; D017211:Treatment Failure
D000959:Antihypertensive Agents