Having high blood pressure and a particular genetic alteration dramatically increases the risk of heart attack, stroke or death, and may explain why some hypertensive patients fare worse than others -- even if they take the same medication, University of Florida researchers announced recently.

The discovery, reported at the annual Scientific Sessions of the American Heart Association, brings scientists a step closer toward determining how certain genes influence the development of hypertension and the bad outcomes associated with the condition. Just as discriminating shoppers buy made-to-order suits to flatter their figure, this type of research may someday enable patients to seek out medicine based not on their size and shape but on their genetic makeup.

UF researchers studied about 5,700 patients ages 50 and older who were participating in a National Institutes of Health-funded substudy of the International Verapamil SR-Trandolapril study, or INVEST-GENES. Other scientists previously had found that hypertensive patients with a certain version of the alpha-adducin gene were less likely to suffer a heart attack or stroke if they were taking a diuretic.

"Specifically, their data suggested that one genotype group benefited from the diuretic and had a reduction in heart attack and stroke, while the other genotype group did not," said Julie Johnson, Pharm.D., director of the UF Center for Pharmacogenomics and chair of the department of pharmacy practice at UF's College of Pharmacy. "We felt we had an ideal population for trying to replicate this finding, which if true could have important clinical implications.

"In our study, carriers of the genetic variation had an approximately 43 percent higher risk of death, heart attack or stroke," she said. "Thus, this helps us piece together the puzzle of the various genes that lead to some people having worse outcomes than others when they have hypertension."

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