Nearly one in three adults in the United States has high blood pressure, also called hypertension. High blood pressure is dangerous because it initially has no symptoms, and eventually increases the risk of stroke, heart attack, heart failure, kidney failure, death. People who cannot control their high blood pressure through lifestyle changes such as losing weight and reducing sodium in your diet, may need medicines.
Many people with high blood pressure may need more than one medication to reach their goal blood pressure. It is estimated that 5% of the hypertensive patients are resistant to conventional antihypertensive therapy1 such as ACE-I, ARBs, Beta blockers and diuretics (water pills). Resistant hypertension is uncontrolled blood pressure in-spite of treatment with lifestyle measures and at least 3 antihypertensive drugs including an adequately dosed diuretic. Polymorphisms in the endothelial nitric oxide synthase (NOS3) gene have been associated with high blood pressure levels and possibly with resistant hypertension.
The NOS3 gene encodes endothelial nitric oxide synthase. This enzyme produces nitric oxide, which is involved in vascular smooth muscle relaxation. Variations in this gene are also associated with susceptibility to coronary spasm. Studies also indicate that genotype -786CC of the NOS3 gene increase the susceptibility to suffer resistant hypertension, which suggest that resistance to conventional therapy could be determined at the endothelial level.1
Antihypertensives, Angiotensin converting enzyme (ACE) inhibitors, Angiotensin II receptor blockers (ARBs), Diuretics, Water pills, Beta blockers