Pharmacogenomics of Hypertension in Africa: Paving the Way for a Pharmacogenetic-Based Approach for the Treatment of Hypertension in Africans
In Africa, the burden of hypertension has been rising at an alarming rate for the last two decades and is a major cause for cardiovascular disease (CVD) mortality and morbidity. Hypertension is characterised by elevated blood pressure (BP) ≥ 140/90 mmHg. Current hypertension guidelines recommend the...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi Limited
2023-01-01
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| Series: | International Journal of Hypertension |
| Online Access: | http://dx.doi.org/10.1155/2023/9919677 |
| _version_ | 1797203680589512704 |
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| author | Jonathan N. Katsukunya Nyarai D. Soko Jashira Naidoo Brian Rayner Dirk Blom Phumla Sinxadi Emile R. Chimusa Michelle Dandara Kevin Dzobo Erika Jones Collet Dandara |
| author_facet | Jonathan N. Katsukunya Nyarai D. Soko Jashira Naidoo Brian Rayner Dirk Blom Phumla Sinxadi Emile R. Chimusa Michelle Dandara Kevin Dzobo Erika Jones Collet Dandara |
| author_sort | Jonathan N. Katsukunya |
| collection | DOAJ |
| description | In Africa, the burden of hypertension has been rising at an alarming rate for the last two decades and is a major cause for cardiovascular disease (CVD) mortality and morbidity. Hypertension is characterised by elevated blood pressure (BP) ≥ 140/90 mmHg. Current hypertension guidelines recommend the use of antihypertensives belonging to the following classes: calcium channel blockers (CCB), angiotensin converting inhibitors (ACEI), angiotensin receptor blockers (ARB), diuretics, β-blockers, and mineralocorticoid receptor antagonists (MRAs), to manage hypertension. Still, a considerable number of hypertensives in Africa have their BP uncontrolled due to poor drug response and remain at the risk of CVD events. Genetic factors are a major contributing factor, accounting for 20% to 80% of individual variability in therapy and poor response. Poor response to antihypertensive drug therapy is characterised by elevated BPs and occurrence of adverse drug reactions (ADRs). As a result, there have been numerous studies which have examined the role of genetic variation and its influence on antihypertensive drug response. These studies are predominantly carried out in non-African populations, including Europeans and Asians, with few or no Africans participating. It is important to note that the greatest genetic diversity is observed in African populations as well as the highest prevalence of hypertension. As a result, this warrants a need to focus on how genetic variation affects response to therapeutic interventions used to manage hypertension in African populations. In this paper, we discuss the implications of genetic diversity in CYP11B2, GRK4, NEDD4L, NPPA, SCNN1B, UMOD, CYP411, WNK, CYP3A4/5, ACE, ADBR1/2, GNB3, NOS3, B2, BEST3, SLC25A31, LRRC15 genes, and chromosome 12q loci on hypertension susceptibility and response to antihypertensive therapy. We show that African populations are poorly explored genetically, and for the few characterised genes, they exhibit qualitative and quantitative differences in the profile of pharmacogene variants when compared to other ethnic groups. We conclude by proposing prioritization of pharmacogenetics research in Africa and possible adoption of pharmacogenetic-guided therapies for hypertension in African patients. Finally, we outline the implications, challenges, and opportunities these studies present for populations of non-European descent. |
| first_indexed | 2024-04-24T08:23:11Z |
| format | Article |
| id | doaj.art-013083cf4127412a82b975bde3918c17 |
| institution | Directory Open Access Journal |
| issn | 2090-0392 |
| language | English |
| last_indexed | 2024-04-24T08:23:11Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi Limited |
| record_format | Article |
| series | International Journal of Hypertension |
| spelling | doaj.art-013083cf4127412a82b975bde3918c172024-04-17T00:00:04ZengHindawi LimitedInternational Journal of Hypertension2090-03922023-01-01202310.1155/2023/9919677Pharmacogenomics of Hypertension in Africa: Paving the Way for a Pharmacogenetic-Based Approach for the Treatment of Hypertension in AfricansJonathan N. Katsukunya0Nyarai D. Soko1Jashira Naidoo2Brian Rayner3Dirk Blom4Phumla Sinxadi5Emile R. Chimusa6Michelle Dandara7Kevin Dzobo8Erika Jones9Collet Dandara10Division of Human GeneticsDivision of Human GeneticsDepartment of MedicineUCT/South African Medical Research Council (SAMRC) Platform for Pharmacogenomics Research and Translation UnitUCT/South African Medical Research Council (SAMRC) Platform for Pharmacogenomics Research and Translation UnitUCT/South African Medical Research Council (SAMRC) Platform for Pharmacogenomics Research and Translation UnitDepartment of Applied SciencesUCT/South African Medical Research Council (SAMRC) Platform for Pharmacogenomics Research and Translation UnitMedical Research Council-SA Wound Healing UnitUCT/South African Medical Research Council (SAMRC) Platform for Pharmacogenomics Research and Translation UnitDivision of Human GeneticsIn Africa, the burden of hypertension has been rising at an alarming rate for the last two decades and is a major cause for cardiovascular disease (CVD) mortality and morbidity. Hypertension is characterised by elevated blood pressure (BP) ≥ 140/90 mmHg. Current hypertension guidelines recommend the use of antihypertensives belonging to the following classes: calcium channel blockers (CCB), angiotensin converting inhibitors (ACEI), angiotensin receptor blockers (ARB), diuretics, β-blockers, and mineralocorticoid receptor antagonists (MRAs), to manage hypertension. Still, a considerable number of hypertensives in Africa have their BP uncontrolled due to poor drug response and remain at the risk of CVD events. Genetic factors are a major contributing factor, accounting for 20% to 80% of individual variability in therapy and poor response. Poor response to antihypertensive drug therapy is characterised by elevated BPs and occurrence of adverse drug reactions (ADRs). As a result, there have been numerous studies which have examined the role of genetic variation and its influence on antihypertensive drug response. These studies are predominantly carried out in non-African populations, including Europeans and Asians, with few or no Africans participating. It is important to note that the greatest genetic diversity is observed in African populations as well as the highest prevalence of hypertension. As a result, this warrants a need to focus on how genetic variation affects response to therapeutic interventions used to manage hypertension in African populations. In this paper, we discuss the implications of genetic diversity in CYP11B2, GRK4, NEDD4L, NPPA, SCNN1B, UMOD, CYP411, WNK, CYP3A4/5, ACE, ADBR1/2, GNB3, NOS3, B2, BEST3, SLC25A31, LRRC15 genes, and chromosome 12q loci on hypertension susceptibility and response to antihypertensive therapy. We show that African populations are poorly explored genetically, and for the few characterised genes, they exhibit qualitative and quantitative differences in the profile of pharmacogene variants when compared to other ethnic groups. We conclude by proposing prioritization of pharmacogenetics research in Africa and possible adoption of pharmacogenetic-guided therapies for hypertension in African patients. Finally, we outline the implications, challenges, and opportunities these studies present for populations of non-European descent.http://dx.doi.org/10.1155/2023/9919677 |
| spellingShingle | Jonathan N. Katsukunya Nyarai D. Soko Jashira Naidoo Brian Rayner Dirk Blom Phumla Sinxadi Emile R. Chimusa Michelle Dandara Kevin Dzobo Erika Jones Collet Dandara Pharmacogenomics of Hypertension in Africa: Paving the Way for a Pharmacogenetic-Based Approach for the Treatment of Hypertension in Africans International Journal of Hypertension |
| title | Pharmacogenomics of Hypertension in Africa: Paving the Way for a Pharmacogenetic-Based Approach for the Treatment of Hypertension in Africans |
| title_full | Pharmacogenomics of Hypertension in Africa: Paving the Way for a Pharmacogenetic-Based Approach for the Treatment of Hypertension in Africans |
| title_fullStr | Pharmacogenomics of Hypertension in Africa: Paving the Way for a Pharmacogenetic-Based Approach for the Treatment of Hypertension in Africans |
| title_full_unstemmed | Pharmacogenomics of Hypertension in Africa: Paving the Way for a Pharmacogenetic-Based Approach for the Treatment of Hypertension in Africans |
| title_short | Pharmacogenomics of Hypertension in Africa: Paving the Way for a Pharmacogenetic-Based Approach for the Treatment of Hypertension in Africans |
| title_sort | pharmacogenomics of hypertension in africa paving the way for a pharmacogenetic based approach for the treatment of hypertension in africans |
| url | http://dx.doi.org/10.1155/2023/9919677 |
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