Aldosterone dysregulation is one of the main causes of resistant hypertension

An international genetic study led by scientists at Amgen deCODE genetics suggests that the hormone aldosterone is more important to the pathology of resistant hypertension than previously thought. One in six hypertensive Icelanders has a drug-resistant form of the disease, meaning that their blood pressure could not be managed by three different concurrently administered hypertension medications. These individuals are more likely to suffer serious cardiovascular and kidney diseases than those whose hypertension is easier to manage.

Vinicius Tragante, a scientist at Amgen deCODE genetics, is the first author of the study, published in the scientific journal Hypertension. The journal also published an editorial discussing the significance of the findings.

The researchers compared genetic data from more than 23,000 patients with resistant hypertension and more than 24,000 patients whose blood pressure was more easily controlled with medication. The study participants came from Iceland, the United Kingdom and the United States. The researchers identified 24 genetic variants associated with an increased likelihood of resistant hypertension. Two thirds of these variants were also associated with hyperaldosteronism and lower potassium levels in the blood. In addition, the researchers demonstrated that the resistant hypertension was a consequence of the hyperaldosteronism effect of these variants.

"The findings shed light on a possible reason why some patients respond poorly to standard treatment for high blood pressure. They suggest that many more than the 8.8% of Icelanders affected by resistant hypertension and currently receive medication that counter the effects of aldosterone, would benefit from such treatment," says Vinicius Tragante, scientist at Amgen deCODE genetics, and first author of the study.