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Letter to the Editor
International Journal of Hypertension
Volume 2013, Article ID 578578, 10 pages
Clinical Study

Genetic and Adverse Health Outcome Associations with Treatment Resistant Hypertension in GenHAT

1Department of Epidemiology, University of Alabama at Birmingham, RPHB 220E, 1530 3rd Avenue South, Birmingham, AL 55294-0022, USA
2School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX 20186, USA
3Department of Laboratory Medicine and Pathology, University of Minnesota, Mayo Mail Code 609, 420 Delaware Street SE, Minneapolis, MN 55455, USA

Received 25 January 2013; Accepted 18 September 2013

Academic Editor: B. Waeber

Copyright © 2013 Amy I. Lynch et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Treatment resistant hypertension (TRH) is defined as uncontrolled hypertension (HTN) despite the use of ≥3 antihypertensive medication classes or controlled HTN while treated with ≥4 antihypertensive medication classes. Risk factors for TRH include increasing age, diminished kidney function, higher body mass index, diabetes, and African American (AA) race. Importantly, previous studies suggest a genetic role in TRH, although the genetics of TRH are largely understudied. With 2203 treatment resistant cases and 2354 treatment responsive controls (36% AA) from the Genetics of Hypertension Associated Treatment Study (GenHAT), we assessed the association of 78 candidate gene polymorphisms with TRH status using logistic regression. After stratifying by race and adjusting for potential confounders, there were 2 genetic variants in the AGT gene (rs699, rs5051) statistically significantly associated with TRH among white participants. The Met allele of rs699 and the G allele of rs5051 were positively associated with TRH:  (1.12–1.44), , and  (1.20–1.53), , respectively. There was no similar association among AA participants (race interaction for rs699 and for rs5051). This research contributes to our understanding of the genetic basis of TRH, and further genetic studies of TRH may help reach the goal of better clinical outcomes for hypertensive patients.