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Chronic Diseases of Lifestyle

Currently, our division – together with Professor Brian Rayner at Groote Schuur Hospital – has a keen interest in researching essential hypertension, modifiers of the disease and pharmacogenomics.

Project Leader: Prof. Raj Ramesar, A/Prof. Brian Rayner

Co-investigator: Prof. Bongani Mayosi

Hypertension (commonly referred to as high blood pressure (HBP)) is a burgeoning problem both in developed and developing countries. Classified as a Chronic Disease of Lifestyle (CDL), hypertension sits alongside obesity and diabetes as one of the main non-communicable CDL killers in South Africa, particularly due to change in diets, and the rapid increase in urbanisation. It is estimated that at least one in four South Africans, between the ages of 15 and 64 years, is prone to, or has developed hypertension and risks of untreated or poorly managed hypertension include cardiovascular disease, kidney disease and cerebral haemorrhage. At present, there is no definitive treatment for hypertension, yet the disease can be chronically maintained and managed. Management of hypertension is not ideal and pharmacological antihypertensives are prescribed on an empiric basis.

With biological heterogeneity for Essential Hypertension (EH) being recognised it is reasonable to assume that the basic pathological processes will require specific targets for optimum response. However, the arena of EH research has, to date, not identified the specific underlying biological pathologies, and as a result targeted therapeutics has not been mentioned. In the meantime, though, there is considerable room for optimizing currently prescribed drugs to function within the confines of the pharmacogenetic framework of patients. The aim of the study is to identify and catalogue the genes and variants which are involved in differential response to antihypertensive treatment in indigenous African populations., thereafter performing whole population studies in all ethnic groups Understanding the pharmacogenomics of antihypertensive will help to explain the observed differences in drug disposition and drug target which manifests itself through variation in response (safe, toxic, efficacious, or poor). Ultimately, a statistical formula, based on genotyping a number of variants, will generated to provide insight into the optional drug and dose for any hypertensive patient.