Diuretic Therapy, the α-Adducin Gene Variant, and the Risk of Myocardial Infarction or Stroke in Persons With Treated Hypertension

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Abstract
Over centuries and across populations, a large number of polymorphisms have appeared in genes that are now said to code for drug receptors,1 drug-metabolizing enzymes,2 and drug-effector pathways.3 Under a variety of historical selection pressures, some of their variant alleles became common long before the appearance of modern pharmacotherapies. By the early 1990s, about 25 million persons in the United States were taking antihypertensive medications.4 This massive population exposure to prescription drugs provides the opportunity for common or powerful drug-gene interactions to occur.5