Abstract
BACKGROUND: Antihypertensives are often prescribed in a 'trial and error' mode in management of hypertension. Significant drug response variability for these antihypertensives affects the therapeutic efficacy and increases the chance of developing adverse reactions. The study aims to investigate the influence of antihypertensives on the DNA methylation and its possible role in drug response variability and adverse events. METHODS: The study evaluated the expression level of epigenetic genes, global DNA methylation, hydroxy-methylation level, and gene level differential methylation in in-vitro system post antihypertensive treatment. RESULTS: The epigenetic gene expression pattern upon amlodipine, enalapril, telmisartan, and metoprolol treatment indicated a drug, dosage, and duration-dependent expression of DNMTs and TETs. Global methylation and hydroxy-methylation patterns overlap with the gene expression patterns of DNMTs and TETs for amlodipine and telmisartan, but variability was observed with metoprolol and enalapril. Gene-specific methylation pattern revealed several drug and duration-specific differential methylated genes, which can potentially impact therapeutic outcomes and adverse events as evidenced by their HPO terms. CONCLUSIONS: The study signifies that antihypertensives influence the methylation pattern and drug-induced differential methylation of certain genes which can potentially contribute to adverse effects while that in other genes may have therapeutic utility for other diseases.