Objectives: control of essential hypertension with captophyte and assess the pharmacogenomics of it. Design: a randomized controlled trial is designed. Setting & conduct: Patients with primary diagnosis of essential hypertension, and after obtaining informed written consent, 10 ml of blood is taken for serum chemistry including (TG, Chol, LDL, HDL, beta carotene) and molecular studies (expression of ACE, ACE2, AGTR, AGTR2, AGT, NOS3 and genotyping for single nucleopeptide polymorphysms of rs1799752 ,rs2106809, rs5186 ,rs699 , rs1799983) are supplied with Captophyte. Inclusion criteria: essential hypertension; age of 20 - 55 years and no response to diet and exercise in pre hypertension state. Exclusion criteria: one or more of the following:
Creatinine levels > 1.5 mg/dl; elevated liver enzymes; intake of any of the anti-hypertensive medications due any other underlying medical causes; concurrent intake of any medications having hepatic metabolism (with super enzymes of cytochrome p450 including CYP2D6 (i.e. imipramine, fluoxetine, and … ). CYP3A4 (clarythromycin, erythromycin, cimetidine, and …) which metabolize most of BB, CCB, ACEI, ARB; medication with warfarin; other cardiovascular complications such as angina pectoris, IHD, hypertensive crisis, or cerebrovascular accidents such as TIA, or stroke which require CCB, BB, ACE; GI disturbances; allergic reactions; immunologic reactions; unwillingness to participate in the study; death of the patient. Captophyte (2.025 g) is administered three times daily in the control group and Captopril 25 mg three times daily combined with placebo is supplied to control group. The patients are followed up weekly. Main outcome is determined by change in blood pressure.