Analysis of associations of polymorphic markers of the CYP2C9, AGTR1, AGT, ACE, CYP11B2 genes with the achievement of target blood pressure values in patients with newly diagnosed arterial hypertension 1-2 degree after 3 weeks of pharmacotherapy with angiotensin II receptor blockers

E.V. Rebrova, E.V. Shikh, S.A. Solovieva, G.G. Melkonyan, N.P. Kulagina

I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Background. The results of numerous pharmacogenetic studies confirm that antihypertensive therapy (AHT) based on the identified polymorphic associations is the most effective and safe.
Objective. Determination of the relationship between the frequency of achieving target blood pressure (BP) values and polymorphic markers CYP2C9*2 (Arg144Cys) and CYP2C9*3 (Ile359Leu), AGTR1 (A1166C), AGT (M235T), ACE (I/D polymorphism), CYP11B2 (C-344T) in patients with newly diagnosed arterial hypertension (AH) 1–2 degree after 3 weeks of AHT with angiotensin II receptor
blockers (ARBs).
Methods. The study included 179 patients from the Moscow region with newly diagnosed AH 1-2 degree, 141 (78.8%) women and 38 (21.2%) men aged 32 to 69 years, who were randomly (by simple randomization) assigned to irbesartan and valsartan groups as mono- or combination therapy with hydrochlorothiazide. After 3 weeks of pharmacotherapy, the presence of genetic polymorphism CYP2C9*2 (Arg144Cys), CYP2C9*3 (Ile359Leu), AGTR1 (A1166C), AGT (M235T), ACE (I/D polymorphism), CYP11B2 (C-344T) was determined.
Results. Patients carrying the genotypes C/C AGT C4072T, D/D ACE (I/D polymorphism), T/T CYP11B2 (C-344T) significantly better achieved target BP values after 3 weeks of valsartan pharmacotherapy for newly diagnosed AH 1-2 degree. Patients carrying the genotype I/I ACE (I/D polymorphism) significantly better achieved target BP values after 3 weeks of irbesartan pharmacotherapy.
Conclusion. In order to personalize the initial AHT with ARBs in patients with newly diagnosed AH 1–2 degree, it is recommended to include polymorphic markers AGT (M235T), ACE (I/D polymorphism), CYP11B2 (C-344T) in the genetic panel.

Keywords

About the Authors

Corresponding author: Ekaterina V. Rebrova, Cand. Sci. (Med.), Associate Professor, Associate Professor at the Department of Clinical Pharmacology and Propaedeutics of Internal Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia; katrina1987@rambler.ru

Similar Articles