Association between genetic polymorphisms of the ABCB1 transporter gene and the response to losartan therapy in patients with newly diagnosed arterial hypertension

Shelekhova T.V., Ruta A.V., Luchinina E.V., Bontsevich R.A., Zaitseva M.R., Levanov A.N., Cherednikova P.A., Luchinin E.A.

1) Saratov State Medical University named after V.I. Razumovsky, Department of Occupational Pathology, Hematology, and Clinical Pharmacology, Saratov, Russia; 2) Mari State University, Yoshkar-Ola, Russia; 3) Belgorod State National Research University, Belgorod, Russia; 4) Kazan State Medical Academy – Branch of the Russian Medical Academy of Continuous Professional Education, Kazan, Russia

Background:  Losartan, a selective angiotensin II receptor blocker, undergoes membrane transport via P-glycoprotein, encoded by the ABCB1 gene, whose expression is characterized by significant individual genetic heterogeneity. The C3435T and C1236T polymorphic alleles of the ABCB1 gene may affect the functional activity of P-glycoprotein, which, in turn, determines the pharmacokinetics and therapeutic efficacy of drugs.
Objective: Evaluation of the association between common ABCB1 gene polymorphisms and the efficacy of antihypertensive monotherapy with losartan.
Materials and methods: The study included 34 patients who underwent genotyping for ABCB1 gene polymorphisms using polymerase chain reaction followed by agarose gel electrophoresis (PCR-RFLP). The efficacy of antihypertensive therapy was assessed by comparing baseline and endpoint systolic (SBP) and diastolic (DBP) blood pressure values measured before and 6 weeks after therapy initiation. Blood pressure changes were calculated as a percentage of baseline.
Results: Patients with the C3435T (CT and TT) genotypes showed a more pronounced reduction in SBP compared to carriers of the CC genotype («wild type»): 11.8% ± 9.7 mmHg. and 6.7%±9.6 mmHg, respectively (p=0.03). At the same time, no statistically significant differences were found between genotypes for the C1236T polymorphism (p=0.07). A comparative analysis of changes in DBP between genotypic groups revealed no significant differences for either the C3435T or C1236T polymorphisms. These data indicate that C3435T influences the antihypertensive effect of losartan, which may be associated with changes in its pharmacokinetic parameters.
Conclusion: This study revealed that the hypotensive response to losartan depends on the C3435T genetic polymorphism of the ABCB1 gene, and hypertensive carriers of the ABCB1 3435 (CT/TT) allele may demonstrate a more pronounced response to losartan therapy. 

For citations: Shelekhova T.V., Ruta A.V., Luchinina E.V., Bontsevich R.A., Zaitseva M.R., Levanov A.N., Cherednikova P.A., Luchinin E.A. Association between genetic polymorphisms of the ABCB1 transporter gene and the response to losartan therapy in patients with newly diagnosed arterial hypertension. Pharmateca. 2026;33(1):16-24. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.1.16-24

Authors’ contribution: Study concept and design – T.V. Shelekhova, A.V. Ruta. Data collection and processing – A.V. Ruta, M.R. Zaitseva. Statistical data processing – P.A. Cherednyakova, E.A. Luchinin. Writing – E.V. Luchinina, A.N. Levanov. Editing – T.V. Shelekhova, R.A. Bontsevich.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Ethical Approval: The study was approved by the Ethics Committee, Protocol No. 6 dated 02.12.2025.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors’ Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.

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About the Authors

Tatiana V. Shelekhova, Dr. Sci. (Med.), Professor, Head of the Department of Occupational Pathology, Hematology, and Clinical Pharmacology, Saratov State Medical University named after V.I. Razumovsky, Saratov, Russia; tshelexova@mail.ru, ORCID: https://orcid.org/0000-0002-4737-7695
Artem V. Ruta, Cand. Sci. (Med.), Associate Professor, Department of Occupational Pathology, Hematology, and Clinical Pharmacology, Saratov State Medical University named after V.I. Razumovsky, Saratov, Russia; artem_ruta@mail.ru, ORCID: https://orcid.org/0000-0001-6500-7877, eLIBRARY SPIN: 1000-3652 (corresponding author)
Elena V. Luchinina, Cand. Sci. (Med.), Associate Professor, Department of Occupational Pathology, Hematology, and Clinical Pharmacology, Saratov State Medical University named after V.I. Razumovsky, Saratov, Russia; eluchinina16@mail.ru, ORCID: https://orcid.org/0000-0002-3120-8491, ResearcherID: AAD-4774-2021, eLIBRARY SPIN: 9505-5244, Scopus Author ID: 57217133083
Roman A. Bontsevich, Cand. Sci. (Med.), Associate Professor; Associate Professor at the Department of Internal Medicine No. 2, Mari State University (Yoshkar-Ola); Associate Professor, Department of Pharmacology and Clinical Pharmacology, Belgorod State National Research University (Belgorod); Associate Professor, Department of Clinical Pharmacology and Pharmacotherapy, Kazan State Medical Academy – Branch of the Russian Medical Academy of Continuous Professional Education, Kazan, Russia; Therapist, Pulmonologist, Clinical Pharmacologist; dr.bontsevich@gmail.com, ORCID: https://orcid.org/00000-0002-9328-3905
Marina R. Zaitseva, Cand. Sci. (Med.), Associate Professor, Department of Occupational Pathology, Hematology, and Clinical Pharmacology, Saratov State Medical University named after V.I. Razumovsky, Saratov, Russia; zayceva5505@mail.ru, ORCID: https://orcid.org/0000-0002-4875-5861
Aleksandr N. Levanov, Teaching Assistant, Department of Occupational Pathology, Hematology, and Clinical Pharmacology, Saratov State Medical University named after V.I. Razumovsky, Saratov, Russia; lewanowan@mail.ru, ORCID: https://orcid.org/0000-0003-4742-0881, Scopus Author ID: 57207693173, eLIBRARY SPIN: 2192-6716
Polina A. Cherednikova, Resident, Department of Occupational Pathology, Hematology, and Clinical Pharmacology, Saratov State Medical University named after V.I. Razumovsky, Saratov, Russia; cherednikovapolina@yandex.ru, eLIBRARY SPIN: 8926-5091
Evgeny A. Luchinin, Lecturer, Department of Occupational Pathology, Hematology, and Clinical Pharmacology, Saratov State Medical University named after V.I. Razumovsky, Saratov, Russia; luchinin.gly10@gmail.com, ORCID https://orcid.org/0000-0001-6304-4594, eLIBRARY SPIN: 7302-3654, Scopus Author ID: 57220079650

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