RAS Genetic Variants in Interaction with ACE Inhibitors Drugs Influences Essential Hypertension Control

• Published in: Archives of medical research Vol. 48; no. 1; pp. 88 - 95
• Main Authors: Heidari, Farzad, Vasudevan, Ramachandran, Mohd Ali, Siti Zubaidah, Ismail, Patimah, Arkani, Mohammad
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2017
• Subjects: Adult; Alleles; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Blood Pressure - drug effects; Case-Control Studies; Cross-Sectional Studies; Enalapril; Enalapril - therapeutic use; Essential Hypertension; Female; Gene polymorphism; Genotype; Humans; Hypertension - drug therapy; Hypertension - genetics; Hypertension - physiopathology; Internal Medicine; Lisinopril; Lisinopril - therapeutic use; Male; Middle Aged; Pharmacogenetics Hypertension; Polymorphism, Single Nucleotide; Renin-Angiotensin System - genetics; Renin-angiotensin-aldosterone System; Pharmacogenetics Hypertension; Lisinopril; Enalapril; Gene polymorphism; Renin-angiotensin-aldosterone System
• ISSN: 0188-4409; 1873-5487; 1873-5487
• DOI: 10.1016/j.arcmed.2017.03.003

Essential Hypertension (EH) is a common disorder associated with increased cardiovascular morbidity and mortality in Malaysia. To investigate how genetic polymorphisms of the renin-angiotensin-aldosterone system (RAS) influence EH control with angiotensin-converting enzyme inhibitor drugs (ACEI). A case–control, cross-sectional population-based nested study (n = 142) included hypertensive subjects treated with ACEI drugs, either lisinopril or enalapril (20 mg, once daily) as monotherapy for 24 weeks. In total seven possible polymorphisms of RAS genes were genotyped. The association between those polymorphisms and the changes in blood pressure were observed in the 24 week treatment. Statistically significant associations of I, G, T, M and G alleles of ACE (I/D, G2350A), AGT (M235T, T175M and G-6A) respectively were observed in essential hypertensive subjects. The decrease in systolic blood pressure and diastolic blood pressure after 24 weeks of treatment of the patients carrying II, GG, and TT genotypes were greater than the groups carrying DD, AA, MM, MM and GG of I/D, G2350A, M235T, T174M and G-6A genotypes respectively. In contrast, No significant difference was observed between renin gene polymorphisms (Bg/I and MboI) and hypertensives. Although this study shows a possible association of polymorphisms of RAS genes with the risk of non-control of HT in ACEI-treated patients and indicates the importance of all this system's components in regulating HT, it needs to be replicated in other data sources.