Polymorphisms in the angiotensinogen and angiotensin II type 1 receptor gene are related to change in left ventricular mass during antihypertensive treatment: results from the Swedish Irbesartan Left Ventricular Hypertrophy Investigation versus Atenolol (SILVHIA) trial
| العنوان: | Polymorphisms in the angiotensinogen and angiotensin II type 1 receptor gene are related to change in left ventricular mass during antihypertensive treatment: results from the Swedish Irbesartan Left Ventricular Hypertrophy Investigation versus Atenolol (SILVHIA) trial |
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| المؤلفون: | Kurland, Lisa, Melhus, Håkan, Karlsson, Julia, Kahan, Thomas, Malmqvist, Karin, Öhman, Peter, Nyström, Fredrik, Hägg, Anders, Lind, Lars |
| المصدر: | Journal of Hypertension. 20(4):657-663 |
| مصطلحات موضوعية: | Aged, Alleles, Angiotensinogen/*genetics, Antihypertensive Agents/*therapeutic use, Atenolol/*therapeutic use, Biphenyl Compounds/*therapeutic use, Female, Humans, Hypertension/*drug therapy/*genetics/pathology, Hypertrophy, Left Ventricular/*drug therapy/*genetics/pathology, Male, Middle Aged, Polymorphism, Genetic, Receptor, Angiotensin, Type 1, Receptors, Angiotensin/antagonists & inhibitors/*genetics, Renin-Angiotensin System/genetics, Research Support, Non-U.S. Gov't, Sweden, Tetrazoles/*therapeutic use, MEDICINE, MEDICIN |
| الوصف: | BACKGROUND: Our aim was to determine if gene polymorphisms in the renin-angiotensin-aldosterone system (RAAS) were related to the degree of change in left ventricular hypertrophy (LVH) during antihypertensive treatment. METHODS AND RESULTS: Patients with essential hypertension and echocardiographically diagnosed LVH were included in a double-blind study to receive treatment with either the angiotensin II type 1 receptor (AT1-receptor) antagonist irbesartan (n = 41), or the beta-1 adrenergic receptor blocker atenolol (n = 43) as monotherapy for 3 months. The angiotensinogen T174M and M235T, the angiotensin-converting enzyme I/D, the AT1-receptor A1166C and the aldosterone synthase (CYP11B2) -344 C/T polymorphisms were analysed and related to the change in left ventricular mass (LVM). Patients with the angiotensinogen 174 TM genotype treated with irbesartan responded with the greatest reduction in LVM (-23 +/- 31SD g/m2 for TM and +0.5 +/- 18 g/m2 for TT, P = 0.005), independent of blood pressure reduction. Both the angiotensinogen 235 T-allele (P = 0.02) and the AT1-receptor 1166 AC genotype responded with the greatest reduction in LVM when treated with irbesartan (-0.1 +/- 19 g/m2 for AA and -18 +/- 30 g/m2 for AC, P = 0.02), independent of blood pressure reduction. These polymorphisms were not associated with the change in LVM during treatment with atenolol. DISCUSSION: The angiotensinogen T174M and M235T and the AT1-receptor A1166C polymorphisms were related to the change in LVH during antihypertensive treatment with an AT1-receptor antagonist; of these angiotensinogen T174M was the most powerful. This highlights the role of the RAAS for left ventricular hypertrophy and the potential of pharmacogenetics as a tool for guidance of antihypertensive therapy. |
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| الوصول الحر: | https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-73090Test http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Retrieve&list_uids=11910301&dopt=CitationTest |
| قاعدة البيانات: | SwePub |
| تدمد: | 02636352 14735598 |
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