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Association of renin–angiotensin system gene polymorphisms with antihypertensive responses to angiotensin-converting enzyme inhibition or angiotensin receptor blockade

Journal of Human Hypertension volume 19, pages 971–974 (2005)Cite this article

Selecting the most appropriate therapeutic regimen for the individual patient is a great clinical challenge. Since the variability in blood pressure (BP) level has been associated with the genetic profile, it has been speculated that the application of genetic information may be useful for implementation of subject-oriented antihypertensive treatment.1 The objective of the present study was to investigate the association between (i) polymorphisms of angiotensin-converting enzyme (ACE; insertion/deletion: II/ID/DD), angiotensinogen (AGT; MT235: MM/TT/MT), angiotensin II type 1 receptor (AT1R; A1166C: AA/AC/CC) and alpha-adducin (ADC; Gly460Trp, allele Trp460: GG/GW/WW), and (ii) antihypertensive responses to ACE inhibition and AT1R blockade. For this purpose, data from two crossover comparative trials of an ACE inhibitor vs an AT1R blocker conducted using ambulatory BP (ABP) monitoring were analysed.

Both studies were conducted at the Hypertension Center, Third University Department of Medicine, Athens, Greece. In study 12 nondiabetic, untreated Greeks with average awake diastolic ABP>85 mmHg were randomized to receive lisinopril 20 mg or telmisartan 80 mg for 5 weeks, and were subsequently crossed-over to the alternative treatment for a second 5-week period. Study 2 was a previously published comparative study3 of lisinopril 20 mg vs losartan 50 mg using identical inclusion criteria and design as study 1. ABP was monitored in both studies for 24 h before randomization and on the final day of each randomized period using noninvasive oscillometric devices SpaceLabs 90207. Blood samples were taken for genotyping analysis at the end of each study, whereas no subject participated in both studies. Genomic DNA was extracted from peripheral blood leucocytes and polymorphisms were detected by polymerase chain reaction.4 Genotyping was performed at the MRC Blood Pressure Group, Western Infirmary, Glasgow, UK. The protocols and the process for obtaining informed consent were approved by the hospital scientific committee.

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Authors and Affiliations

  1. Third University Department of Medicine, Hypertension Center, Sotiria Hospital, Athens, Greece

    G S Stergiou, S P Efstathiou & T D Mountokalakis

  2. MRC Blood Pressure Group, Western Infirmary, Glasgow, UK

    G C Inglis & J M C Connell

  3. Division of Cardiovascular and Medical Sciences, Western Infirmary, Glasgow, UK

    G T McInnes

Authors
  1. G S Stergiou
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  2. S P Efstathiou
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  3. G C Inglis
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  4. J M C Connell
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  5. G T McInnes
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  6. T D Mountokalakis
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Correspondence to G S Stergiou.

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Stergiou, G., Efstathiou, S., Inglis, G. et al. Association of renin–angiotensin system gene polymorphisms with antihypertensive responses to angiotensin-converting enzyme inhibition or angiotensin receptor blockade. J Hum Hypertens 19, 971–974 (2005). https://doi.org/10.1038/sj.jhh.1001918

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  • DOI: https://doi.org/10.1038/sj.jhh.1001918

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