¹University of Florida, College of Pharmacy, Center for Pharmacogenomics, University of Florida, College of Medicine, Gainesville, FL

Abstract

Background: The AGTR1 1166A>C gene polymorphism (SNP) has been associated with hypertension. We investigated whether this SNP affects blood pressure (BP) response to ACE inhibitor (ACEI) therapy in an ethnically diverse group of hypertensive coronary artery disease patients who had an ACEI (trandolapril) added to verapamil SR 240 mg monotherapy to achieve BP goals during INVEST.

Methods: 575 patients met the criteria for analysis and were genotyped by pyrosequencing. ANCOVA was used to compare BP response to ACEI addition adjusting for genotype, age, gender, race, body mass index, ACEI dose, diabetes and interaction terms between genotype and other factors. For presentation, patients were divided into four 10 year age groups.

Results: Mean duration from ACEI addition to BP assessment was 68 days. Systolic (SBP) and diastolic BP response did not differ between genotypes. Age was significantly associated with SBP response (p=0.033). Mean ( SD) adjusted SBP and mean SBP reduction after ACEI addition are shown (table). BP response did not differ significantly between ethnic groups. In 87% of white and 88% of Hispanic patients, trandolapril 2 mg daily was added to verapamil, whereas in 93% of African Americans trandolapril 4 mg daily was added, consistent with study protocol recommendations.

Conclusions: Age was an important determinant of BP response to ACEI addition, while AGTR1 1166A>C genotype was not. African Americans achieved similar BP response as other ethnic groups, which might be due to higher ACEI dosing.