L.P. Sydorchuk, K.M. Amosova Influence of long-term pharmacogenetically determined treatment on ultrasonography data and left ventricular geometry model in patients with arterial hypertension

The aim of the study was to evaluate the influence of pharmacogenetically determined treatment of essential arterial hypertensive patients (EAH) on ultrasonography data depending on polymorphism of 5 genes: I/D in
angiotensin-converting enzyme gene (ACE), А1166С in gene of the first type receptor of angiotensin II (AGTR1), T894G in gene of endothelial NO-synthase (eNOS), Pro12Ala in gene of PPAR-γ2 receptor, Arg389Gly in gene of β1-adrenergic receptor (ADRb1). 249 patients with EAH І–ІІІ stages severities (EAH I – 26.5 % (66) patients; EAH ІІ – 45.8 % (114); EAH ІІІ – 27.7 % (69); women – 48.2 % (120), men – 51.8 % (129), mean ages 50.5±10.4 years) were observed. All subjects were examined by genetic polymorphisms analysis for five genes by polymerase chain reaction based method. DRA extracted from venous blood, genes’ alleles (AGTR1, eNOS, PPAR-γ2, ADRb1) split by restriction enzymes Ddel, BanII, CseI and FaqI. Standard linear structural myocardial data evaluated with Echo-KG (ASE, Penn Convention). Patients were split depending on ACE gene genotypes and combo therapy type prescription for 6 groups: 1st gr. – I-allele carriers (n=60) took hydrochlorothiazide (HCTZ) and angiotensin II type-1 receptor blocker (ARB); 2nd gr. – I/D-genotype carriers (n=34) took HCTZ+β1-adrenoblockers (β1-AB); 3rd gr. – I/D-genotype carriers (n=50) took HCTZ+ACE inhibitor (ACEI); 4th gr. – DD-genotype carriers (n=15) took calcium channel blocker (CCB)+ ARB; 5th gr. – DD-genotype carriers (n=15) took CCB+β1-AB; 6th gr. – DD-genotype carriers (n=27) took CCB+ACEI. Pharmacogenetically determined treatment significantly increased number of patients with normal LV myocardial geometry (Р=0.02) with decreasing of patients amount with hypertrophic LV myocardial models (Р<0.01). More effective organ-protection (after LVMI normalization) in EAH patients was under CCB+ARB II (13.3 %) and CCB+β1-АB (20.0 %) combination treatment.

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