Features of the clinical course of arterial hypertension in patients with gene polymorphism under the influence of antihypertensive medicines

Abstract

Arterial hypertension is a very heterogeneous disease, therefore the influence of environmental factors along with genetic factors leads to various options for the development and course of arterial hypertension. The aim of the study – to find out the effect of fixed combinations of antihypertensive drugs on the features of the clinical course of arterial hypertension in patients with gene polymorphism. We examined 86 patients. The patients were divided into 2 groups: group 1 consisted of 43 people who received a fixed combination of valsartan and amlodipine, group 2 included 43 patients who received a fixed combination of olmesartan and amlodipine. In patients of group 1, a significant decrease in average daily systolic blood pressure (SBP) in carriers of the AC genotype of the AGTR1 gene was established by 7.0% (p<0.01), as well as SBP and DBP (diastolic blood pressure) in carriers of the CC genotype by 11.3 % and 9.8% (p<0.01) respectively. Carriers of the TT, TC, and CC genotypes of the eNOS gene had a significant decrease in SBP by 7.8%, 8.3%, and 13.6% (p<0.01), respectively, and DBP was significantly different from the indicator before treatment in carriers of the CC genotype and decreased by 11.0% (p<0.02). In patients of group 2, a significant decrease in SBP in carriers of the AC genotype of the AGTR1 gene was established by 8.2 % and in DBP in carriers of the CC genotype by 11.2% (p<0.01). Carriers of TT, TC and CC genotypes of the eNOS gene had a probable decrease in the level of average daily SBP by 8.3%, 9.7% and 16.5%, respectively, compared to the level before treatment (p<0.01). In carriers of the CC genotype of the eNOS gene, BP decreased by 13.2% (p<0.01). It has been proven that the use of fixed combinations of valsartan with amlodipine and olmesartan with amlodipine in terms of its effect on the clinical course and the level of SBP and DBP in patients with arterial hypertension with a gene polymorphism is almost the same and is most pronounced in carriers of the CC genotype of the AGTR1 and eNOS genes. Keywords: valsartan, olmesartan, amlodipine.