Abstract
BackgroundTo study the genetic forms and pathophysiology of arterial hypertension by evaluating plasma renin activity in the Shors, minor indigenous peoples inhabiting the south of Western Siberia.MethodsA single-stage study of indigenous (the Shors) and non-indigenous peoples living in the villages of Gornaya Shoria of the Kemerovo region in the south of Western Siberia was conducted in the period from 2013 to 2017. One thousand four hundred nine adults (901 Shors and 508 non-indigenous inhabitants) were recruited in the study using a continuous sampling plan. Arterial blood pressure was measured according to 2018 ESC/ESH guidelines for the management of arterial hypertension. All the respondents underwent clinical and instrumental examination. Plasma renin activity was determined by enzyme-linked immunoassay with the BRG kits (Germany). Polymorphisms of ACE (I/D, rs 4340), АGT (c.803 T > C, rs699), AGTR1 (А1166С, rs5186), ADRB1 (с.145A > G, Ser49Gly, rs1801252) and ADRA2B (I/D, rs 28,365,031) genes were tested using polymerase chain reaction.ResultsRenin-dependent hypertensive patients prevailed in both ethnic groups (65.6% in the indigenous group vs. 89.8% in the non-indigenous group, p = 0.001). Prevalence of a volume-dependent AH was low in both groups (34.4% in the indigenous group vs. 10.2% in the non-indigenous group, р = 0.001). The D/D and Т/Т genotypes of the АСЕ [OR = 6.97; 95% CI (1.07–55.58)] and AGT [OR = 3.53; 95% CI (1.02–12.91)] genes were associated with the renin-dependent AH in the Shors. The C/C genotype of AGTR1 gene was found to predispose to the volume-dependent AH [OR = 5.25; 95% CI (1.03–27.89)]. The C/C genotype of AGTR1 gene was associated with moderate or high renin levels suggesting essential AH in the non-indigenous group [OR = 5.00; 95% CI (1.21–22.30), р = 0.029].ConclusionAn in-depth understanding of AH pathophysiology and its genetic forms ensures the optimal choice of blood pressure-lowering treatment and optimizes AH control.
Highlights
To study the genetic forms and pathophysiology of arterial hypertension by evaluating plasma renin activity in the Shors, minor indigenous peoples inhabiting the south of Western Siberia
The renin-dependent arterial hypertension (AH) was more commonly found in both ethnic groups as compared to the volume-dependent AH (65.6% vs 34.4% (p = 0.001) among the indigenous group and 89.8% vs 10.2% (p = 0.001) among the nonindigenous group)
The defined differences between the ethnic groups in the mean renin values were consistent with the differences of the polymorphisms in candidate genes encoding the components of the renin-angiotensin-aldosterone system (RAAS) and sympathoadrenal system (SAS)
Summary
To study the genetic forms and pathophysiology of arterial hypertension by evaluating plasma renin activity in the Shors, minor indigenous peoples inhabiting the south of Western Siberia. Essential arterial hypertension (AH) is one of the most prevalent modifiable cardiovascular risk factor worldwide. Its monitoring and effective control is a global goal focused on reducing morbidity and mortality of cardiovascular diseases [1]. The interaction of the sympathoadrenal system (SAS) and the renin-angiotensin-aldosterone system (RAAS) plays a major role in blood pressure (BP) control in the human body. Renin is a proteolytic enzyme that catalyzes the first step in the activation of the RAAS cascade and the subsequent production of angiotensin II, the main effector molecule of the RAAS [3]
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