INTERRELATION OF ANTIHYPERTENSIVE EFFECT OF COMBINATION OF VALSARTAN AND AMLODIPINE WITH VARIOUS POLYMORPHIC VARIANTS OF GENES CYP2C9 AND CYP11B2 IN PATIENTS WITH OBESITY

Abstract

Aim. To assess the efficiency of combined antihypertensive therapy in patients with arterial hypertension and obesity depending on the polymorphism of CYP2C9 andCYP11B2 genes. Materials and methods. 80 patients with obesity and concomitant uncontrolled medicamentally arterial hypertension (1-2 stage) were included in our study. These patients took the fixed dose combination of the valsartan and amlodipine in a dose of 80-160/5-10mg per day. Blood pressure of all patients was measured by the procedure mentioned in the recommendations for diagnosis and treatment of arterial hypertension (ESH/ESC, 2013; РМОАГ, 2010) before and after 8 weeks of treatment. All tested people had venous blood sampling succeeded by DNA extraction from leukocytes. The amplification of the polymorphic variants CYP2C9 andCYP11B2 genes was performed in real time by means of primers and probes (Synthol, Russia) and Taq Man method (allele discrimination). Results. It is shown that the patients with *1/*2 variant of CYP2C9 gen reached the target level of the arterial blood pressure more often than patients who had polymorphism *1/*1 (92,8% against 47,3%) while analyzing the efficiency of the treatment with account of the polymorphic variants of CYP11B2 gene the reaching of the target level of the arterial blood pressure was seeing more often in the case of mutant polymorphism *2/*2 then in the case of *1/*2 polymorphism (76,5% against 50%). It was also determined that the accurate predominate of *2*2 polymorphism CYP11B2 gene over other its variants was seeing among the patients with more frequent polymorphism of CYP2C9 − *1/*1 who reached the target level of the arterial blood pressure after 8 weeks of the therapy. Conclusion. The interrelation between the antihypertensive combination of valsartan and amlodipine with the polymorphism of CYP2C9 and CYP11B2 genes witch was determined in our study can be considered in cases of the treatment of the patients who suffer from arterial hypertension and obesity. Probably, new usage of the genetic testing results as one of the individualized medicine direction may promote the optimization and effectiveness of the combined medical treatment among the patients with arterial hypertension and obesity.