PP.42.24

Abstract

Objective: The latest studies have revealed that genetic variability in renin-angiotensin-aldosterone system (RAAS) might have an impact on the development of left ventricular hypertrophy (LVH). We aimed to investigate prevalence the polymorphisms of RAAS: angiotensin-converting enzyme (ACE) I/D, renin (REN) 19–83G/A, aldosterone synthase (CYP11B2) C344T, angiotensinogen (AGT) M235T, angiotensin II type 1 receptor (AGTR1) A1166C and 2 receptor (AGTR2) C3123A depending on LVH in non diabetic hypertensive patients (pts). Design and method: The clinical, echocardiographic and genetic examination were performed in 161 pts with essential hypertension. Exclusion criterias were secondary hypertension, no previous evidence of coronary heart disease, diabetes mellitus and body mass index (BMI) >40 kg/m2. Genotyping were performed by polymerase chain reaction and restriction digestion. According to LV mass index (LVMI) all pts divided in two groups: 60 pts with normal LVMI (<125 g/m2 in men, <110 g/m2 in women) and 80 pts with LVH (>125 g/m2 in men, >110 g/m2 in women). Results: Mean age of hypertensive pts was 49.1 ± 11.9 years (87 men and 74 women), average office systolic/diastolic blood pressure levels were 140.8 ± 20.1/89.3 ± 12.6 mmHg, BMI = 29.9 ± 4.7 kg/m2. These two groups did not differ by age, gender, BP, BMI, level of physical activity, smoking and the numbers of pts accepted daily antihypertensive treatment. The genotype distribution the studied genetic polymorphisms of RAAS and the frequencies of the alleles were no significant difference between pts with normal or increased LVMI, except (A1166C) AGTR1 and (C3123A) AGTR2 gene polymorphisms. The presence of the CC and AC genotypes the A1166C polymorphism of gene AGTR1 was associated with an increased LVMI - the odds ratio (OR) = 1.95 (95% CI = 1.46–2.60) in contrast AA genotype in hypertensive pts. LVMI in hypertensive women was significantly higher in the presence of AA genotype C3123A polymorphism AGTR2 gene vs. CC genotype (OR = 6.25; 95% CI = 3.19–12.26). Similar differences among hypertensive men depending on C3123A genotype AGTR2 gene were not obtained. Conclusions: The molecular-genetic study of RAAS gene polymorphisms showed the CC and AC genotypes (A1166C) AGTR1 gene in hypertensive pts and AA genotype (C3123A) AGTR2 gene in hypertensive women were associated with LVH.