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Volume 8, Number 4, December 2007
Impact of renin-angiotensin-aldosterone system genes on the treatment response of patients with hypertension and metabolic syndrome
Haralampos J Milionis, Michael S Kostapanos, Konstantinos Vakalis, Ioanna Theodorou, Ioanna Bouba, Rigas Kalaitzidis, Ioannis Georgiou, Moses S Elisaf, Kostas C Siamopoulos
Objective: To evaluate the influence of clinical, biochemical and genetic markers on the response to antihypertensive treatment in patients with essential hypertension and the metabolic syndrome (MetS).
Methods: Measurements of anthropometric indices, blood pressure (BP), and metabolic parameters were obtained from the medical records of 132 (77 women) newly diagnosed, untreated hypertensive patients. Renin-angiotensin-aldosterone system (RAAS) genes polymorphisms (including ACE I/D, angiotensinogen M235T, angiotensin II type 1 receptor [AT1-receptor] A1166C) were determined. Response to treatment was defined as BP less than 140/90 mmHg.
Results: Patients with MetS (n=60) had higher systolic BP and pulse pressure and a more atherogenic lipid profile than patients without MetS. The frequencies of the ACE and the AT1-receptor gene polymorphisms were similar between patients with and without MetS. Response to treatment was positively associated with pulse pressure, and the presence of the C allele as well as the AC genotype of the AT1-receptor gene and inversely with age after adjustment for confounding factors.
Conclusions: RAAS genes distribution does not differ between hypertensive patients with and without the MetS. Higher baseline pulse pressure levels, the presence of the C allele and/or the AC genotype may be in favour of a better response to structured antihypertensive treatment in patients with MetS. However, these findings need to be evaluated in future studies.
JRAAS 2007;8:181-189. View full PDF article (open in new window)
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