Sartori Michelangelo, Semplicini Andrea, Siffert Winfried, Mormino Paolo, Mazzer Alberto, Pegoraro Fabrizio, Mos Lucio, Winnicki Mikolaj, Palatini Paolo
Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy.
Hypertension. 2003 Nov;42(5):909-14. doi: 10.1161/01.HYP.0000097600.58083.EE. Epub 2003 Oct 13.
The 825T allele of the GNB3 gene has been associated with essential hypertension and obesity in cross-sectional studies. We have therefore planned a longitudinal cohort study to assess whether the GNB3 825T allele is predictive of blood pressure increase in young subjects with grade I hypertension. We genotyped at the GNB3 825 locus 461 participants of the Hypertension and Ambulatory Recording Venetia Study (HARVEST) study (age, 18 to 45 years) at low cardiovascular risk, according to 1999 ISH/WHO criteria. The study end point was eligibility for antihypertensive medication, that is, progression to grade II hypertension during the first year of observation or office systolic blood pressure > or =150 mm Hg and/or office diastolic blood pressure > or =95 mm Hg in two later consecutive visits during follow-up. At baseline, there was no statistically significant difference among genotypes with respect to body mass index, blood pressure, and heart rate. During follow-up (mean, 4.7 years), 113 (51.1%) patients with CC genotype and 145 (60.4%) patients with TT/TC genotype reached the end point. According to survival analysis, the patients carrying the 825T allele had an increased risk of reaching the blood pressure end point (CI, 1.108 to 1.843; P=0.006). In young patients with grade I hypertension, the 825T allele is associated with increased risk of progression to more severe hypertension requiring antihypertensive therapy. The GNB3 825T allele may be considered a genetic marker of predisposition for hypertension.
在横断面研究中,GNB3基因的825T等位基因已被证实与原发性高血压和肥胖有关。因此,我们计划开展一项纵向队列研究,以评估GNB3 825T等位基因是否可预测I级高血压年轻患者的血压升高情况。我们根据1999年ISH/WHO标准,对心血管风险较低的461名高血压与动态血压记录威尼斯研究(HARVEST)的参与者(年龄18至45岁)进行了GNB3 825位点的基因分型。研究终点为符合抗高血压药物治疗标准,即在观察的第一年进展为II级高血压,或在随访期间随后连续两次就诊时诊室收缩压≥150 mmHg和/或诊室舒张压≥95 mmHg。在基线时,各基因型在体重指数、血压和心率方面无统计学显著差异。在随访期间(平均4.7年),113名(51.1%)CC基因型患者和145名(60.4%)TT/TC基因型患者达到了终点。根据生存分析,携带825T等位基因的患者达到血压终点的风险增加(CI,1.108至1.843;P = 0.006)。在I级高血压年轻患者中,825T等位基因与进展为需要抗高血压治疗的更严重高血压的风险增加有关。GNB3 825T等位基因可被视为高血压易感性的遗传标志物。