Wu Shou-ling, Li Yun, Liu Ke-jian, Hou Guo-sheng, Wang Jian-jun, Wu Yun-Tao, Song Shao-min
The Affiliated Kailuan Hospital, North China Coal Medical College, Tangshan 063000, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2005 Jul;33(7):595-8.
To determine whether the blood pressure (BP) response to hydrochlorothiazide (HCTZ) was associated with the angiotensin converting-enzyme (ACE) I/D and aldosterone synthase (CYP11B2)-344T/C polymorphisms.
The BP response to HCTZ 12.5 mg once daily for 6 weeks was assessed in 829 subjects with mild or moderate essential hypertension, and compared across the ACE and CYP11B2 genotypes.
Of the 829 enrolled subjects, 785 completed the study. The systolic BP response differed according to the ACE (DD 9.4 +/- 15.7 mm Hg, ID 4.8 +/- 16.3 mm Hg, and II 5.1 +/- 14.8 mm Hg, P < 0.01), but not the CYP11B2 genotype (P > 0.05). Subjects with the combination of ACE DD and CYP11B2 CC genotypes tended to have a more pronounced systolic BP reduction than the other genotypic combinations of these 2 genes. Multiple linear regression analyses showed that the ACE DD genotype and serum aldosterone concentration at baseline were associated with the systolic BP reduction after treatment. None of the genetic associations with changes in diastolic BP or mean arterial pressure reached statistical significance (P > 0.05).
The present study suggested that the ACE DD genotype was associated with the systolic BP response to HCTZ, and that the subjects with the combination of ACE DD and CYP11B2 CC genotypes might have a better BP response to HCTZ than the other genotypic combinations of these 2 genes.
确定血压(BP)对氢氯噻嗪(HCTZ)的反应是否与血管紧张素转换酶(ACE)I/D及醛固酮合酶(CYP11B2)-344T/C基因多态性相关。
对829例轻度或中度原发性高血压患者评估其对每日一次12.5mg HCTZ治疗6周的血压反应,并比较ACE和CYP11B2基因各基因型间的差异。
829例入组患者中,785例完成研究。收缩压反应因ACE基因型不同而有差异(DD型9.4±15.7mmHg,ID型4.8±16.3mmHg,II型5.1±14.8mmHg,P<0.01),但CYP11B2基因型间无差异(P>0.05)。ACE DD型与CYP11B2 CC型基因组合的患者收缩压降低往往比这两个基因的其他基因型组合更明显。多元线性回归分析显示,ACE DD基因型及基线血清醛固酮浓度与治疗后收缩压降低相关。与舒张压或平均动脉压变化的基因关联均未达到统计学显著性(P>0.05)。
本研究提示,ACE DD基因型与HCTZ治疗的收缩压反应相关,且ACE DD型与CYP11B2 CC型基因组合的患者对HCTZ的血压反应可能优于这两个基因的其他基因型组合。