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约旦高血压患者样本中缬沙坦反应的变异性及其与基因型和其他非遗传参数的关系:一项前瞻性试点研究。

Variability in Response to Valsartan and Its Relationship With Genotype and Other Nongenetic Parameters Among a Sample of Hypertensive Individuals in Jordan: A Prospective Pilot Study.

作者信息

Alhawari Hussein, Jarrar Yazun, Zihlif Malek, Wahbeh Ayman, Alshelleh Sameeha, Ojjoh Khaled, Abdelrazaq Dalia, Alhawari Hussam

机构信息

Department of Internal Medicine School of Medicine, The University of Jordan Amman Jordan.

Department of Basic Medical Sciences Faculty of Medicine, Al-Balqa Applied University Al-Salt Jordan.

出版信息

Health Sci Rep. 2025 Apr 16;8(4):e70611. doi: 10.1002/hsr2.70611. eCollection 2025 Apr.

Abstract

BACKGROUND

Valsartan, an angiotensin receptor antagonist widely used in hypertension and heart failure management, exhibits noticeable interindividual variation in response among hypertensive patients at the University of Jordan Hospital. The gene variant , a functional genetic variant, influences the renin-angiotensin system.

AIMS

This study aims to explore interindividual variations in the valsartan response, considering genetics, particularly the variant, and other nongenetic factors.

METHODS

This cohort study involved 95 unrelated Arabic Jordanians diagnosed with essential hypertension. Systolic (SBP) and diastolic blood pressure (DBP) measurements were taken at the initiation of 160 mg valsartan and after 1 month of treatment, assessing the valsartan response for each patient. Genetic analysis of was done using the polymerase chain reaction-restriction fragment length polymorphism genotyping method. Anthropometric data were collected from University of Jordan Hospital computer records.

RESULTS

Valsartan response assessment revealed diverse individual responses, the response to valsartan varied, with SBP reductions from < 10 to > 70 mmHg and DBP from < 2 to 30 mmHg. Patients with homozygous genotypes showed a less significant response ( < 0.05) to valsartan than heterozygous and reference genotypes. Additionally, results indicated a positive correlation of age ( = 0.03) and a negative correlation of height ( = 0.02-0.04) with the valsartan response. Regression analysis demonstrated that the patients' sex significantly influenced the valsartan response ( < 0.05).

CONCLUSIONS

This study identifies the genotype as a potential genetic contributor to variability in the valsartan response. Associations with age, height, and sex underscore the importance of considering genetic and demographic factors in tailoring valsartan therapy, for advancing personalized hypertension management.

摘要

背景

缬沙坦是一种广泛用于治疗高血压和心力衰竭的血管紧张素受体拮抗剂,在约旦大学医院的高血压患者中,其反应存在显著的个体差异。基因变体是一种功能性基因变体,会影响肾素-血管紧张素系统。

目的

本研究旨在探讨缬沙坦反应的个体差异,考虑遗传学因素,特别是基因变体,以及其他非遗传因素。

方法

这项队列研究纳入了95名被诊断为原发性高血压的无亲缘关系的阿拉伯约旦人。在开始服用160毫克缬沙坦时以及治疗1个月后测量收缩压(SBP)和舒张压(DBP),评估每位患者的缬沙坦反应。使用聚合酶链反应-限制性片段长度多态性基因分型方法对进行基因分析。人体测量数据从约旦大学医院的计算机记录中收集。

结果

缬沙坦反应评估显示个体反应多样,对缬沙坦的反应各不相同,收缩压降低幅度从<10至>70 mmHg,舒张压降低幅度从<2至30 mmHg。纯合基因型患者对缬沙坦的反应比杂合基因型和参照基因型患者更不显著(<0.05)。此外,结果表明年龄与缬沙坦反应呈正相关(=0.03),身高与缬沙坦反应呈负相关(=0.02 - 0.04)。回归分析表明患者的性别对缬沙坦反应有显著影响(<0.05)。

结论

本研究确定基因型是缬沙坦反应变异性的一个潜在遗传因素。与年龄、身高和性别的关联强调了在调整缬沙坦治疗方案时考虑遗传和人口统计学因素对于推进个性化高血压管理的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7372/12003916/681f4d6aef1b/HSR2-8-e70611-g001.jpg

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