Effects of ACE2 polymorphism on the clinical outcomes of irbesartan for the treatment of stage 2 hypertension concomitant with chronic renal failure

doi:10.12092/j.issn.1009-2501.2018.06.010

Abstract

Abstract:

AIM: To investigate the effects of ACE2 gene polymorphism on the treatment of irbesartan for the patients with stage-2 hypertension concomitant with chronic renal failure. METHODS: A total of 135 patients with stage-2 hypertension concomitant with chronic renal failure in the department of nephrology and rheumatism were included in this study. All of the patients were given irbesartan 150-300 mg once daily. After 4 weeks treatment, the antihypertensive effect were evaluated, the serum creatinine (Scr) and blood urea nitrogen (BUN) were determined. Genotyping of polymorphism of ACE2 G8790A were performed using the restriction fragment length polymorphic polymerase chain reaction (PCR-RFLP). The blood pressure and Scr and BUN levels in different genotypes were compared. RESULTS:Compared with the pre-treatment baseline blood pressure, The SBP and DBP in patients after irbesartan treatment were significantly reduced, and there was a significant statistical difference (P<0.01). At the same time, compared with the state of renal function before treatment, the Scr and BUN were both significantly reduced in patients after irbesartan treatment, and there was a statistically significant difference (P< 0.05). In terms of genotypes, ACE2 gene G8790A sites, on the other hand, there were more variations, the genotyping results show that the wild type TT 64 cases, 58 cases of TC genotype, CC genotype 13cases, the minimum allele frequency was 0.31, the genotypes distribution in accordance with hardy-weinberg equilibrium (P=0.979). Based on genotypes, the results showed that the decrease of blood pressure in patients with TT genotypes were significantly higher than that of TC and CC genotypes patients, and the results were statistically significant (P=0.018). However, there was no significant difference in the serum creatinine and blood urea nitrogen according to the three groups of genotypes. CONCLUSION: Irbesartan may help the patients with stage-2 hypertension concomitant with chronic renal failure by relieving the disease symptoms. ACE2 G8790A polymorphism may influence the antihypertensive effect of irbesartan treatment. However, there was no significant effect of the polymorphism on the clinical outcomes for irbesartan improvement in renal function.

Key words: irbesartan, hypertension, chronic renal failure, ACE2, polymorphism

CLC Number:

R968

MENG Jingqian, ZHAO Yingying, ZHANG Wenji, ZHANG Wanzhe, SHEN Pengxiao，LIU Ding, SU Chenhao, SHEN Jie, WANG Jiansheng. Effects of ACE2 polymorphism on the clinical outcomes of irbesartan for the treatment of stage 2 hypertension concomitant with chronic renal failure[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2018, 23(6): 661-666.

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