Impact of renin-angiotensin-aldosterone system gene variants on the severity of hypertension in patients with newly diagnosed hypertension

Abstract

ackground:The severity of hypertension has prog-nostic significance. Previous studies have assessed therelationship between renin-angiotensin-aldosterone sys-tem (RAAS) genotype and the severity of hypertension ineither treated patients or those who have only recentlydiscontinued treatment.Methods:We assessed the impact of RAAS genotypeon ambulatory and office blood pressure (BP) in 231 newlydiagnosed hypertensive patients of African ancestry whohad never received therapy. Subjects were genotyped forvariants of the angiotensin-converting enzyme (insertion/deletion), angiotensinogen (M235T, 20A3C), and al-dosterone synthase (CYP11B2)( 344C3T) genes.Results:TheCYP11B2gene polymorphism was asso-ciated with systolic BP (SBP). In comparison to subjectswith at least one copy of the 344C allele (n 75),patients who were homozygous for the 344T allele (n 156) had both higher ambulatory SBP (150 1v144 1mmHg,P .002 before andP .01 after adjusting formultiple genotyping) and office SBP (163 2v156 2mm Hg,P .01 before andP .05 after adjusting formultiple genotyping). Neither the angiotensin-convertingenzyme insertion/deletion nor the angiotensinogen genepolymorphisms were associated with ambulatory or officeSBP or diastolic BP (DBP). TheCYP11B2gene variantalso did not affect DBP.Conclusion:A variant within theCYP11B2locus hasa clinically important impact on the severity of SBPchanges in individuals with newly diagnosed hypertensionwho are of African ethnicity.