STRUCTURAL AND FUNCTIONAL CONDITION OF THE HEART IN PATIENTS WITH ARTERIAL HYPERTENSION DEPENDING ON THE POLYMORPHISM OF GENES UNDER THE INFLUENCE OF FIXED COMBINATIONS OF ANTIHYPERTENSIVE DRUGS
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i1.14527Keywords:
arterial hypertension, gene polymorphism, valsartan, olmesartan, amlodipineAbstract
SUMMARY. The influence of the interrelationship of genetic factors and external influences on the course of arterial hypertension remains an urgent problem today.
The aim – to find out the effect of fixed combinations of valsartan with amlodipine and olmesartan with amlodipine in patients with arterial hypertension with gene polymorphism on the structural and functional state of the heart.
Material and Methods. 86 patients with arterial hypertension took part in the study. The control group consisted of 30 practically healthy people. Structural and functional state of the heart was studied on the Acuson Sequoia 512 device according to the standard method according to the recommendations of the American Society of Echocardiography and the European Association of Echocardiography. The study of the allelic polymorphism A1166C of the angiotensin II receptor gene of the first type and T786C – the promoter of the eNOS gene was carried out by the method of polymerase chain reaction with electrophoretic detection of the results.
Results. After 6 months of treatment with the use of a fixed combination of valsartan and amlodipine in patients with arterial hypertension, the parameters of TPWLV, LVMMi, and the size of the LA significantly improved, and diastolic dysfunction decreased in patients with the AC genotype of the AGTR1 gene compared to the values before treatment. Also, the size of the LA and LVMMi in patients with the CC genotype of the same gene probably decreased. The use of a fixed combination of olmesartan and amlodipine contributed to a probable reduction of TPWLV, LVMMi and the size of the LA in carriers of the CC genotype of both studied genes. A significant decrease in IVS, LVMMi, and LA was observed in heterozygotes of the AGTR1 gene. In patients with the TT genotype of the eNOS gene, the IVS was probably reduced, and in carriers of the TC genotype of the same gene, the size of the LA was reliably reduced.
Conclusions. The use of a fixed combination of valsartan with amlodipine for 6 months in patients with arterial hypertension significantly improves the structural and functional state of the heart in carriers of the C allele (AC+CC genotype) of the AGTR1 gene, while in patients with the T786C polymorphism of the eNOS gene, the use of this combination does not leads to probable changes in ultrasound of the heart. The use of a fixed combination of olmesaratne with amlodipine contributes to a reliable improvement of the indicators of the structural and functional state of the heart in patients with the presence of the C allele of the AGTR1 gene and eNOS, as well as a decrease in the thickness of the posterior wall of the left ventricle in homozygotes for the T allele of the eNOS gene.
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