Is there relationship between the A1166C polymorphism of the angiotensin II receptor AT1 and plasma renin activity, insulin resistance and reduction of blood pressure after angiotensin‑converting enzyme inhibitor therapy?

Objectives. The aim of this study was to assess the relationship between the A1166C polymorphism of the angiotensin AT1 receptor gene and reduction of blood pressure and pulse pressure in patients with mild and moderate arterial hypertension. Moreover, we sought to investigate the impact of insulin resistance and plasma renin activity on blood pressure reduction following treatment with perindopril depending on the A1166C polymorphism of the AT1 receptor gene. Patients and methods. The study included 64 patients with mild‑to‑moderate essential hypertension, with a mean age of 40.5 ±16.4 years. Before and after treatment with angiotensin‑converting enzyme inhibitors (ACEI) blood pressure measurement with a traditional method and ambulatory blood pressure monitoring were performed and blood samples were taken for laboratory investigation. Results. The A1166C genotype distribution was: AA 53.1% in 34 patients, AC 43.8% in 28 patients, CC 3.1% in 2 patients. There were no statistically significant differences in the magnitude of blood pressure reduction and pulse pressure after treatment with perindopril between genotypes. Only in patients with genotype AA insulin resistance correlated with body mass index and only in these patients we observed a significant correlation between plasma renin activity and reduction of diastolic blood pressure. There was an inverse correlation between insulin resistance and reduction of systolic blood pressure only in patients with genotype AC. Conclusions. The A1166C polymorphism of the AT1 receptor gene is not associated with reduction of blood pressure after treatment with ACEI in patients with essential hypertension. There is a negative correlation between plasma renin activity and reduction of diastolic blood pressure only in patients with genotype AA. There is an inverse correlation between insulin resistance and systolic blood pressure only in patients with AC genotype.