تأثير تعدد الأشكال الجينية (ABO) وفصيلة الدم في نشاط الإنزيم المحول للأنجيوتنسين والاستجابة لعلاج الكانديسارتان عند مرضى ارتفاع ضغط الدم في محافظة كربلاء

Effect of ABO Gene Polymorphism and blood Group on ACE Activity and Response to Candesartan Treatment in Hypertensive Patients in Kerbala Province

Abstract

Background: Hypertension is the leading cause of cardiovascular diseases. It may affect individual at any age, but became dramatically more common at progressively older age. The most common risk factors include smoking, family history, obesity, diabetic, stress, lack of exercise, and high salt consumption. Candesartan is widely used as first line drug for hypertensive patient, irrespective of the therapeutic success that demonstrates an interindividual variation in hypertensive patient. ABO gene polymorphism and ABO blood group has been reported to affect the ACE plasma level. The ACE plasma level is directly related with angiotensin II level which lead to increase blood pressure.
Aim of study: To investigate the relationship of ABO gene polymorphism ABO1 rs495828 and ABO2 rs8176740, and ABO phenotype in the same patient on ACE activity on Kerbala’a province community with those who suffering from hypertension and response to candesartan treatment.
Participants and Methods: The study was performed in a cross-sectional manner, 92 patients with hypertension were selected to participate in this study, who taking candesartan tablet 8 mg/oral once daily. Blood samples were collected from individuals who agreed to have genetic testing performed, and ACE plasma level were measured, angiotensin II level, angiotensinogen level, serum creatinine, urea, potassium, sodium, chloride, and blood group. Also measure blood pressure, heart rate and echocardiogram to measure IVS, LVH, ejection fraction and diastolic dysfunction.
Results: The findings of this study; in hypertensive patients, clearly indicates that ABO1 (G>T)(rs495828) genetic polymorphism have a
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considerable influence on ACE levels. , while ABO2 (A>T) (rs8176740) genetic polymorphisms had non-significant effect on ACE level .There is significant relation between blood group and ACE level .
Conclusions: This study states that the candesartan medication illustrates acceptable blood pressure when the ACE and angiotensin II levels are high, while candesartan is not a good choice for patients with low levels of ACE and angiotensin II. The greatest ACE and angiotensin II levels are seen in people of blood type AB, and their SBP is within the normal range. For ABO1 rs495828, candesartan not good choice for TT carrier which have lower levels of ACE and angiotensin II. There was no significant association between ABO2 rs8176740 and ACE level. Hypertensive heart disease may be prevented with the use of candesartan treatment, which lowers angiotensin II levels.