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PI‐26
Author(s) -
Brunner M.,
Karnes J. H.,
Gong Y.,
Langaee T. Y.,
CooperDeHoff R. M.,
Pepine C. J.,
Johnson J. A.
Publication year - 2006
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1016/j.clpt.2005.12.047
Subject(s) - trandolapril , medicine , blood pressure , angiotensin converting enzyme , endocrinology , ace inhibitor , verapamil , pharmacogenetics , genotype , gene polymorphism , biology , calcium , genetics , gene
BACKGROUND The AGTR1 1166A>C gene polymorphism (SNP) has been associated with hypertension. We investigated whether this SNP affects blood pressure (BP) response to ACE inhibitor (ACEI) therapy in an ethnically diverse group of hypertensive coronary artery disease patients who had an ACEI (trandolapril) added to verapamil SR 240 mg monotherapy to achieve BP goals during INVEST. METHODS 575 patients met the criteria for analysis and were genotyped by pyrosequencing. ANCOVA was used to compare BP response to ACEI addition adjusting for genotype, age, gender, race, body mass index, ACEI dose, diabetes and interaction terms between genotype and other factors. For presentation, patients were divided into four 10 year age groups. RESULTS Mean duration from ACEI addition to BP assessment was 68 days. Systolic (SBP) and diastolic BP response did not differ between genotypes. Age was significantly associated with SBP response (p=0.033). Mean (± SD) adjusted SBP and mean SBP reduction after ACEI addition are shown (table). BP response did not differ significantly between ethnic groups. In 87% of white and 88% of Hispanic patients, trandolapril 2 mg daily was added to verapamil, whereas in 93% of African Americans trandolapril 4 mg daily was added, consistent with study protocol recommendations.SBP after ACEI addition to verapamil SR (mm HG) SBP reduction after ACEI addition to verapamil SR (mm HG)Genotype A/A 142.2 ± 17.2 −8.2 ± 17.3A/C 140.3 ± 14.4 −10.1 ± 16.8C/C 143.2 ± 22.4 −8.5 ± 21.2 Age 50–59 years 138.5 ± 14.4 −10.1 ± 14.7 65.8 ± 9.8 60–69 years 142.2 ± 16.4 −9.3 ± 18.0 (mean ± SD) 70–79 years 142.7 ± 18.5 −8.4 ± 18.780 years and older 144.3 ± 18.0 −8.3 ± 19.1 Ethnic groups African American 140.9 ± 17.6 −7.0 ± 17.6Hispanic 142.4 ± 16.9 −9.6 ± 17.1White 142.4 ± 16.1 −8.9 ± 17.7CONCLUSIONS Age was an important determinant of BP response to ACEI addition, while AGTR1 1166A>C genotype was not. African Americans achieved similar BP response as other ethnic groups, which might be due to higher ACEI dosing. Clinical Pharmacology & Therapeutics (2005) 79 , P14–P14; doi: 10.1016/j.clpt.2005.12.047