The role of the sympathoadrenal system candidate gene (ADRB 1, ADRA2B) polymorphism in the antihypertensive efficiency of β-adrenoblocker in the indigenous Shor people

Objective – is to study the dynamics of blood pressure (BP) in the indigenous population of the Shors in response to the antihypertensive therapy with a β-blocker (metoprolol succinate), taking into account the polymorphism of the candidate genes of the sympathetic adrenal system (ADRB1 and ADRA2B). Design and methods. The study of the indigenous population (the Shors) living in the areas of Mountain Shoria (Kemerovo region) was carried out. Using continuous sampling method, 901 people (18 years old and above) were examined. Measurement of blood pressure was carried out in accordance with the recommendations of the Russian Society of Cardiology / the Russian Society of Hypertension (2010). The survey allowed identifying the number of respondents with arterial hypertension (AH) for further observation - 367 people (40.7%). The second screening was performed one year after the patients were included in the study. The criterion for putting the patient under prospective observation was regular intake of the medication prescribed (162 people). Antihypertensive therapy was prescribed by a cardiologist according to the recommendations of the Russian Society of Cardiology /the Russian Society of Hypertension (2010). It included taking a β1-selective medication, metoprolol succinate, from the group of β-adrenergic blockers in a dose of 100 mg per day. Gene polymorphism ADRB1 (c.145A> G, Ser49Gly, rs1801252) and ADRA2B (I/D, rs28365031) were tested using polymerase chain reaction. Results . The study of the indigenous population proves that there is an association between carrying the A allele in the homozygous state of the ADRB1 gene and achieving the target level of blood pressure (OR = 2.36) while taking a β-blocker (metoprolol succinate). In the Shor population ADRA2B gene polymorphism was not associated with the effective treatment of hypertension using this medication. Conclusion . An epidemiological study in Mountain Shoria has demonstrated an antihypertensive effect of metoprolol succinate in its dependence on the polymorphism of the candidate genes (ADRB1 and ADRA2B). They are coding the components of the sympathetic adrenal system which plays an important role in the pathogenesis of hypertension. Today there are no clinical algorithms for checking personalized sensibility to the β-blockers, and therefore further research in this area remains a topical subject.