Association of Angiotensinogen (M235T) Gene Polymorphism with Blood Pressure Lowering Response to Angiotensin Converting Enzyme Inhibitor (Enalapril)

Purpose: It has been suggested that genetic backgrounds, which have an association with essential hypertension, may also determine the responsiveness to ACE inhibitor. We determined the association of angiotensinogen (M235T) gene polymorphism with essential hypertension and the relationship between polymorphism in the angiotensinogen (M235T) gene and blood pressure response to ACE inhibitor (Enalapril) in patients with essential hypertension from northern Indian subjects. Methods: 250 patients with essential hypertension and 250 normal healthy controls from Delhi and surrounding areas were recruited for the investigation. Blood pressure was recorded before and after 6 weeks of treatment with ACE inhibitors, Enalapril. Genotyping were carried out by polymerase chain reaction and Restriction fragment length polymorphism technique. Results: Statistically significant association of T allele was observed with essential hypertension [x2 = 14.67, p = 0.00013, Odds ratio = 1.76 (1.3-2.32) at 95% CI], the relative risk at 95% CI being 1.28 (1.2-1.54). The decrease in systolic blood pressure and diastolic blood pressure after six weeks of treatment of the patients carrying TT genotype (SBP = 26±17.4 mmHg, DBP = 14.83±7.6mmHg) were greater than the groups carrying MT (SBP = 3.0±7.8 mmHg, DBP =6.2±3.0 mmHg) and MM genotypes (SBP = 1.2±0.8 mmHg, DBP = 0.10±12.1 mm Hg. Conclusions: The angiotensinogen (M235T) gene polymorphism is significantly associated with essential hypertension. Patients carrying TT genotype had higher blood pressure lowering response when treated with ACE inhibitor, Enalapril than those carrying MM and MT genotypes suggesting that the T allele may be a possible genetic marker for essential hypertension. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

Download Full-text

Effects of Indomethacin Alone and during Diuretic or β-Adrenoreceptor-Blockade Therapy on Blood Pressure and the Renin System in Essential Hypertension

Clinical Science ◽

10.1042/cs055203s ◽

1978 ◽

Vol 55 (s4) ◽

pp. 203s-205s ◽

Cited By ~ 12

Author(s):

J. A. Lopez-Ovejero ◽

M. A. Weber ◽

J. I. M. Drayer ◽

J. E. Sealey ◽

J. H. Laragh

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Water Retention ◽

Antihypertensive Effect ◽

Renin Secretion ◽

Blood Pressure Lowering ◽

Blood Pressure Lowering Effect ◽

Uncomplicated Hypertension ◽

Pressure Lowering ◽

Propranolol Therapy

1. Indomethacin was administered alone or in addition to either diuretic or propranolol therapy to three groups of patients with essential hypertension on a free sodium diet. 2. Indomethacin administration reduced renin secretion by about 30% in untreated uncomplicated hypertensive patients and by about 75% in those whose renin secretion had either been stimulated or suppressed by maintained diuretic or β-adrenoreceptor-blockade therapy. 3. Indomethacin administration produced no net effect on blood pressure in untreated patients with uncomplicated hypertension but it blunted or reversed the antihypertensive effect of either diuretic or propranolol therapy. 4. Salt and water retention may be an important factor in the blood pressure-raising effect of indomethacin during diuretic or propranolol therapy: In addition, prostaglandin synthesis may be important in counteracting increased α-adrenergic tone, which may limit the blood pressure-lowering effect of β-adrenoreceptor-blockade. 5. Because of these interactions and their pressor potential indomethacin should be used with caution when combined with either diuretics or β-adrenoreceptor blockers.

Download Full-text

14 Moderate reduction of dietary sodium intake enhances the blood pressure response to a converting enzyme inhibitor in essential hypertension

Journal of Hypertension ◽

10.1097/00004872-199111000-00031 ◽

1991 ◽

Vol 9 (11) ◽

pp. 1086

Author(s):

D R J Singer ◽

N D Markandu ◽

F P Cappuccio ◽

G A MacGregor

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Enzyme Inhibitor ◽

Sodium Intake ◽

Blood Pressure Response ◽

Pressure Response ◽

Dietary Sodium ◽

Converting Enzyme ◽

Converting Enzyme Inhibitor ◽

Moderate Reduction

Download Full-text

Lactotripeptides and antihypertensive effects: a critical review

British Journal Of Nutrition ◽

10.1017/s0007114508137722 ◽

2008 ◽

Vol 101 (6) ◽

pp. 776-786 ◽

Cited By ~ 80

Author(s):

Esther Boelsma ◽

Joris Kloek

Keyword(s):

Blood Pressure ◽

High Blood Pressure ◽

Blood Pressure Response ◽

Lifestyle Changes ◽

Healthy Diet ◽

Elevated Blood Pressure ◽

Current Evidence ◽

Elevated Blood ◽

Blood Pressure Lowering ◽

Pressure Lowering

Hypertension or high blood pressure is a significant health problem worldwide. Typically, lifestyle changes, including adopting a healthy diet, are recommended for people with an elevated blood pressure. Lactotripeptides are bioactive milk peptides with potential antihypertensive properties in man. These peptides, as part of a food product or as nutraceutical, may contribute to the prevention and treatment of hypertension. This paper reviews the current evidence of the blood pressure control properties of lactotripeptides in man. Blood pressure-lowering effects of lactotripeptides are typically measured after 4–6 weeks of treatment. However, in some cases, a blood pressure response has been observed after 1–2 weeks. Maximum blood pressure reductions approximate 13 mmHg (systolic blood pressure) and 8 mmHg (diastolic blood pressure) after active treatment compared with placebo, and are likely reached after 8–12 weeks of treatment. Effective dosages of lactotripeptides range from 3·07 to 52·5 mg/d. Evidence indicates that lactotripeptides are only effective at elevated blood pressure; no further lowering of normal blood pressure has been observed. Concomitant intake of antihypertensive medication does not seem to influence the potency of lactotripeptides to lower blood pressure. Similarly, ethnicity has not been found to influence the extent of lactotripeptide-induced blood pressure lowering. Based on the currently available data, lactotripeptides appear to be safe and effective. Thus, they can be part of a healthy diet and lifestyle to prevent or reduce high blood pressure.

Download Full-text

Blood Pressure Lowering in Essential Hypertension With an Oral Renin Inhibitor, Aliskiren

Hypertension ◽

10.1161/01.hyp.0000101688.17370.87 ◽

2003 ◽

Vol 42 (6) ◽

pp. 1137-1143 ◽

Cited By ~ 254

Author(s):

Alice Stanton ◽

Chris Jensen ◽

Juerg Nussberger ◽

Eoin O'Brien

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Renin Inhibitor ◽

Blood Pressure Lowering ◽

Pressure Lowering

Download Full-text

Postpropranolol vasodilation in adrenalectomized glucocorticoid hypertensive rats

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1987.252.6.h1243 ◽

1987 ◽

Vol 252 (6) ◽

pp. H1243-H1248

Author(s):

D. J. DiPette ◽

J. F. Burris ◽

A. Rogers ◽

B. Waeber ◽

H. R. Brunner

Keyword(s):

Blood Pressure ◽

Blood Flow ◽

Blood Pressure Lowering ◽

Hypertensive Rats ◽

Blood Pressure Lowering Effect ◽

Lowering Effect ◽

Before And After ◽

Pressure Lowering ◽

Regional Hemodynamics ◽

Increased Blood Flow

Acute beta-adrenoreceptor blockade results in an enhanced blood pressure-lowering effect in glucocorticoid hypertensive rats in the absence of the adrenals. To evaluate the possible mechanism of this enhanced blood pressure-lowering effect, systemic and regional hemodynamics were determined by the radioactive microsphere technique before and after propranolol administration in bilaterally adrenalectomized (AX) and sham-operated (SH) glucocorticoid hypertensive rats. Propranolol decreased mean blood pressure (BP) and heart rate (HR) to a greater extent in the AX animals. In response to propranolol, cardiac output (CO) decreased equally in both the AX and SH animals. Regional vascular responses to propranolol were similar between the AX and SH animals, except in muscle. In muscle propranolol significantly decreased blood flow and increased resistance in the SH animals. In marked contrast, in the AX animals propranolol significantly increased blood flow and decreased vascular resistance. The results of this study show that in adrenalectomized glucocorticoid hypertensive rats, the enhanced BP lowering effect of acute beta-adrenoreceptor blockade is not mediated by changes in CO. Additionally, in glucocorticoid hypertensive rats acute beta-adrenoreceptor blockade causes selective vasodilation in skeletal muscle.

Download Full-text