Document Detail


CYP2C9 genotype modifies activity of the renin-angiotensin-aldosterone system in hypertensive men.
MedLine Citation:
PMID:  19593208     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Two variants of the CYP2C9 gene, CYP2C9*2 and CYP2C9*3, have been indicated to have impaired enzyme function, and thus suspected to reduce the formation of the active metabolite of losartan. Cytochrome P450 (CYP) enzymes are also involved in eicosanoid biosynthesis and regulation of blood pressure (BP) and sodium homeostasis. METHODS: We studied the impact of these variants on BP response to losartan and three other antihypertensive drugs and on baseline indicators of the activity of the renin-angiotensin-aldosterone system. The participants were 217 moderately hypertensive Finnish men that participated in the double-blind, cross-over, placebo-controlled GENRES Study. RESULTS: BP responses to losartan did not differ between CYP2C9*2 or CYP2C9*3 allele carriers and CYP2C9*1*1 patients. A suggestive finding of less pronounced ambulatory BP response to losartan in CYP2C9*1*3 patients with low-normal kidney function was made. At baseline of the GENRES Study, CYP2C9*1*3 patients had significantly lower plasma renin activity and aldosterone levels than CYP2C9*1*1 patients (both P values 0.004). In a replication study in patients with treatment-resistant hypertension, men with CYP2C9*3 allele also had lower plasma renin activity (P = 0.03) and aldosterone levels (P = 0.18). In addition, these men had attenuated renin and aldosterone responses in captopril challenge test (P = 0.29 and 0.006, respectively). CONCLUSION: The CYP2C9*3 allele was associated with lower activity of the renin-angiotensin-aldosterone system in hypertensive men, which may reflect a more efficient sodium reabsorption capacity. CYP2C9*2 and CYP2C9*3 alleles do not influence the antihypertensive effect of losartan in men with essential hypertension and normal kidney function.
Authors:
Kati M Donner; Timo P Hiltunen; Timo Suonsyrj??; Tuula Hannila-Handelberg; Ilkka Tikkanen; Miia Antikainen; Ari Hirvonen; Kimmo Kontula
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  27     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-11-09     Completed Date:  2010-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  2001-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Helsinki, FIN-00029 Helsinki, Finland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aldosterone / blood
Amlodipine / therapeutic use
Antihypertensive Agents / therapeutic use*
Aryl Hydrocarbon Hydroxylases / genetics*
Bisoprolol / therapeutic use
Cross-Over Studies
Double-Blind Method
Drug Resistance / genetics
Electrolytes / blood
Gene Frequency
Genotype
Humans
Hypertension, Renal / drug therapy*,  genetics*
Losartan / therapeutic use*
Male
Middle Aged
Placebos
Renin / blood
Renin-Angiotensin System / drug effects,  genetics
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Electrolytes; 0/Placebos; 114798-26-4/Losartan; 52-39-1/Aldosterone; 66722-44-9/Bisoprolol; 88150-42-9/Amlodipine; EC 1.14.14.1/Aryl Hydrocarbon Hydroxylases; EC 1.14.14.1/CYP2C9 protein, human; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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