Abstract

Microalbuminuria (30-300 mg/24h) is observed in 15 to 25% of patients with essential hypertension (EH), and systolic arterial pressure (SAP) is the strongest correlate with the log of urinary albumin excretion (UAE). Studies were conducted in 173 patients with never-treated EH in whom diabetes or impaired glucose tolerance were excluded. UAE was determined in 24-hr urine collections. We tested whether variants of genotypes of the renin-angiotensin system may influence the relationship between SAP and log(UAE). Genotyping was performed for different variants of the angiotensin I-converting enzyme (ACE) genes [I/D and 4656(CT)2/3], angiotensinogen (AGT) gene [M235T], and type 1 angiotensin II receptor (AT1R) gene [A1166C].

The distribution of AT1R A1166C genotype was 59% for AA, 32% for AC, and 9% for CC. The slope of the correlation SAP vs UAE was much steeper in CC (0.0306±0.0074) vs 0.0094±0.0025 for AA and 0.0077±0.0029 for AC genotypes. Tendency to a steeper slope was observed in TT vs MM and MT AGT genotypes. In contrast, no influence of ACE I/D and 4656 was detected.

Analysis of UAE with respect to SAP allowed to demonstrate that the existence of homozygous mutation of 1166 A->C on the AT1R locus enhances the impact of SAP on UAE in essential hypertension. Investigation of the effect of AT1R antagonists on UAE according to AT1R genotypes may be of interest.

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