Renin-angiotensin-aldosterone System Polymorphisms in Resistant Hypertension and Adverse Cardiovascular Events
Status:
Completed
Trial end date:
2010-12-01
Target enrollment:
Participant gender:
Summary
Renin-angiotensin-aldosterone system (RAAS) polymorphisms influence 24h arterial pressure
fluctuation. Resistant systemic arterial hypertension (RSAH) has an increased risk of end
organ damage and unfavourable prognosis, whereas pseudo-RSAH usually respond favourably to
drug therapy.
To prospectively investigate, in subjects with RSAH in a tropical South American city: 1)
Adverse cardiovascular events defined as fatal and non-fatal stroke or acute myocardial
infarction (AMI); and 2) the association of RAAS polymorphisms and adverse cardiovascular
events in this population.
Study population: 212 hypertensives recruited from primary care assistance (time since first
diagnosis of hypertension: 16.5±8.1 years) and without appropriate pressure control, between
2001 and 2006, corresponding to 0.48% of all hypertensives under care (18 new cases/year),
57±10 years old, 66% females. Under drug treatment schedule: three or more drugs including a
diuretic. Ninety two randomly selected hypertensives basis had renin-angiotensin-aldosterone
system genetic profile determined. Genetic assessment was carried out using a polymerase
chain reaction assay amplification technique. The following single nucleotide polymorphisms
were analyzed: renin (G1051A), angiotensinogen (M235T), angiotensin converting enzyme-ACE
(I/D), angiotensin II type 1 receptor (A1166C), aldosterone synthase (C344T) and
mineralocorticoid receptor (G3514C).