The AGTR1 polymorphism is associated with the onset of Hypertension in the diabetic population

Abstract Introduction Diabetes Mellitus (DM) is a risk factor for cardiovascular disease with increasing prevalence in developed societies. Essential hypertension (EH) is a very common pathology in diabetics, when it coexists it substantially increases cardiovascular risk and accelerates micro and macrovascular lesions of DM. The renin-angiotensin-aldosterone system (RAAS) plays a vital role in the regulation of glucose metabolism and blood pressure. The genetic polymorphisms of this system are candidate genes for its regulation. Objective With the present study, we intend to investigate whether RAAS polymorphisms are associated with the appearance of EH in diabetic patients. Methods In a sample of 203 diabetic individuals, all of them collected blood to determine the five genetic polymorphisms of RAAS, namely: ACE I/D rs4340, ACE A2350G rs4343, AGT T174M rs4762, AGT M235T rs699 and AGTR1 A1166C rs5186. We constituted two groups according to whether they had EH (n=163) or not (n=40). We compared the groups in relation to the genotypic frequencies of the five polymorphisms to determine which ones are associated with EH in diabetics and calculated the best genetic model (dominant, recessive, additive and multiplicative) where this association was verified. The chi-square test was performed to assess the differences between the groups and the respective ORs were calculated with confidence intervals. Finally, a multivariate analysis was performed to determine which genetic polymorphisms are significantly and independently associated with EH in diabetic patients. Statistical analysis was performed using SPSS for Windows version 25.0. We used the value of p0.05 as the threshold of significance. Results Of the 203 individuals studied, the hypertensive diabetic group included individuals with a mean age of 54.8 ± 6.9 years and 62% were male. The group of diabetics without hypertension (controls) included individuals aged 54.2 ± 6.5 years and 67.5% were male. The genetic variant that was associated with the appearance of EH in diabetic patients was AGTR1 in 3 models: dominant (OR 3.754; 95%CI 1.681-8.381; p=0.001), additive (OR 3.095; 95%CI 1.515-6.322; p=0.002) and multiplicative (OR 3.097; 95%CI 1.533-6.257; p=0.001). After multivariate analysis, the AGTR1 AC genotype remained in the equation, being significantly and independently associated with EH in the diabetic population with an OR of 3.478 (95%CI 1.499-8.068; p=0.004). Conclusions The AGTR1 genetic variant was significantly and independently associated with the onset of EH in the diabetic population. Diabetics carrying these genetic variants are more predisposed to the appearance of EH, and must take special care in terms of behaviour, thus reducing cardiovascular risk.