Key result
Ser49Gly and Arg389Gly polymorphisms were not significantly associated with blood pressure changes during atenolol treatment, though 49Gly carriers trended toward greater heart rate reduction (p=0.06).
Why the study?
Do beta1-adrenergic receptor gene polymorphisms (Ser49Gly and Arg389Gly) affect the change in heart rate or blood pressure in patients with essential hypertension and LV hypertrophy treated with atenolol?
RCT (n=101)
double-blind
randomized
Do beta1-adrenergic receptor gene polymorphisms (Ser49Gly and Arg389Gly) affect the change in heart rate or blood pressure in patients with essential hypertension and LV hypertrophy treated with atenolol?
p-value: p=0.06
Beta1-adrenergic receptor polymorphisms (Ser49Gly and Arg389Gly) do not significantly alter the blood pressure or heart rate response to 12 weeks of atenolol therapy in hypertensive patients with LV hypertrophy.
No genotyping for these variants is warranted before atenolol in hypertensive LVH; confirms null pharmacogenetic effect on response.
BACKGROUND: Studies suggest that the Ser49Gly and Arg389Gly polymorphisms in the beta1-adrenergic receptor might be of functional importance for the cardiovascular system. Both have been associated with altered receptor activity in vitro, and with hypertension and cardiac failure in vivo. HYPOTHESIS: The aim of this study was to test whether these polymorphisms were associated with the change in heart rate or blood pressure in patients with essential hypertension and left ventricular (LV) hypertrophy treated with the beta1-adrenergic receptor blocker atenolol. METHODS: Blood pressure and heart rate were measured in 101 hypertensive patients with echocardiographically verified LV hypertrophy, randomized in a double-blind study to treatment with either the beta1-adrenergic receptor blocker atenolol or the angiotensin II type I receptor antagonist irbesartan. Changes in blood pressure and heart rate were evaluated after 12 weeks. Beta1-adrenergic receptor genotyping was performed using polymerase chain reaction and restriction fragment length polymorphism. RESULTS: We found no significant associations between the changes in the measured variables and either of the two polymorphisms. However, carriers of the 49Gly allele showed a tendency toward a greater reduction in heart rate compared with patients with the Ser/Ser49 genotype (p = 0.06). CONCLUSIONS: The Ser49Gly and Arg389Gly beta1-adrenergic receptor polymorphisms do not seem to exert a major effect on the changes in heart rate and blood pressure during 12 weeks of treatment with atenolol in patients with essential hypertension and LV hypertrophy.
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Karlsson et al. (2004) conducted an RCT in essential hypertension and left ventricular (LV) hypertrophy (n=101). Atenolol vs. Irbesartan was evaluated on changes in blood pressure and heart rate (p=0.06). Ser49Gly and Arg389Gly polymorphisms were not significantly associated with blood pressure changes during atenolol treatment, though 49Gly carriers trended toward greater heart rate reduction (p=0.06).
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