Key result
The B2BKR +9/+9 genotype was associated with significantly less left ventricular mass regression during antihypertensive treatment compared to other genotypes (-10.0 vs -21.6 g/m2; P=0.03).
Why the study?
Does the B2BKR +9/+9 genotype affect left ventricular mass regression in patients with essential hypertension and LV hypertrophy receiving antihypertensive treatment?
RCT (n=90)
Double-blind
Does the B2BKR +9/+9 genotype affect left ventricular mass regression in patients with essential hypertension and LV hypertrophy receiving antihypertensive treatment?
Absolute Event Rate: -10% vs -21.6%
p-value: p=0.03
The B2BKR +9/+9 genotype is associated with an attenuated reduction in left ventricular mass index during antihypertensive treatment in patients with essential hypertension and LV hypertrophy.
Attenuated LV mass regression with B2BKR +9/+9 genotype should not yet change practice; leaves open need for genotype-stratified trials in hypertensive LVH.
OBJECTIVE: Hypertension is associated with a number of adverse morphologic and functional changes in the cardiovascular system, including left ventricular (LV) hypertrophy. Studies have demonstrated that bradykinin, through the B2 bradykinin receptor (B2BKR), mediates important cardiovascular effects that may protect against LV hypertrophy. Recently, a +9/-9 exon 1 polymorphism of the B2BKR was shown to be strongly associated with LV growth response among normotensive males undergoing physical training. We aimed to clarify whether the processes found in exercise-induced LV growth in normotensive people also occur in pathological LV hypertrophy. DESIGN AND METHODS: We determined the B2BKR genotype of 90 patients with essential hypertension and echocardiographically diagnosed LV hypertrophy, included in a double-blind study to receive treatment for 48 weeks with either the angiotensin II type 1 (AT1) receptor antagonist irbesartan or the beta1-adrenoceptor antagonist atenolol. RESULTS: B2BKR +9/+9 genotypes responded poorly in LV mass regression, independent of blood pressure reduction or treatment, as compared to the other genotypes (adjusted mean change in LV mass index = -10.0 +/- 4.6 versus -21.6 +/- 2.2 g/m2, P = 0.03). CONCLUSIONS: Our results suggest an impact of the B2BKR polymorphism on LV mass regression during antihypertensive treatment.
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Hallberg et al. (2003) conducted an RCT in essential hypertension and left ventricular hypertrophy (n=90). B2BKR +9/+9 genotype vs. other B2BKR genotypes was evaluated on adjusted mean change in LV mass index (p=0.03). The B2BKR +9/+9 genotype was associated with significantly less left ventricular mass regression during antihypertensive treatment compared to other genotypes (-10.0 vs -21.6 g/m2; P=0.03).
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