Key result
In hypertensive patients with high treatment adherence, the C/T genotype of MTHFR C677T polymorphism was associated with increased heart failure risk (OR 4.82; 95% CI 2.24-10.60).
Why the study?
To determine the risk of heart failure in patients with hypertension and high treatment adherence based on NT-proBNP levels and gene polymorphisms.
Are specific gene polymorphisms associated with an increased risk of heart failure (indicated by NT-proBNP >125 pg/ml) in hypertensive patients with high treatment adherence?
Cross-Sectional (n=232)
Are specific gene polymorphisms associated with an increased risk of heart failure (indicated by NT-proBNP >125 pg/ml) in hypertensive patients with high treatment adherence?
In hypertensive patients with high treatment adherence, the MTHFR C677T and MTRR Ile22Met gene polymorphisms are associated with elevated NT-proBNP levels, suggesting a genetic predisposition to heart failure risk.
Aim. To determine the heart failure (HF) risk in patients with hypertension (HTN) and high adherence to treatment, depending on the blood concentration of the N-terminal pro-brain natriuretic peptide (NT-proBNP) and gene polymorphism. Material and methods. The study included 232 patients with HTN without a verified diagnosis of HF. The mean age was 46,13±8,21 years. Patients were evaluated for genotypes by following markers: AGT Thr174Met rs4762, GNB3 C825T rs5443, MTHFR C677T rs1801133, MTRR Ile22Met rs1801394, ApoE Cys130Arg rs 429358, PPAR α G/C rs425377. We also assessed ejection fraction, diastolic function and left ventricular mass index by echocardiography and determined NT-proBNP blood levels. Patients were divided into two groups depending on the NT-proBNP concentration. The group 1 consisted of 64 (27,6%) patients with NT-proBNP >125 pg/ml, the group 2 — 168 (72,4%) patients with NT-proBNP <125 pg/ml. Results. Among patients with NT-proBNP >125 pg/ml, the most significant was the C/T genotype of MTHFR C677T polymorphism (rs1801133), 95% confidence interval (CI) for the odds ratio (OR) and relative risk (RR) of HF was 4,82 and 3,29, respectively (95% CI for OR=2,24-10,60; for OR=1,80-6,39). The A/G and G/G genotypes of the MTRR Ile22Met polymorphism (rs1801394) were statistically significant. The probability of HF with the A/G genotype of the MTRR gene increased by more than 2 times (OR=2,32, 95% CI=1,15-4,64), and the OR of its development was 1,77 (95% CI=1,11-2,69). The probability of HF with the G/G genotype increased more than 3 times (OR=3,65, 95% CI=1,37-9,76), and the OR of its development was 2,20 (95% CI=1,25-3,27). Correlation analysis revealed a direct relationship between the NTproBNP levels and polymorphism of the MTHFR (r=0,47; p<0,005) and MTRR (r=0,33; p<0,05) genes. Conclusion. In patients with HTN and high adherence to treatment, the HF risk with an Nt-proBNP >125 pg/ml depends on genetic determinism. Candidate genes for the HF in HTN patients with high adherence to treatment are the genotypes C/T of MTHFR C677T polymorphism (rs1801133), and A/G and G/G of MTRR Ile22Met polymorphism (rs1801394).
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Козиолова et al. (2020) conducted a cross-sectional in Hypertension (n=232). MTHFR C677T and MTRR Ile22Met gene polymorphisms vs. Other genotypes was evaluated on Heart failure risk (associated with NT-proBNP >125 pg/ml) (OR 4.82, 95% CI 2.24-10.60). In hypertensive patients with high treatment adherence, the C/T genotype of MTHFR C677T polymorphism was associated with increased heart failure risk (OR 4.82; 95% CI 2.24-10.60).
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