Perindopril reduced pulse wave velocity more in AT1-R C allele carriers than AA homozygotes (-2.85 vs -0.94 m/s; P<0.001), whereas nitrendipine decreased it only in AA homozygotes.
Observational (n=82)
Does the AT1-R A1166C polymorphism influence the effects of perindopril versus nitrendipine on arterial stiffness in hypertensive individuals?
The AT1-R A1166C genotype predicts opposite responses in arterial stiffness to ACE inhibitors versus calcium channel blockers in hypertensive patients, suggesting a potential role for genotype-guided antihypertensive therapy.
Angiotensin-converting enzyme inhibitors improve arterial stiffness independently of blood pressure reduction. Since we have recently shown that in hypertensive individuals the A1166C polymorphism of the angiotensin II type 1 receptor (AT1-R) is an independent determinant of aortic stiffness, we designed the present study to assess the influence of this polymorphism on the changes of aortic stiffness after chronic treatment with the angiotensin-converting enzyme inhibitor perindopril and the calcium channel blocker nitrendipine. Forty perindopril- and 42 nitrendipine-treated hypertensive individuals were studied. We evaluated aortic stiffness by measuring the carotid-femoral pulse wave velocity. Carriers of the AT1-RC allele showed higher baseline values of pulse wave velocity than AA homozygotes (P < .05). In the perindopril group, a threefold greater reduction in pulse wave velocity was observed in carriers of the C allele than in AA homozygotes (-2.85 +/- 0.62 versus -0.94 +/- 0.32 m/s, respectively; P < .001), whereas in the nitrendipine group, pulse wave velocity decreased only in AA homozygotes and not in AT1-R C carriers (-1.38 +/- 0.35 versus +0.04 +/- 0.60 m/s, respectively; P < .01). These results indicate that according to the AT1-R A1166C genotype, an angiotensin-converting enzyme inhibitor and a calcium channel blocker affect pulse wave velocity in opposite ways. Since some evidence shows that increased pulse wave velocity may enhance cardiovascular risk, it might be useful for physicians to consider the AT1-R genotype when prescribing an angiotensin-converting enzyme inhibitor or calcium channel blocker to a hypertensive individual.
Bénétos et al. (Sun,) conducted a observational in Hypertension (n=82). Perindopril vs. Nitrendipine was evaluated on Changes in aortic stiffness (carotid-femoral pulse wave velocity). Perindopril reduced pulse wave velocity more in AT1-R C allele carriers than AA homozygotes (-2.85 vs -0.94 m/s; P<0.001), whereas nitrendipine decreased it only in AA homozygotes.