AGTR1 A1166C gene polymorphism is associated with the effectiveness of valsartan monotherapy in Chinese patients with essential hypertension: A retrospective analysis

Objective: To investigate whether angiotensin II type 1 receptor ( AGTR1 A1166C) gene polymorphism was associated with the effectiveness of valsartan monotherapy in Chinese patients with essential hypertension. Methods: This retrospective analysis included 198 patients (⩾18 years of age) who received valsartan monotherapy (80 mg/day) for newly developed essential hypertension at the authors’ center between January 1, 2020 and December 31, 2023. Genotyping for AGTR1 A1166C gene polymorphism was done by polymerase chain reaction (PCR)-melting curve analysis of genomic DNA from peripheral blood samples. A dominant genetic model for AGTR1 A1166C (AA genotype versus AC + CC genotype) was used. Multivariate regression analysis of baseline variables and AGTR1 polymorphism was conducted to identify predictors of target blood pressure attainment (<140/90 mmHg) at the 4-week follow-up. Results: The median age of the 198 patients was (53.7±13.5) years, and 58% were men. Genotyping assays showed that 164 patients had the AA genotype, and 34 patients were of the AC/CC genotype, including 30 with the AC genotype and 4 with the CC genotype. Allele distribution was consistent with Hardy Weinberg equilibrium. 109 Patients (55.1%) attained the blood pressure target. Multivariate analysis showed that smoking (versus no smoking, HR 0.314, 95% CI 0.159-0.619, P =0.001) and AGTR1 A1166C AA genotype (versus AC/CC, HR 2.927, 95% CI 1.296-6.611, P =0.023) were significant and independent predictors of target attainment. 25 Patients (73.5%) with AGTR1 A1166C AC/CC genotype attained the target versus 51.2% (51/164) of patients with AGTR1 A1166C AA genotype ( P =0.017). Patients with AGTR1 A1166C AC/CC genotype had a significantly greater reduction in systolic blood pressure (33.1±10.8) mmHg versus (29.2±11.7) mmHg in AA carriers; P =0.029). Conclusions: Hypertensive patients carrying one or two C alleles of the AGTR1 A1166C gene were more responsive to valsartan treatment.