Евразийский Кардиологический Журнал (Mar 2011)

Autonomic nervous system state, calcium channel activity and gene polymorphisms of angiotensin-converting enzyme inhibitor and β2-adrenergic receptor in patients with complicated essential arterial hypertension

  • A. S. Jumagulova,
  • A. G. Polupanov,
  • T. A. Romanova,
  • N. B. Cheskidova

DOI
https://doi.org/10.38109/2225-1685-2011-1-38-45
Journal volume & issue
Vol. 0, no. 1
pp. 38 – 45

Abstract

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Objective: to study the state of the autonomic nervous system (ANS), gene polymorphism of angiotensin-converting enzyme (ACE) and β2-adrenergic receptors, and intracellular calcium metabolism in patients with essential hypertension (EH) with a complicated course of the disease (left ventricular hypertrophy (LVH ) and ischemic stroke). Materials and methods: A total of 250 Kirgiz male with EH, among them 180 patients without stroke, 70 patients who had ischemic stroke and 35 patients with LVH were examined. Control group -19 healthy peoples. It were performed daily blood pressure monitoring, echocardiography, duplex scanning of carotid arteries, the activity of calcium channels, spectral analysis of heart rate variability (HRV) during active tilt-test and genotyping on ACE and the β2-adrenergic receptors. Results: It was observed a significant reduction of HRV and decreased response of LF (low frequency) component to tilt-test in hypertensive patients, compared to control. Tilt-test in patients with complications of EH had shown inverse response of LF to orthostatic test. It was found hyperactivity of ATP/ADP dependent calcium channels in platelets in patients with EH during the development of LVH. Patients with Gln27Gln genotype in compare to other variants of Gln27Glu polymorphism of β2-AR were characterized by increasing meanings of BP and its morning raises which possibly may cause increasing of left ventricular mass in these patients. 3. Our data support an association between I/D polymorphism and stroke in patients with EH. Presence of DD genotype may be considered as independent from daily profile of BP and intima-media thickness predictor of ischemic stroke in patients with EH. Conclusion: We propose several possible clinical and genetic predictors of complicated EH (rigid response of LF-component during tilt-test, the presence of hyperactivity calcium channel, carrier of Gln27Gln polymorphism of β2-adrenergic receptors and I/D polymorphism of ACE gene).

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