Medičnì Perspektivi (Sep 2022)
Features of the daily profile of blood pressure, taking into account polymorphism of the angiotensin II type 1 receptor gene in patients with arterial hypertension after myocardial infarction
Abstract
The article presents the results of a study of the daily blood pressure profile, taking into account the polymorphism of the angiotensin II type 1 receptor gene in patients with arterial hypertension with past myocardial infarction. The study involved 36 men with stage III hypertension, grade 1-3 arterial hypertension, with past myocardial infarction. The average age in the study group was 57.0 (52.0; 64.0) years, the experience of hypertension was 6.3 (4.0; 15.0) years. The average period after a heart attack was 48.0 (12.0; 144.0) months. The study of the type 1 angiotensin II receptor gene on the DNA-sorb-B test system was carried out by the polymerase chain reaction method with the restriction of products by endonuclease. 24-hour blood pressure monitoring was performed according to the standard method. It was found that, in general, in the group, the levels of systolic and diastolic blood pressure according to the median corresponded to the target ones. But the blood pressure load indicators both for the day and separately during the day and at night exceeded the normal range. In an intergroup analysis, significantly higher blood pressure figures and pressure load indices were registered in patients with the CC genotype of the angiotensin II type 1 receptor gene. In addition, this group of patients showed a high incidence of adverse variants of circadian fluctuations in blood pressure. In accordance to the daily monitoring data, only 13 (34.2%) patients achieved the target level of blood pressure: with the AA genotype – in 6 (15.9%) patients, with the AC genotype – in 6 (15.9%) patients and in 1 (2.6%) patient with CC genotype of the angiotensin II type 1 receptor gene. In 4 (10.5%) patients with the AA genotype and in 3 (7.9%) patients with the AC genotype of the angiotensin II type 1 receptor gene, achievement of the target level of blood pressure was registered in the normal range of blood pressure load indices. In other cases, the target level of arterial pressure was accompanied by an increase in pressure load indices, which indicates incomplete daily control of arterial hypertension.
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