ACE GENE INSERTION /DELETION GENOTYPES BASED EVALUATION OF RESPONSE TO ANTI-HYPERTENSIVEâ€™S IN CASES OF ESSENTIAL HYPERTENSION AND T2DM WITH HYPERTENSION â€“ A PHARMACOGENOMIC STUDY
Maryam Shaik, Mohammed Abdul Azeem, Md Leaqath Ali, Mohammed Khaleel, MA. Raheem, M. Kaleem Ullah, Nooruddin Owaisi, Mohd. Mohiuddin, Syed Sultan Mohiuddin Quadri, Nusrath Fathima, *M. Ishaq
The objective of present study was to investigate the pattern of response to anti-hypertensive in T2DM patients with hypertension and cases of essential hypertension having different ACE gene Insertion/ Deletion genotype. Blood samples from 45 cases of T2DM + hypertension and 40 cases belonging to essential hypertension (ET) were analyzed for ACE Insertion/deletion genotypes and correlated with response to anti-hypertensiveâ€™s being taken by these patients. Blood samples from 50 healthy individuals served as controls, for comparing frequencies of the three different genotypes. The frequencies of DD genotype were found to be significantly (P<0.05) increased in both the clinical groups (31% in T2DM + HTN and 35% in E.T cases) compared to control. Genotype based analysis of responses to anti-hypertensiveâ€™s revealed that 33.3% T2DM patients with hypertension having DD genotype responded to ACE inhibitors, while none in the essential hypertension group responded to ACE inhibitors. However, 77.7% ET patients with DD genotype responded to ARBS (either alone or in combination with calcium channel blockers/ Beta blockers). Interestingly the II genotype patients of both clinical groups responded in a comparable manner to ARBs (75% in ET and 80% in T2DM + HTN cases). In case of T2DM patients with ID genotype 72.2% responded to ARBs while only 57.14% cases in ET group responded ARBs either alone or in combination (P<0.05). Higher percentage of T2DM + HTN cases (II and ID genotypes) responded to ARBs than those in the essential hypertension group which may be attributed to higher rate of oxidative stress in T2DM + HTN cases.
Keywords: ACE Gene I/D Polymorphism, Essential hypertension, T2DM with Hypertension, Response to Anti-Hypertensives.
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