ANGIOTENSIN I-CONVERTING ENZYME GENOTYPES AND ANGIOTENSIN-II RECEPTORS - RESPONSE TO THERAPY

In the present study, we studied angiotensin II type 1 (AT(1)) and typ e 2 (AT(2)) receptor messengers by quantitative reverse transcriptase- polymerase chain reaction. We examined peripheral blood mononuclear ce lls from 30 healthy subjects and 50 subjects with primary hypertension , in whom angiotensin I-converting enzyme genotype was determined, bef ore and after 15 days of treatment with different antihypertensive dru gs. The medication included a calcium channel antagonist, an angiotens in I-converting enzyme inhibitor, and a beta(1)-blocker. We also studi ed the relationship between AT(1) receptor gene expression and biochem ical parameters of the renin-angiotensin system. ATI receptor messenge r levels were positively correlated with plasma renin activity in both normotensive and untreated hypertensive subjects. Increases of this m essenger: and plasma angiotensin II levels were correlated with the D ailele in the same individuals. AT(1) receptor messenger levels decrea sed significantly with angiotensin I-converting enzyme inhibitor treat ment in subjects with the BE genotype, and a significant decrease was observed in subjects with the II and ID genotypes treated with a calci um antagonist. No changes were observed in mRNA with the beta(1)-block er. We conclude that the AT(2) receptor is not expressed in peripheral leukocytes and that AT(1) receptor messenger levels vary in relation to angiotensin I-converting enzyme genotype and pharmacological treatm ent, These results suggest that angiotensin I-converting enzyme genoty pe may be an important factor when deciding on antihypertensive therap y in individuals with primary hypertension.