INFLUENCE OF THE ANGIOTENSIN-II TYPE-1 RECEPTOR GENE POLYMORPHISM ON THE EFFECTS OF PERINDOPRIL AND NITRENDIPINE ON ARTERIAL STIFFNESS IN HYPERTENSIVE INDIVIDUALS

Angiotensin-converting enzyme inhibitors improve arterial stiffness in dependently of blood pressure reduction. Since we have recently shown that in hypertensive individuals the A(1166)C Polymorphism of the angi otensin II type 1 receptor (AT(1)-R) is an independent determinant of aortic stiffness, we designed the present study to assess the influenc e of this polymorphism on the changes of aortic stiffness after chroni c treatment with the angiotensin-converting enzyme inhibitor perindopr il and the calcium; channel blocker nitrendipine. Forty perindopril- a nd 42 nitrendipine-treated hypertensive individuals were studied. We e valuated aortic stiffness by measuring the carotid-femoral pulse wave velocity. Carriers of the AT(1)-R C allele showed higher baseline valu es of pulse wave velocity than AA homozygotes (P<.05). In the perindop ril group, a threefold greater reduction in pulse wave velocity was ob served in carriers of the C allele than in AA homozygotes (-2.85 +/- 0 .62 versus -0.94 +/- 0.32 m/s, respectively; P<.001), whereas in the n itrendipine group, pulse wave velocity decreased only in AA homozygote s and not in AT(1)-R C carriers (-1.38 +/- 0.35 versus +0.04 +/- 0.60 m/s, respectively; P<.01). These results indicate that according to th e AT(1)-R A(1166)C genotype, an angiotensin-converting enzyme inhibito r and a calcium channel blocker affect pulse wave velocity in opposite ways. Since some evidence shows that increased pulse wave velocity ma y enhance cardiovascular risk, it might be useful for physicians to co nsider the AT(1)-R genotype when prescribing an angiotensin-converting enzyme inhibitor or calcium channel blocker to a hypertensive individ ual.