Aldosterone synthase (CYP11B2)-344 C/T polymorphism is associated with left ventricular structure in human arterial hypertension

OBJECTIVES This study examined the association between the -344 C/T polymor phism of the human aldosterone synthase promoter and left ventricular struc ture in arterial hypertension. BACKGROUND Because of conflicting results from different studies, the mecha nism of such an association, if any, has not been determined. METHODS We examined the aldosterone synthase promoter genotype in 120 young (age: 26 +/- 3 years) male, white subjects with normal or mildly elevated blood pressure. Left ventricular structural parameters and urinary sodium e xcretion over 24 h before and after additional oral sodium load (6 g/day ov er 1 week) were determined. RESULTS Hypertensive subjects with the CC genotype had a greater left ventr icular end-diastolic diameter bur smaller relative wall thickness than thos e with the TT genotype (54 +/- 2 vs. 50 +/- 4 mm, and 0.37 +/- 0.07 vs. 0.4 4 +/- 0.06 mm, respectively; p < 0.05). Hypertensive subjects with the TT g enotype (n = 15) had a greater increase in urinary sodium excretion after o ral sodium load than those with the CC genotype (n = 11) (135 +/- 95 vs. 24 +/- 133 mmol/liter/day; p < 0.05). Serum aldosterone levels were found to be decreased after oral sodium load in hypertensive subjects with the TT an d CT genotypes only (-37 +/- 45 and -38 +/- 51 pg/ml respectively; all p < 0.01) but nut in those with the CC genotype (-12 +/- 30 pg/ml, n.s.). Such differences were not found in normotensive subjects. CONCLUSIONS Hypertensive subjects with the -344 CC genotype of the aldoster one synthase promoter are characterized by a pattern of early eccentric lef t ventricular hypertrophy. Differences in renal sodium handling across the genotypes might contribute to this finding. CT Am Coil Cardiol 2001;37:878- 84) (C) 2001 by the American College of Cardiology.