Different Polymorphisms of the Renin-Angiotensin-Aldosterone System Genes are Associated with Poorer Blood Pressure Control in Hypertensive Older Adults.

Introduction: Adequate blood pressure control (BPC) is crucial for preventing hypertension, as well as for mitigating the risks associated with inadequate control among hypertensive older adults. Identifying modifiable factors (i.e., dietary and biochemical patterns, sociodemographic characteristics, and health habits) and non-modifiable factors (i.e., genetic background) is crucial for improving control rates.

Aim: This study aimed to analyze the association between Renin-Angiotensin-Aldosterone System gene polymorphisms, sociodemographic characteristics, health and lifestyle habits, and BPC in older adults.

Methods: one hundred and forty-three older adults comprised the study population, and were genotyped for angiotensinogen (AGT) [M235T], renin (REN) [G2646A] angiotensin-converting enzyme (ACE) [InDel], angiotensin II type 1 receptor (AT1R) [A1166C] aldosterone synthase (CYP11B2) [C344T] gene polymorphisms. Sociodemographic characteristics, health, and lifestyle habits were recorded using questionnaires, and blood pressure was measured using standard methods. A Poisson multivariate regression was applied.

Results: Our finding indicated that, together, LDL-C, the A allele of the REN gene (G2646A), and genotype II of the ACE gene (InDel) were significantly associated with inadequate BPC in the community-dwelling older adults.

Conclusions: Due to its non-modifiable nature, the genetic background has the potential to identify individuals with a greater risk of illness. The knowledge of the genetic profiles prone to impaired BPC and its interaction with modifiable factors could guide more effective behaviors and/or treatments aiming to mitigate the morbidity and mortality related to poor BPC among hypertensive older adults.