Effectiveness of antihypertensive agents in stage I/II hypertensive patients with ace (I/D) gene polymorphism

Background: Angiotensin converting enzyme (ACE) is the key enzyme, regulates the blood pressure which is encoded by 21kb gene that consists of 26 exons and is located on chromosome 17, contains a polymorphism in the form of either Insertion (I) or Deletion (D). The aim was to study the effect of antihypertensive drugs in patients of essential hypertension associated with ACE gene polymorphism. Methods: Hypertensive patients were recruited followed by genetic test was done for detecting ACE gene polymorphism, then patients were divided as Group-A & B. Group –A and B patients were treated with atenolol (25mg) and azilsartan (40 mg) for three months respectively. Results: Systolic and diastolic blood pressure was recorded in both the groups before and after commencement of treatment. Among 88 patients of newly diagnosed hypertension, majority of study population belongs to genotype D/D (38.63%) followed by I/D (31.81%) and II (29.54%) genotype. Significant difference was found in systolic blood pressure (p<0.05) of both groups but not diastolic blood pressure (p>0.05). Conclusion: The rate of control of blood pressure was high in I/I genotype followed by D/D genotype irrespective of treatment group. Overall better prognosis was observed with azilsartan 40mg compared to atenolol 25mg treatment in patients with ACE gene polymorphisms.