4.4 Correlation Between NCX1 Polymorphisms and Therapy-Resistant Essential Hypertension
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High Blood Press Cardiovasc Prev 2008; 15 (3): 171-215 1120-9879/08/0003-0171/$48.00/0 © 2008 Adis Data Information BV. All rights reserved.
Genetics and Pharmacogenomics 4.4 Correlation Between NCX1 Polymorphisms and Therapy-Resistant Essential Hypertension V. Trimarco (1), R. Giudice (2), L. Lardo (2), M. Marino (2), R. Izzo (2), A. Vasta (2), C.S. Cimmino (2), G. Di Renzo (1), L. Annunziato (1), N. De Luca (2) ` di Napoli “Federico II”, Napoli; (2) (1)Dipartimento di Neuroscienze, Universita Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche, ` di Napoli “Federico II”, Napoli, It Italy Universita Introduction. Despite the current availability of increasingly effective drugs for arterial hypertension, it is frequent to find, in clinical practice cases of therapy-resistant essential hypertensive patients. New guidelines define resistant essential hypertension as the clinical condition where pharmacological or non-pharmacological treatments (usage of at least three antihypertensive drugs in appropriate doses) have a non-adequate effect on reducing systolic and/or diastolic pressure values. Methods. In this study 520 patients affected by essential hypertension and subject to antihypertensive therapy have been involved (average age was 58.9±11.9 ages; 43.3% female). All these patients were under diagnosis and therapy of arterial hypertension with the Federico II University of Naples Center for Hypertension and had been submitted to genetic screening for the polymorphism of the NXC1 gene. NCX 1 is a Na+/Ca++ transporter involved with smooth muscle contractility of arterial blood vessels and divided into homozygote (O without mutations) and mutated (M at least 1 gene mutated). Results. Within the observed population, 104 patients with hypertension (20%) demonstrated resistance at the therapy whereas 163 (31%) proved to be bearers of the NCX1 mutation. There were no differences for ages, sex, aspect lipid and glycaemic, duration of hypertension disease, left ventricular mass index and initial systolic blood pressure between the two groups while initial diastolic blood pressure resulted in significantly different (90.7 vs 88.5 mmHg, O vs M; p = 0.035). Antihypertensive therapy resistant incidence resulted 17.1 % for the O group and 26.4% (chi square ^2= 0.0018) for the M group. Conclusions. The characterization of the NCX1 gene code polymorphism seems to be useful to determine antihypertensive therapy resistance in hypertensive patients.
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