Genetic variation in renin predicts the effects of thiazide diuretics
Article first published online: 25 JAN 2011
© 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation
European Journal of Clinical Investigation
Volume 41, Issue 8, pages 828–835, August 2011
How to Cite
Huang, C.-C., Chung, C.-M., Hung, S.-I., Leu, H.-B., Wu, T.-C., Huang, P.-H., Lin, S.-J., Pan, W.-H. and Chen, J.-W. (2011), Genetic variation in renin predicts the effects of thiazide diuretics. European Journal of Clinical Investigation, 41: 828–835. doi: 10.1111/j.1365-2362.2011.02472.x
- Issue published online: 6 JUL 2011
- Article first published online: 25 JAN 2011
- Received 28 July 2010; accepted 26 December 2010
- Blood pressure;
- single nucleotide polymorphism
Eur J Clin Invest 2011; 41 (8): 828–835
Background While genetic variants of renin-angiotensin-aldosterone system (RAAS) may modify the blood pressure (BP) response to thiazide diuretics, there was no evidence of genetic variations in renin (REN) playing a role. This study aimed to address the potential effects of genetic variations of RAAS on the response to initial treatment of hydrochlorothiazide (HCTZ).
Materials and methods We enrolled nondiabetic hypertensive patients with a systolic blood pressure (SBP) ≥ 140 or a diastolic blood pressure (DBP) ≥ 90 mmHg, who were either previously untreated or unsatisfactorily treated. After lifestyle modification and diet instruction for 2 weeks, 90 patients with persistently elevated BP were given HCTZ 50 mg every morning for 2 weeks. Single nucleotide polymorphism markers were selected from genes involving in RAAS, including rs7079 and rs699 of angiotensinogen, rs4293 and rs4353 of angiotensin-converting enzyme and rs1464816 and rs11240688 of REN.
Results The patients were divided into three groups according to the SBP response after HCTZ. The upper 1/3 responders had older age (P = 0·035), higher SBP (P = 0·039), higher pulse pressure (P = 0·006) and lower plasma REN activity (PRA) (P = 0·020) when compared with the lower 1/3 responders. Renin rs11240688 CC polymorphism (β = 9·931, corrected P = 0·012), Log PRA (β = 7·451, P = 0·004) and baseline SBP (β = 0·299, P = 0·006) were the independent predictors for the BP lowering response.
Conclusions In addition to PRA, renin rs11240688 CC polymorphism may also independently predict the effect of HCTZ.