EVALUATION OF RESPONSE TO ANTIHYPERTENSIVE'S IN PREECLAMPSIA AND GESTATIONAL HYPERTENSION CASES WITH DIFFERENT ACE GENE INSERTION/DELETION GENOTYPES
DOI:
https://doi.org/10.22159/ajpcr.2017.v10i12.20868Keywords:
Preeclampsia, Gestational hypertension, Nil, Angiotensin converting enzyme insertiondeletion genotypesAbstract
Â
 Objective: The objective of this research study was to investigate if there exists a relationship between angiotensin converting enzyme (ACE) genes insertion/deletion (I/D) genotypes and the antihypertensive treatment being received by preeclampsia (PE) and gestational hypertension (GH) patients.
Methods: A total of 50 PE and 35 GH cases were included. ACE gene I/D genotyping was carried out on the blood samples of cases and correlated with the antihypertensive treatment being received by these patients. Details of antihypertensives being received by them were nifedipine (a calcium channel blocker 10 mg) and methyldopa (an alpha 2 receptor agonist 250 mg) which is considered as the first-line of treatment. 30 normotensive pregnant women of comparable gestational period served as controls.
Results: It was observed that a combination of calcium channel blocker (nifedipine 10 mg), as well as alpha 2 agonist (methyldopa 250 mg), was required in patients with D' allele containing genotypes. However, PE and GH patients with II genotype as well as those of GH patients responded well to either nifedipine or methyldopa. If confirmed these results appear to be of clinical significance as prior knowledge of ACE I/D genotypes will be useful in the management of PE cases in general and severe PE cases in particular.
Conclusion: Prior knowledge of ACE I/D genotypes appears to be helpful in the management of PE and GH cases.
Downloads
References
Why Mothers Die: Report on Confidential Enquiries Into Maternal Deaths in the United Kingdom 1997-1999. London: Royal College of Obstetricians and Gynecologists; 2001.
Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol 2011;25(4):391-403.
Venkateshwaramurthy N, John C, Perumal P. Study on anti-hypertensive in preeclampsia. Asian J Pharm Clin Res 2012;5(3):0974-2441.
Velusamy S. Comparision of treatment outcome of antihypertensive drugs in the management of pregnancy induced hypertension. Int J Pharm Pharm Sci 2017; 9(3):287-9.
Jhansi C, Mys H, Sandeep K, Rao PC, Lakshmi CC. Comparison of efficiency and safety of oral labetalol and nifedipine in preeclampsia: A prospective observational study. Int J Pharm Pharm Sci 2015;7(9):277-80.
Salimi S, Mokhtari M, Yaghmaei M, Jamshidi M, Naghavi A. Association of angiotensin-converting enzyme intron 16 insertion/ deletion and angiotensin II Type 1 receptor A1166C gene polymorphisms with preeclampsia in South East of Iran. J Biomed Biotechnol 2011;2011:941515.
Aggarwal S, Dimri N, Tandon I, Agarwal S. Preeclampsia in North Indian women: The contribution of genetic polymorphisms. J Obstet Gynaecol Res 2011;37(10):1335-41.
Rahimi Z, Rahimi Z, Mozafari H, Parsian A. Preeclampsia and angiotensin converting enzyme(ACE) I/D and angiotensin II Type 1 receptor (ATIR) A1166C polymorphisms: Association with ACE I/D polymorphism. J Renin Angiotens Aldosterone Syst0 2012;14(2):174-80.
Bereketoglu C, Kasap M, Pazarbasi A. Studies on angiotensin converting enzyme insertion/deletion polymorphism and genotype distributions in Turkish population. J Pregn 2012;108206:4.
Sandrim VC, Palei AC, Luizon MR, Izidoro-Toledo TC, Cavalli RC, Tanus-Santos JE. Enos haplotypes affect the responsiveness to antihypertensive therapy in preeclampsia but not in gestational hypertension. Pharmacogenomics J 2010;10(1):40-5.
Mello G, Parretti E, Gensini F, Sticchi E, Mecacci F, Scarselli G, et al. Maternal-fetal flow, negative events, and preeclampsia: Role of ACE I/D polymorphism. Hypertension 2003;41(4):932-7.
Lahiri DK, Nurnberger JI Jr. A rapid non-enzymatic method for the preparation of HMW DNA from blood for RFLP studies. Nucleic Acids Res 1991;19(19):5444.
Seckin D, Illhan N, Ilkey E, Illhan N, Ilkay E. ACE gene polymorphism is associated with the extent of coronary atherosclerosis. Adv Mol Med 2005;1:87-91.
Podymow T, August P. Update on the use of antihypertensive drugs in pregnancy. Hypertension 2008;51(4):960-9.
JNC 7. 7th Report of the Joint National Committee on Prevention, detection evaluation and treatment of high blood pressure. The JNC 7 Report. J Am Med Assoc 2003;289(19):2563.
Williams PJ, Morgan L. The role of genetics in pre-eclampsia and potential pharmacogenomic interventions. Pharmgenomics Pers Med 2012;5:37-51.
Jacobsen P, Rossing K, Rossing P, Tarnow L, Mallet C, Poirier O, et al. Angiotensin converting enzyme gene polymorphism and ACE inhibition in diabetic nephropathy. Kidney Int 1998;53(4):1002-6.
Warnholtz A, Nickenig G, Schulz E, Macharzina R, Bräsen JH, Skatchkov M, et al. Increased NADH-oxidase-mediated superoxide production in the early stages of atherosclerosis: Evidence for involvement of the renin-angiotensin system. Circulation 1999;99(15):2027-33.
Paravicini TM, Touyz RM. Redox signaling in hypertension. Cardiovasc Res 2006;71(2):247-58.
Montezano AC, Nguyen Dinh Cat A, Rios FJ, Touyz RM. Angiotensin II and vascular injury. Curr Hypertens Rep 2014;16(6):431.
Nguyen Dinh Cat A, Montezano AC, Burger D, Touyz RM. Angiotensin II, NADPH oxidase, and redox signaling in the vasculature. Antioxid Redox Signal 2013;19(10):1110-20.
Imanishi T, Kobayashi K, Kuroi A, Mochizuki S, Goto M, Yoshida K, et al. Effects of angiotensin II on NO bioavailability evaluated using a catheter-type NO sensor. Hypertension 2006;48(6):1058-65.
Sheena PS. Comparative study of oxidative stress in pregnancy induced hypertension preeclampsia and Eclampsia. Int J Biomed Adv Res 2012;3(11):810-4.
Paulose RM, Bairy KL, Prabhu MM, Eesha BR, Nayak V, Tripathy A. Comparison of efficiency and adverse drug reactions of monotherapy versus combination therapy of antihypertensive among diabetic hypertensive patients in a tertiary care hospital. Asian J Pharm Clin Res 2016;10(2):0974-2441.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
