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Hypertensive APOL1 risk allele carriers demonstrate greater blood pressure reduction with angiotensin receptor blockade compared to low risk carriers


Autoři: Patrick N. Cunningham aff001;  Zhiying Wang aff002;  Megan L. Grove aff002;  Rhonda M. Cooper-DeHoff aff003;  Amber L. Beitelshees aff004;  Yan Gong aff003;  John G. Gums aff003;  Julie A. Johnson aff003;  Stephen T. Turner aff005;  Eric Boerwinkle aff002;  Arlene B. Chapman aff001
Působiště autorů: Section of Nephrology, University of Chicago, Chicago, Illinois, United States of America aff001;  Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America aff002;  Department of Pharmacotherapy and Translational Research, College of Pharmacy and Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America aff003;  Endocrinology, Diabetes, and Nutrition Division, Department of Medicine, University of Maryland, Baltimore, Maryland, United States of America aff004;  Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, United States of America aff005;  Baylor College of Medicine, Human Genome Sequencing Center, Houston, Texas, United States of America aff006
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0221957

Souhrn

Background

Hypertension (HTN) disproportionately affects African Americans (AAs), who respond better to thiazide diuretics than other antihypertensives. Variants of the APOL1 gene found in AAs are associated with a higher rate of kidney disease and play a complex role in cardiovascular disease.

Methods

AA subjects from four HTN trials (n = 961) (GERA1, GERA2, PEAR1, and PEAR2) were evaluated for blood pressure (BP) response based on APOL1 genotype after 4–9 weeks of monotherapy with thiazides, beta blockers, or candesartan. APOL1 G1 and G2 variants were determined by direct sequencing or imputation.

Results

Baseline systolic BP (SBP) and diastolic BP (DBP) levels did not differ based on APOL1 genotype. Subjects with 1–2 APOL1 risk alleles had a greater SBP response to candesartan (-12.2 +/- 1.2 vs -7.5 +/- 1.8 mmHg, p = 0.03; GERA2), and a greater decline in albuminuria with candesartan (-8.3 +/- 3.1 vs +3.7 +/- 4.3 mg/day, p = 0.02). APOL1 genotype did not associate with BP response to thiazides or beta blockers. GWAS was performed to determine associations with BP response to candesartan depending on APOL1 genotype. While no SNPs reached genome wide significance, SNP rs10113352, intronic in CSMD1, predicted greater office SBP response to candesartan (p = 3.7 x 10−7) in those with 1–2 risk alleles, while SNP rs286856, intronic in DPP6, predicted greater office SBP response (p = 3.2 x 10−7) in those with 0 risk alleles.

Conclusions

Hypertensive AAs without overt kidney disease who carry 1 or more APOL1 risk variants have a greater BP and albuminuria reduction in response to candesartan therapy. BP response to thiazides or beta blockers did not differ by APOL1 genotype. Future studies confirming this initial finding in an independent cohort are required.

Klíčová slova:

Biology and life sciences – Computational biology – Genome-wide association studies – Genetics – Genomics – Genome analysis – Human genetics – Genetic loci – Alleles – Heredity – Genetic mapping – Variant genotypes – Anatomy – Renal system – Kidneys – Medicine and health sciences – Vascular medicine – Blood pressure – Hypertension – Pharmacology – Drugs – Antihypertensives – Diuretics


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