[Comparative genetic analysis of different forms of low-renin arterial hypertension].

High level of clinical and genetic heterogeneity is a characteristic of arterial hypertension (AH) that is one of the most wide-spread cardiovascular diseases. In most cases (excluding a few monogenic forms), AH is a polygenic disease and genes of renin-angiotensin-aldosterone system play an important role in AH predisposition. 20-25% AH cases occur during low activity of renin in blood plasma (low-renin form of AH) while aldosterone production can be increased (hyperaldosteronism, HA) or normal. We examined polymorphism of genes that code the renin-angiotensin-aldosterone system components in the groups of low-renin forms of AH, namely, primary HA, idiopathic HA and AH with normal level of aldosterone. For all HA cases, the absence of chimeric CYP11B2/CYP11B1 gene that is a cause for monogenic disease--amilial HA of first type, was shown. A comparison of distributions of alleles and genotypes of polymorphous regions of genes: CYP11B2 (C-344T), REN (C-5434T, C-5312T and A BglI G), AGT (Thr174Met), ACE (I/D), CMA (G-1903A), AT2R1 (A1166C) and of their combinations is the groups described above was done. The analysis of carriership of the alleles and genotypes combinations of the polymorphous regions has shown that genes CYP11B2, REN, ACE, CMA andA T2R1 participate in development of low-renin HA. The results are evidence of similarities and some definite differences in genetic nature of the different forms of low-renin AH and, to say more widely, argue that the investigation of genetic predisposition for clinically heterogeneous forms of polygene diseases by comparison of groups of patients, separated in accordance with peculiarities of disease course, holds much promise for their hereditary background understanding.

[Changes in parameters of orthogonal ECG in hypertensive patients given combined antihypertensive treatment].

AIM: To evaluate changes in parameters of orthogonal ECG in hypertensive patients on trandolapril+verapamil combination. MATERIAL AND METHODS: Eighteen patients before and after 8-week therapy were examined using orthogonal ECG and 24-h monitoring of blood pressure. Computer processing of orthogonal ECG was made with calculation of some vectorcardiography (VCG) and d mapping parameters. Also, 24-h blood pressure monitoring was made. RESULTS: 8-week therapy significantly reduced mean diurnal and nocturnal systolic and diastolic blood pressure (SBP, DBP), improved their variability. In patients with VCG signs of left ventricular hypertrophy the treatment significantly diminished some VCG parameters. A direct correlation was found between initial diurnal SBP variability and SQRSxyz, SQRSxz; dynamics of nocturnal SBP variability and dynamics of SQRSxyz, SQRSxz and Rx+Sz (r = 0.7; p < 0.05). A direct correlation was between dynamics of SBP and IADI (r = 0.7; p < 0.05). CONCLUSION: Hypertensive patients treated with a fixed combination trandolapril/verapamil exhibit a positive trend not only in parameters of 24-h monitoring of blood pressure but also in parameters of orthogonal ECG.

[Contribution of CYP11B2, REN and AGT genes in genetic predisposition to arterial hypertension associated with hyperaldosteronism].

We carried out comparison of distribution of alleles and genotypes of polymorphic loci of renin-angiotensin-aldosterone system genes: CYP11B2 (C-344T), AGT (Thr174Met) and REN (C-5434T, C-5312T, and A BglI G) and their combinations in two groups of patients with low renin forms of arterial hypertension (AH). Group 1 included 59 patients with low renin hyperaldosteronism (HA) at the background of glomerular zone adenoma and hyperplasia of adrenal cortex. Group 2 included 28 patients with low renin hypertensive disease characterized by normal level of aldosterone. Complex analysis of carriership of allele and genotype combinations evidence for the difference in genetic nature of two forms of low renin AH. Participation of CYP11B2 and REN and possibly AGT genes in development of low renin AH was convincingly shown.