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Most of the known actions of angiotensin II are mediated by the angiotensin II type 1 receptor (AGT1R). The adenine/cytosine1166 (A/C1166) polymorphism of the AGT1R gene has been shown to be associated with hypertension and hypertension-related diseases. Thus, it may have the potential to predict the blood pressure response of patients with hypertension to angiotensin-converting enzyme inhibitors (ACEIs).To investigate the association between the A/C1166 polymorphism and the blood pressure response to ACEIs in a hypertensive cohort.After a 2-week, single-blind, placebo run-in period, ACEIs were administered for 6 weeks to 509 hypertensive patients. The polymorphism was determined by PCR followed by restriction enzyme digestion.The AA genotype, AC genotype, and CC genotype were present in 464 (91.2%), 44 (8.6%), and 1 (0.2%) of patients, respectively. As the frequency of the C allele was quite low (0.05), the genotypes were classified according to the presence or absence of the C allele. After 6 weeks of treatment, the systolic blood pressure reductions in patients with the AA genotype and AC + CC genotype were 14.3 ± 12.6 and 14.1 ± 12.2 mmHg, respectively (P = 0.908). The diastolic blood pressure reductions in patients with the AA genotype and AC + CC genotype were 8.6 ± 7.1 and 8.8 ± 6.9 mmHg, respectively (P = 0.816). There were no differences in the changes in systolic or diastolic blood pressure after treatment among the two genotype groups.The AGT1R A/C1166 polymorphism does not predict the response to antihypertensive treatment with ACEIs in Chinese hypertensive patients.