Influence of Autonomic Dysfunction, Gln27Glu Polymorphism of b2-Adrenergic Receptor, and I/D Polymorphism of Angiotensin-Converting Enzyme Genes on Target Organs (Heart and Brain) in Kyrgyz Patients with Essential Hypertension

Andrey Polupanov, PhD,ScD, Abdimutalip Halmatov, PhD, Bolot Kalmyrzaev, PhD, Tatyana Romanova, PhD, ScD*, Natalia Cheskidova, PhD, Ainagul Dzhumagulova, PhD, ScD

Mirsaid Mirrakhimov National Center of Cardiology and Internal Medicine, Bishkek, Kyrgyzstan

*Corresponding author: Tatyana Romanova, PhD,ScD, Mirsaid Mirrakhimov National Center of Cardiology and Internal Medicine, 3, Togolok Moldo str., 720040, Bishkek, Kyrgyzstan. Tel.: 996-312-66-5027, Fax: 996-312-66-0387.E-mail:


Background: Essential hypertension (EH) is traditionally associated with overactivity of sympathetic and renin-angiotensin systems and has multifactorial origin, arising from an interaction between susceptibility genes and environmental factors.

Objectives: to examine the autonomic nervous system, polymorphism of the angiotensin-converting enzyme (ACE) and β2-adrenergic receptor (β2-AR) genes in hypertensive patients with complications (left ventricular hypertrophy and ischemic stroke).

Methods: Heart rate variability (HRV) with active tilt-test, 24 h blood pressure monitoring (BP), echocardiography, Gln27Glu polymorphism of β2-AR, and I/D polymorphism of ACE genes were studied in 250 Kyrgyz EH patients with and without complications.

Results: A significant reduction of HRV and decreased response of LF (low frequency) component to tilt-test in hypertensive patients were observed compared to control. Tilt-test in patients with complications of EH had shown inverse response of LF to orthostatic test. Patients with Gln27Gln genotype in comparison to other variants of Gln27Glu polymorphism of β2-AR were characterized by increasing meanings of BP and its morning raises, which possibly may cause increasing of left ventricular mass in these patients. In EH patients with ischemic stroke, DD genotype frequency was more than twofold greater than those with uncomplicated EH. Night hypertension, greater BP variability, and increased carotid intimal thickness are common features in patients with the DD genotype of the ACE gene.

Conclusion: The inverse reaction of LF to orthostatic test can be regarded as an unfavorable prognostic sign, predisposing complications of EH. Our data support an association between I/D polymorphism of ACE gene and stroke in patients with EH.

essential hypertension, heart rate variability, stroke, genes.
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Int J Biomed. 2011; 1(2):59-65. © 2011 International Medical Research and Development Corporation. All rights reserved