Hypertension Pharmacogenomics Clinical Study Of Individual Drugs And Anti—hypertension Gene Orientation In Nanyang

Background:Essential hypertension (EH) is a ancient and common disease. According to a survey, to2010, there are200millions EH patients in China. At present, changing lifestyle and drug are the main treatment of hypertension, and most of the EH patients should take drugs. For a long time, the choice of antihypertensive drugs in hypertensive patients is mainly based on the clinical experience. However,antihypertensive drug curative effect and adverse reactions of individual differences in different patients have obvious difference. In recent years, the domestic and foreign research confirmed that antihypertensive drug efficacy and drug adverse reactions are closely related to genetic factors. Now antihypertensive drug related with gene polymorphism and patients with different clinical antihypertensive efficacy and adverse reactions of correlation study has become a hot topic of many researchers. Application of gene polymorphism of clinical research on individual treatment of hypertension is of great importance.Now research on hypertension related gene polymorphism is limited to a polymorphism and efficacy of correlation studies. So far, there has no therapeutic schedule according to prospective for genotying observation curative effect and adverse reactions. This study will research the five classes of antihypertensive drug efficacy of related genes [angiotensin gene (ACE gene-rs4646994), angiotensin Ⅱ type Ⅰ receptor gene (AGTR1gene-rs5182), endogenous nitric oxide synthase gene (eNOS3-rs1799983gene), epithelial sodium channel encoding gene (SCNN1G gene rs5723, rs5729), beta1adrenergic receptor gene (ADRB1gene-rs1801252, rs1801253), cytochrome oxidase P4502D6gene (CYPD2D6gene-rs1065852, rs4986774, rs5030655, rs28371725), a1C subunit of L-type calcium channel gene (CACNA1C gene rs5065), a serine threonine kinase39gene (STK39gene-rs1137617), cytochrome P4502C9gene (CYP2C9gene rs1057910)] which have reached a consensus through the Tap-man probe method. According to the result of these detections, the clinical antihypertensive effect and the incidence of common adverse reactions were observed. Compared to conventional antihypertensive medication options and gene oriented, and then, the clinical significance of gene orientation antihypertensive therapy were explored.Objective:To analyse the gene distribution of antihypertensive drugs of Henan Nanyang hypertensive area patients, and to provide reference for the individual treatment of this regions, improve the economic benefits of antihypertensive treatment, To observe and contrast the clinical efficacy、the incidence rate of adverse reaction, the average daily antihypertensive costs of conventional antihypertensive therapy and gene oriented therapy, then to explore the clinical significance of gene orientation antihypertensive drugs.Methods:This study enrolled135patients with essential hypertension, we test13related gene locus by Tap-man probe method for five classes of antihypertensive drug which has reached the domestic and foreign professional accept,then we analysed the gene distribution of antihypertensive drugs in different population. the patients with primary hypertension in135cases were divided into A group of56person (conventional group)and B group(gene oriented group) of73person (for compliance and adverse reaction to remove6people), the level of blood pressure were recorded in0weeks,2weeks,4weeks,8weeks, and the incidence of adverse reactions. the biochemical indicators of patients were recorded in0weeks and8weeks. All the data was handled by t test or chi square test analysis.Results:1. Hydrochlorothiazide, losartan and amlodipine may be better for the hypertension patients in Nanyang area,2. Metoprolol may have a poor effect of antihypertensive and have a high risk of bradycardia,3.The female patients who take ACEI drugs have a poor effect of antihypertensive and have a high risk of cough (P<0.05),4. Amlodipine may have a better effect for the hypertension patients with obesity(P<0.05).5. A, B two groups patients’ eventually blood pressure are standard, but the B group patients’ blood pressure reached faster and less volatile(P<0.05);6.the adverse reaction and the average cost of anti hypertension of B group were significantly higher than A group(P<0.05)。Conclusion:The patients with hypertension in Nanyang area can widely use hydrochlorothiazide, losartan and amlodipine; but metoprolol is just the opposite; female patients does not be suggested the application of ACEI; the hypertension patients with obesity may be better with amlodipine.Gene orientation antihypertensive regimen can not only make blood pressure reach the standard rapidly, but also reduce the incidence of adverse reactions, and can reduce the economic burden of EH patients significantly.