INTERRELATION OF GENES POLYMORPHISM OF THE ENDOTHELIAL NO-SYNTHASE (G894T, T786C) AND THE ENDOTHELIN-1 (G5665T) WITH THE EFFICIENCY OF THERAPY IN PATIENTS WITH ARTERIAL HYPERTENSION AFTER PREVIOUS ISCHEMIC STROKE

Background. Gene polymorphism of the endothelial NO-synthase (e-NOS) (G894T, T786C) and endothelin-1 (EDN-1) (G5665T) may be associated with a different response of patients with arterial hypertension (AH) to endotheliotropic therapy (ET). The aim of the study was to investigate the interrelation of the gene polymorphism of the e-NOS (G894T, T786C) and EDN-1 (G5665T) with the efficacy of therapy in patients with arterial hypertension after previous ischemic stroke. Material and methods: 65 people with arterial hypertension of II degree after previous ischemic stroke were examined. In all the patients, genotypes of e-NOS genes (G894T, T786C) and EDN-1 (G5665T) gene were determined. Endothelial function and vascular wall stiffness parameters were assessed in subgroups of homozygotes for dominant alleles (SGA) and in subgroups containing a recessive allele (SGB) before and after 12 weeks of ET. Results: Patients of SGB of e-NOS (G894T, T786C) and EDN-1 (G5665T) genes did not show a significant increase in forearm blood flow (FBF) and the percentage of target values of this parameter was lower compared to that in SGA. There was no significant decrease in the pulse wave velocity (PWV) in patients of EDN-1 (G5665T) gene SGB. The percentage of achievement of the target values of PWV in SGB was lower compared to that in SGA. Conclusions: Gene polymorphism of the e-NOS (G894T, T786C) and EDN-1 (G5665T) is not associated with the hypotensive effect of the drugs. The effect of the G894T e-NOS gene, T786C e-NOS gene and the G5665T EDN-1 gene correlated with the efficacy of endothelial dysfunction correction, which is manifested by the absence of a significant increase in FBF in carriers of genotypes with recessive alleles. The interrelation of the G5665T EDN-1 gene with the efficiency of correction of increased pulse wave velocity has been revealed, which is manifested by the absence of a significant lowering of this parameter in carriers of genotype with recessive alleles.