Blood pressure reduction in telmisartan-treated angiotensinogen G-217A polymorphism hypertensive patients: A pilot study

Context: The angiotensinogen (AGT) G-217A polymorphism has been proved as one factor contributing the susceptibility of hypertension, meanwhile, the effect of this polymorphism to the variability antihypertensive response remains unknown. Aims: To investigate whether the angiotensinogen (AGT) G-217A polymorphism affects the blood pressure response to telmisartan and valsartan in Indonesian hypertensive patients. Methods: The blood pressure was measured by ambulatory blood pressure monitoring (ABPM) and plasma angiotensinogen (AGT) levels of telmisartan- and valsartan-treated AGT G-217A polymorphism hypertensive patients (n=46) were analyzed using ELISA at the baseline and 4 months after treatments. Molecular docking was used to predict the interaction between C/EBPα and AGT G-217A polymorphism. Results: Daytime and 24 hours blood pressure in telmisartan-treated -217 AA/AG patients were significantly lower compared to GG genotype patients. The plasma AGT level in those who had AA/AG genotype and received telmisartan 80 mg was also slightly decreased compared to GG genotype, even these differences were failed to reach statistically significant. The docking results showed that the basic region of C/EBPα transcription factor recognized the partially homologous of its consensus sequences within -217A oligonucleotide, but not in -217G oligonucleotide. Conclusions: The blood pressure reduction responses in telmisartan-treated angiotensinogen G-217A polymorphism hypertensive patients might correlate with PPARγ agonist effects of telmisartan via C/EBPα and AGT -217A interaction.