Angiotensin I-converting enzyme genotypes and angiotensin II receptors - Response to therapy

In the present study, we studied angiotensin II type 1 (AT(1)) and type 2 (AT(2)) receptor messengers by quantitative reverse transcriptase-polymerase chain reaction. We examined peripheral blood mononuclear cells from 30 healthy subjects and 50 subjects with primary hypertension, in whom angiotensin I-converting enzyme genotype was determined, before and after 15 days of treatment with different antihypertensive drugs. The medication included a calcium channel antagonist, an angiotensin I-converting enzyme inhibitor, and a beta(1)-blocker. We also studied the relationship between AT(1) receptor gene expression and biochemical parameters of the renin-angiotensin system. ATI receptor messenger levels were positively correlated with plasma renin activity in both normotensive and untreated hypertensive subjects. Increases of this messenger: and plasma angiotensin II levels were correlated with the D ailele in the same individuals. AT(1) receptor messenger levels decreased significantly with angiotensin I-converting enzyme inhibitor treatment in subjects with the BE genotype, and a significant decrease was observed in subjects with the II and ID genotypes treated with a calcium antagonist. No changes were observed in mRNA with the beta(1)-blocker. We conclude that the AT(2) receptor is not expressed in peripheral leukocytes and that AT(1) receptor messenger levels vary in relation to angiotensin I-converting enzyme genotype and pharmacological treatment, These results suggest that angiotensin I-converting enzyme genotype may be an important factor when deciding on antihypertensive therapy in individuals with primary hypertension.