RISK OF ARTERIAL HYPERTENSION IN THE POPULATION OF WESTERN UKRAINE DEPENDING ON CLINICAL, GENDER, AND MOLECULAR-GENETIC PREDICTORS
Introduction. Nowadays, the number of adults with hypertension has doubled worldwide from 650 million in 1990 to 1.28 billion in 2019, mostly in low- and middle-income countries. Late diagnosis of the disease leads to increased morbidity, target organs damage, and early disability. Therefore, risk factors stratification for patients with hypertension is an important task of modern medicine.
Objective. To study the risk of essential arterial hypertension (EAH) in the population of Western Ukraine, taking into account anthropometric, clinical and demographic, gender and genetic factors (NOS3, rs2070744 and GNB3, rs5443).
Materials and methods. 100 patients with EAH and 48 apparently healthy individuals (the control group) participated in the study. All participants underwent clinical and laboratory examinations. Risk factors included a burdened anamnesis of cardiovascular disease (CVD), type 2 diabetes mellitus (DM2), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), body mass index (BMI) in men (M) and women (W). GNB3 (rs5443) and NOS3 (rs2070744) genes genotyping was performed by real-time PCR.
Results. The EAH risk in the population generally increased due to the CVD burdened heredity regardless of the NOS3 (rs2070744) and GNB3 (rs5443) genes genotypes by almost 3–4.5 times, with the most pronounced correlation in the mutation C-allele carriers of the NOS3 gene and in T-allele carriers of the GNB3 gene [OR = 3.10–4.29; OR (95% CI): 1.03–13.77; p ≤ 0.041–0.005], due to DM2 – by 7–14 times [OR = 7.14–14.25; OR (95% CI): 1.0–127.2; p ≤ 0.043–0.006], due to increased WC (M > 102 cm, W > 88 cm) – by 3.5–17 times [OR = 3.45–16.67; OR (95% CI): 1.06–66.09; p ≤ 0.035–0.0001]. Gender analysis confirmed the association between increased risk of EAH and elevated WHR, but only for women (> 0.85 U) – by 4.5–51 times [OR = 4.44–51.33; OR (95% CI): 1.10–346.9; p ≤ 0.036–0.0001] in TT‑genotype carriers of the NOS3 gene and in the CC-genotype carriers of the GNB3 gene. Augmented BMI (> 25.0 kg/m2) also enhanced the EAH risk by more than 6–9 times [OR = 6.29–9.0; OR (95% CI): 1.0–83.07; p ≤ 0.034–0.011], but only in women with TT genotype of the NOS3 gene and the CC genotype of the GNB3 gene (rs5443) – by 5 times [OR = 4.80; OR (95% CI): 1.25–18.42; p = 0.019] and 11.5 times [OR = 11.50; OR (95% CI): 2.01–65.91; p = 0.004], respectively.
Conclusions. The risk of EAH in the Western Ukraine population increased with burdened CVD heredity regardless of genetic factors, DM2, elevated BMI, WC and WHR, but only in women, with the most pronounced correlation in the TT genotype carriers of NOS3 gene and CC genotype patients of GNB3 gene.
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