Interactive Effect of the KCNJ11 Ile337Val Polymorphism and Cigarette Smoking on the Antihypertensive Response to Irbesartan in Chinese Hypertensive Patients

Am J Hypertens. 2016 May;29(5):553-9. doi: 10.1093/ajh/hpv144. Epub 2015 Aug 24.

Abstract

Objective: This study was designed to detect the association of the potassium inwardly rectifying channel, subfamily J, member 11 (KCNJ11) gene polymorphism with antihypertensive therapeutic response to irbesartan in a large-scale Chinese hypertensive population.

Methods: A total of 1,099 patients with essential hypertension were enrolled to receive a daily dose of 150 mg irbesartan for 27 days. Pretreatment baseline blood pressure (BP) and posttreatment BP on the 28th day were measured. Plasma irbesartan concentrations were measured by high-performance liquid chromatography-fluorescence. The KCNJ11 I337V gene polymorphism was determined using high-throughput TaqMan technology.

Results: The HapMap data in the Han Chinese population showed that the I337V was used as a representative for 4 common functional polymorphisms. Our results showed that the association of antihypertensive response to irbesartan and the KCNJ11 genetic variant in the total sample was not significant. However, in nonsmokers, relative to the GG genotype, subjects with the homozygous AA genotype had a significantly higher therapeutic response to irbesartan (adjusted beta ± SE: 4.7±1.9 mm Hg, P = 0.015). In smokers, the subjects with the homozygous AA genotype had a significantly lower therapeutic response to irbesartan (adjusted beta ± SE: -5.6±2.5 mm Hg, P = 0.026). A multivariate linear regression model confirmed that there was a significant interactive effect between the KCNJ11 gene and smoking on irbesartan treatment (interaction P = 0.001).

Conclusion: The interactive effect of smoking status and the KCNJ11 genotype may influence the antihypertensive effects of irbesartan, which indicates a consideration for future individualized antihypertensive drug treatment.

Keywords: KCNJ11 gene polymorphism; blood pressure; blood pressure response; essential hypertension; hypertension; irbesartan; smoking..

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Angiotensin II Type 1 Receptor Blockers / blood
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use*
  • Antihypertensive Agents / blood
  • Antihypertensive Agents / therapeutic use*
  • Asian People / genetics
  • Biphenyl Compounds / blood
  • Biphenyl Compounds / therapeutic use*
  • Blood Pressure / drug effects*
  • Blood Pressure / genetics
  • Chi-Square Distribution
  • China / epidemiology
  • Chromatography, High Pressure Liquid
  • Essential Hypertension
  • Female
  • Gene Frequency
  • Gene-Environment Interaction*
  • Genetic Association Studies
  • Genetic Predisposition to Disease
  • Heterozygote
  • High-Throughput Nucleotide Sequencing
  • Homozygote
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy*
  • Hypertension / ethnology
  • Hypertension / genetics*
  • Irbesartan
  • Least-Squares Analysis
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Phenotype
  • Polymorphism, Single Nucleotide*
  • Potassium Channels, Inwardly Rectifying / genetics*
  • Risk Assessment
  • Risk Factors
  • Smoking / adverse effects*
  • Smoking / ethnology
  • Tetrazoles / blood
  • Tetrazoles / therapeutic use*
  • Treatment Outcome

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Antihypertensive Agents
  • Biphenyl Compounds
  • Kir6.2 channel
  • Potassium Channels, Inwardly Rectifying
  • Tetrazoles
  • Irbesartan