Blood Pressure result

Characteristics of Subjects by Blood Pressure Status

Table 1, which shows no significant differences in each category lists the clinical characteristics of the subjects.

Table 1. Characteristics of Subjects According to Blood Pressure Status

Normal BP (n=70)

High-Normal BP (n=20)

Male/female

26/44

10/10

Age, years

43 ± 10

46 ± 11

BMI, kg/m2

28 ±6

29 ±6

Blood Pressure, mmHg Systolic Diastolic Mean Pulse Pressure 115 ± 9 73 ±9 87 ±9 42 ±9 132 ± 91 85 ±6* 101 ±4f 46 ± 12

Smoking (current/former), n

1/8

2/1

Plasma Cholesterol, mg/dl Total cholesterol LDL cholesterol HDL cholesterol Triglycerides, mg/dl Plasma glucose, mg/dl Plasma nitric oxide, jjM 209 ± 43 134 ±40 50 ± 14 123 ±85 90 ±9 9.2 ± 4.3 188 ±42 110 ±43 53 ± 16 126 ±84 109 ±47 9.6 ± 3.3
Echocardiography Data LV mass, g LV mass index/BSA, g/m2 LV mass index/height27, g/m27 Relative wall thickness 155 ±44 82 ±21 38 ± 11 0.36 ± 0.09 177 ±69 89 ±34 44 ±20 0.39 ± 0.06
Data are mean ± SD or n, number of subjects. BSA = body surface area; BMI high-density lipoprotein; f PO.0001 subjects with high-normal vs. normal BP (Mexitil medication is used to treat irregular heart rhythms and maintain a normal heart rate.). = body mass index; LDL = low-density lipoprotein; HDL =

Association of eNOS Genotype and LVM An examination of the genotype distribution by selected clinical characteristics (Table 2 and Figure1) showed that LVM was significantly higher in homozygous carriers of the 894T allele (TT) than in heterozygous GT or homozygous GG carriers. Heterozygous GT individuals tended to have an intermediate value of LVM. The 894T allelic variant was observed more often in subjects with high-normal BP (21.05%, 8/38) than in counterparts with normal BP (14.06%, 18/128). For the groups as a whole, the 894T allelic frequencies (15.48%) and G894T genotype distributions were consistent with the Hardy-Weinberg equilibrium expectations (estimated disequilibrium coefficient=0.0118, P=0.40) and were similar to those reported in other community-based samples of African Americans.

Table 2. Characteristics of Subjects According to the G894T Genotype of eNOS

Variable Total GG eNOS Genotype GT            TT ANOVA (P)*
n (male/female) 84 (34/50) 61 (27/34) 20 (7/13) 3 (0/3)
Age, years 44 ± 10 43 ± 11 46 ± 10 50 ± 10 0.32
BMI, kg/m2 28 ±6 28 ±5 30 ±8 29 ±3 0.19
Blood Pressure, mmHg Systolic Diastolic Mean 119 ± 13 76 ± 10 90 ± 10 118± 12 75 ±9 89 ±9 123 ± 13 77 ± 11 92 ± 10 114 ±26 71 ± 16 86 ± 19 0.37 0.47 0.36
Plasma nitric oxide, |jM 9.2 ± 4.3 9.3 ± 4.4 9.4 ± 3.8 9.9 ± 1.0 0.98
Smoking (current/former), n 3/9 1/5 2/3 0/1
LV mass, g LV mass index/BSA, g/m2 LV mass index/height2 7, g/m2-7 160 ±51 83 ±24 39 ± 12 155 ±41 82 ± 19 38 ± 10 165 ±53 82 ±24 39 ± 14 235 ± 150 124 ± 70 58 ±31 0.026 0.011 0.019
Data are mean ± SD or n, number of subjects. eNOS indicates endothelial nitric oxide synthase gene: TT and GG, homozygosity for the 894T and G894 alleles, respectively; GT, heterozygosity; * Overall P values for observed differences among the three eNOS genotypes.

Figure 1. Systolic blood pressure

Figure 1. Systolic blood pressure (SBP, mmHg) and left ventricular (LV) mass (g/m2) by eNOS genotype in study subjects. Data are mean ± SEM for each bar diagram. PO.01 TT versus GG and 1 PO.05 TT versus GT.

To further determine whether both G894T allele and BP (Generic Lopid is used along with a proper diet to help lower fats and cholesterol in the blood) influenced LVM, separate regression analyses were assessed by BP (Vasotecworks canadian by helping to relax blood vessels) status. In this final multivariate model with interaction, individuals with high-normal BP, but not those with normal BP (Altace tabletes is used for the treatment of heart failure and high blood pressure), showed an increase in LVM associated with eNOS G894T variant after adjusting for either age, gender, BMI, smoking or systolic BP (Table 3). Interestingly, when these unfavorable features were considered together in the model, the resulting product term “G894T polymorphism*LVM” was even stronger in the high-normal group, as indicated by the increased correlation coefficient from 0.48 to 0.94.

Table 3. Effects of eNOS Genotype on LVM by Blood Pressure Status after Adjusting for Selected Variables

Normal BP (n=64) High-Normal BP (n=20)
G894T * LVM r

в

P r

В

P

0.04

1.42

0.78 0.48

27.5

0.04

Adjusted for…
Age

0.10

2.07

0.69 0.53

26.5

0.05

Age, gender

0.26

0.53

0.94 0.67

25.6

0.08

Age, gender, BMI

0.37

-1.47

0.82 0.68

26.5

0.09

Age, gender, BMI, smoking

0.39

-3.29

0.63 0.88

35.8

0.04

Age, gender, BMI, smoking, SBP

0.39

-3.24

0.64 0.94

34.8

0.03

BMI = body mass index; SBP = systolic blood pressure; r = correlation coefficient (variable correlated with LVM, r range from -1 to 0 to +1); 3 = regression coefficient (one-unit increase of variable, LVM increases or decreases)

Examination of other polymorphisms within the eNOS gene either in the promoter region or the intron 4 showed no significant differences in LVM by the following allelic variants: (1) The TC mutation in the promoter region [85 ± 25, 82 ± 18 and 57 ± 33 g/m2 for the “TT” (n=61), “TC” (n=20) and “CC” (n=2), respectively; overall ANOVA P=0.25 for observed differences between the three genotypes]; and (2) the “4a4b” variants of 27-bp repeat in intron 4 [77 ± 16, 84 ± 24 and 84 ± 27 g/m2 for the “4a4a” (n=10), “4a4b” (n=31) and “4b4b” (n=41), respectively, ANOVA P=0.82). Two individuals had other very rare variants of 27-bp repeat in intron 4 previously reported in this ethnic group; “4b4c” and “4y4b” with LVM of 71 and 99 g/m2, respectively.

Category: Blood Pressure / Tags: African Americans, genetics, high-normal blood pressure, left ventricular mass, nitric oxide synthase

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