Genetic determinants of pseudoresistant arterial hypertension in patients with concomitant obesity

Abstract

The article focuses on studying the genetic determinants affecting the development of pseudoresistant arterial hypertension in patients with accompanying obesity. We examined 200 stage II hypertensive patients with class I–II obesity aged 45–55. Treatment is provided following the 2018 European guidelines. If the target level of blood pressure after three months of dual antihypertensive therapy with perindopril and amlodipine was not reached, the thiazide-like diuretic indapamide was additionally prescribed. Diet therapy aimed at lowering blood pressure to target values and correcting body weight was prescribed as a non-drug treatment. Patients were advised to increase physical activity by fast walking for at least 45 minutes daily. Resistant hypertension was diagnosed in 48 patients, while pseudoresistance was detected in 27 patients. It was established that the determinants of pseudoresistant hypertension in patients with concomitant obesity are the genetic polymorphism of IRS-1 and ADIPOQ, relative wall thickness of the left ventricular, HOMA index, body mass index and mean blood pressure. Concurrently, the main predictors are IRS-1 and ADIPOQ polymorphisms.