It's known that pathological changes in structural and functional condition of the heart, which are caused by arterial hypertension, trigger development of chronic heart failure and disablement of population. Nowadays, it proven that candidate genes, expression products of which participate in regulating vascular tone, have considerable influence upon development of arterial hypertension, however their role in pathogenesis of arterial hypertension has not been fully clarified, and results of the respective researches significantly vary among different populations. To determine the structural and functional state of the heart in patients with hypertension depending on the polymorphism of the A1116C gene of the angiotensin II receptor type I and the T786C promoter of the endothelial NO-synthase gene we examined 86 patients, aged from 45 to 76 years. 30 people without signs of hypertension were in the control group. The structural and functional state of the heart was assessed by cardiac ultrasound according to standard methods. Studies of the A1166C allelic polymorphism of the angiotensin II receptor gene type 1 and the T786C promoter of the eNOS gene were performed by polymerase chain reaction with electrophoretic detection of results. Analysis of cardiac ultrasound showed, that in the patients – carriers of C-allele of both studied genes (AС+СС and TC+CC) left ventricular ejection fraction tended to decrease. We found a bigger thickness of the posterior wall of the left ventricle in patients with CC genotype compared to carriers of AA genotype A1166C – (1.3±0.07) cm vs. (1.1±0.05) cm (p<0.005). The mass of the left ventricular myocardium index in the group of patients with the genotype AC and CC was (157.5±7.3) g/m2 and (161.5±7.1)) g/m2, respectively, being by 16.7% and 19.6% more than in carriers of AA genotype of the AGTR1 gene. In the groups of patients-carriers of C-allele (TC+CC) of the eNOS gene the mass of the left ventricular myocardium index values were (155.2±11.4)) g/m2 and (158.4±7.9)) g/m2, respectively, which is by 5.4% and 7.5% more than in carriers of TT genotype. The mean size of the left atrium was significantly higher in patients who had AC and CC genotype of the AGTR1 gene, as well as TC and CC genotype of the eNOS gene compared with the control group. Carriers of C-allele (AC+CC genotype) of AGTR1 gene polymorphism had clearly bigger sizes of the left atrium, as compared to homozygotes by A-allele. The severity of diastolic dysfunction was higher in carriers of the CC genotype of the AGTR1 gene and the eNOS gene than in heterozygotes of the studied genes by 4.3% and 3.3%, respectively. The research shows that inheritance of CC genotype for A1166C polymorphism of the the angiotensin II type 1 receptor gene and of CC T786C polymorphism in the promoter of eNOS gene is associated with more noticeable changes in structural and functional heart condition among patients with arterial hypertension.

Relevance. Dissensions in genotype distribution may substantively vary among different ethnic groups; that is why association of particular polymorphous markers with arterial hypertension (AH) development not always matches among distinct populations, which makes researches significant for every ethnic and population group. Objective is to study prevalence of polymorphism of A1166C-gene of angiotensin II receptor of the first type and T786C-promoter of endothelial NO-synthase gene among patients with arterial hypertension, residents of Ternopil region. Material and methods. We have examined 86 patients with arterial hypertension who were treated and examined in the therapeutic department of the Central District Hospital in Kozova, aged from 45 to 76 years. The control group consisted of 30 healthy individuals. Genetic typing of endothelial NOS genes and angiotensin II receptors (type 1) genes was performed by means of polymerase chain reaction with electrophoretic scheme of result detection. Results. When analyzing the frequency distribution of genotypes of polymorphism A1166C of the angiotensin II receptor gene type 1, it was found that the proportion of CC genotype in patients with stage 3 hypertension was 61.1%, which is probably more than in the control group – 16.6% (χ² = 10, 0, p = 0.002). Among patients with stage 2 hypertension, the frequency of AA genotype A1166C polymorphism of the angiotensin II type 1 receptor gene was lower than in the control group (19.1% vs. 43.3%, χ² = 5.2, p = 0.02), and among patients with stage 3 hypertension, the number of individuals with the AA genotype was 11.1% versus 43.3% in the control group (χ² = 5.43, p = 0.02). Analysis of the T-786C polymorphism of the eNOS gene promoter revealed that in patients with stage 2 hypertension, the frequency of pathological CC genotype was higher than in the control group (38.3% vs. 16.6%, χ² = 4.09, p = 0.04 ), patients with stage 3 hypertension also had a greater number of carriers of the CC genotype than in the control group (44.4% vs. 16.6%, χ² = 4.4, p = 0.03). Conclusions. Results of the research have shown that polymorphism of the type 1 angiotensin II receptors’ A1166C gene and of the eNOS gene T786C-promotor are associated with development of arterial hypertension.