Differences in the response to pharmacotherapy with angiotensin II receptor blockers may be determined by polymorphisms in the genes responsible for their target of action. In this work, we investigate the pharmacodynamic parameters of daily blood pressure monitoring (DBPM) to assess the efficacy of therapy with angiotensin II receptor blockers in the form of monotherapy and as part of combination therapy in patients with arterial hypertension, depending on their genetic characteristics, i.e., polymorphism A1166C of the angiotensin II type 1 receptor gene (AGTR1). The study included 179 patients in the Moscow Oblast with newly diagnosed arterial hypertension of 1–2 stages. Among them, 141 (78.8%) were women and 38 (21.2%) were men aged 32 to 69 years, randomly assigned to irbesartan and valsartan groups in the form of mono- or combination therapy with hydrochlorothiazide by a simple randomization method. Following three weeks of pharmacotherapy, the presence of the rs5186 (A1166C) genetic polymorphism of AGTR1 gene was determined. DВPM was performed when patients were included in the study and after three months of therapy. The maximum antihypertensive effect was observed in heterozygotes A/C in the group of patients taking valsartan after three months of prescribed angiotensin II receptor blockers pharmacotherapy. This effect was manifested in a decreased average daily systolic blood pressure (SBP) and diastolic blood pressure (DBD), average night SBP, variability of night SBP and DBP. Among patients treated with irbesartan, there was no statistically significant association of the A1166C polymorphism genotype of the AGTR1 gene with these indicators. Heterozygotes showed a statistically significantly more pronounced decrease in the average sleeping heart rate in the group of valsartan patients. At the same time, the average daily heart rate decreased more significantly in C/C homozygotes in both the group of irbesartan and valsartan patients. Thus, when developing personalized treatment plans for patients with newly diagnosed stage 1–2 arterial hypertension using detection of the A1166C genetic polymorphism of the AGTR1 gene, it is advisable to recommend valsartan as a more effective initial therapy with angiotensin II receptor blockers in the form of mono- or combination therapy depending on the risk group for patients in the Moscow Oblast who are carriers of the A/C genotype.
