Observational studyPharmacogenomics2026
Association of ACE I/D polymorphism with blood pressure response to valsartan-hydrochlorothiazide combination therapy in hypertensive patients from Khyber Pakhtunkhwa, Pakistan.
Observational study in Pharmacogenomics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundInterindividual variability in antihypertensive response may be partly explained by genetic variation. The angiotensin-converting enzyme insertion/deletion polymorphism (ACE I/D; rs1799752) has been associated with variable response to renin-angiotensin-aldosterone system-targeting therapies, but evidence for valsartan-hydrochlorothiazide (Val-HCTZ) combination therapy remains limited, particularly in South Asian populations.
methodsIn this multicenter prospective cohort study, 645 hypertensive patients from Khyber Pakhtunkhwa, Pakistan, receiving fixed-dose Val-HCTZ were enrolled; 627 were included in the final analysis after excluding 18 patients with poor adherence (<80%) followed for 3 months. ACE I/D genotyping was performed by polymerase chain reaction with confirmatory testing. The primary analysis evaluated blood pressure reduction across ACE I/D genotypes using regression models adjusted for age, sex, and body mass index. Achievement of target blood pressure (<140/90 mmHg) was analyzed as a secondary outcome.
resultsGenotype distribution was in Hardy-Weinberg equilibrium (
conclusionACE I/D genotype was associated with variation in blood pressure response to fixed-dose Val-HCTZ therapy in this Pakistani cohort, with the most robust finding being poorer response among ID carriers. These findings support further investigation of ACE I/D as a candidate pharmacogenetic marker in genotype-stratified and interventional studies.
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