| Abstrak/Abstract |
Hypertension is a prevalent health concern in Indonesia, impacting 34.11% of the population in 2018. Despite ACE inhibitors being the first-line treatment, their clinical responses vary, with 39.4% of Indonesian hypertensive patients failing to reach therapeutic targets. ACE gene polymorphisms, particularly the insertion/deletion (I/D) polymorphism, are correlated with ACE inhibitor response variability in several populations. However, no prior data has explored this correlation in Indonesian hypertensive patients. This multicenter case-control study investigated the correlation between ACE I/D polymorphism and captopril effectiveness in Indonesian hypertensive patients. Hypertensive patients from Yogyakarta and Bali were divided into control (n=69) and case (n=73) groups based on target achievement. ACE I/D polymorphism was identified using Polymerase Chain Reaction (PCR) and electrophoresis, with gene prevalence tested against Hardy-Weinberg Equilibrium. Statistical analysis included chi-square test, Fisher's exact test, independent t-test, one-way ANOVA, odds ratio, and binary logistic regression. Genotype frequencies for the case group were II (58.9%), ID (32.9%), and DD (6.2%), while the control group had frequencies of II (63.8%), ID (40.4%), and DD (5.8%). No significant differences in genotype frequencies (p=0.779; OR < 1.455; 95% CI) or allele distribution (p=0.465; OR = 1.230) were observed. The difference of blood pressure reduction among the three genotypes in all participants also lacked statistical significance (p-value of ΔSBP: 0.543; ΔDBP: 0.773). Similarly, both the case groups (p-value for ΔSBP: 0.179; ΔDBP: 0.331) and the control groups (p-value for ΔSBP: 0.600; ΔDBP: 0.693) also exhibited no statistical significance in blood pressure reduction differences within genotypes. ACE I/D polymorphism is not significantly associated with blood pressure reduction following captopril therapy in Indonesian hypertensive patients. Other gene polymorphisms (e.g., AGT, AT1, AT2, ACE2) and environmental factors may play a more substantial role in captopril's effectiveness. These results underscore the limited predictive utility of ACE I/D polymorphism in managing hypertension with captopril. |
