PO43 Prospects for the use of genetic risk scores in management and prevention in young hypertensive patients with or without concomitant obesity

Abstract The concept of evolutionary accumulation of gene polymorphisms in the realization of the hypertensive phenotype becomes promising in understanding of arterial hypertension. A large amount of data about genetic polymorphisms in population have been accumulated and perspective approaches to their integrative assessment are being formulated for practical management. The purpose of the research was to analyze the proportion of modified candidate genes (CG) in the group of young hypertensive patients (YHP) with normal or overweight or obesity with the group of non-hypertensive patients by calculating the gene modification index (GMI) for the assessment usage of genetic stratification in the management of YHP. Methods: 123 YHP (mean age 32,8 18-44, m/f 72/51), (ESC/ISH 2018) and 30 patients (control group (CG) without AH (mean age 31,1 18-44, m/f 17/13) were examined. YHP were divided into 3 groups depending on BWI : group 1 – YHP with normal BWI (n = 41, BWI - 23,0±0,2 кг/м2); group 2 - YHP with overweigt (n = 40, BWI -27,5±0,2 кг/м2); and group 3 - YHP with obesity (n =42 BWI - 34,3±0,4 кг/м2) Patients were analysed on the following CG polymorphisms by PCR: ADD1:1378, AGT:704, AGT:521, AGTR1:1166, AGTR2:1675, CYP11B2:-344, GNB3:825, NOS3:-786, NOS3:894. The GMI represents the percentage of "pathological" genotypes. The GMI from 0 to 20% was considered as low genetic risk (GR), 21 to 40 % - moderate GR, 41 to 70% - high GR, 71 to 100% - very high GR. Results: The GMI in the 1st group was (45.3±2.1%), in the 2nd – (56.4±2.3%), in the 3rd – (63.3±2.4%), while a significant difference was observed between the 1st and 2nd and 3rd groups (p1 = 0.031, p2 = 0.004, p3 = 0.053). GMI was significantly higher in hypertensive obese and overweight patients compared to patients with normal BMI. Analyzing the result of the CG, a highly significant difference with the main groups was found (P1,2,3 = 0,000). Low GR was observed in (14.6 %) patients of the 1st group, in (7.5 %) of the 2nd , in (2.4 %) of the 3rd and in (83.3 %) of CG (p1 = 0.121, p2 = 0.026, p3 = 0.194), when comparing the main groups with the CG, a highly significant difference was found (P1, 2, 3 = 0.000). Moderate GR in the main groups 1, 2, 3 was: (31.7%), (22.5%) and (19%) patients, respectively, without a significant difference between groups (p1 = 0.27, p2 = 0.095, p3 = 0.345), in CG was observed in (16.7%) patients. Most often, a high GR was found in the examined main groups without a significant difference between the groups (p1 = 0.13, p2 = 0.088, p3 = 0.43) in the 1st group – in (34.2 %) patients, in the 2nd – in (45 %), in the 3rd – in (47.6 %). The ultra-high GR was distributed as follows similarly with no significant difference between the groups Conclusions: YHP by indicators GMI differed significantly from healthy young people, which allows this indicator to be used both in pre-nosological diagnosis. In the examined groups of YHP, depending on the presence of obesity or overweight, significant differences were found in the calculation of GMI, which was significantly higher in overweight and especially obese patients. Integrative assessment of genetic cardiovascular risk by calculating GMI is a promising direction in the management of young patients with AH and can be used for the prognosis and prevention.