Genetic variation in CYP4A11 and blood pressure response to mineralocorticoid receptor antagonism or ENaC inhibition: An exploratory pilot study in African Americans

Cheryl L. Laffer, Fernando Elijovich, George J. Eckert, Wanzhu Tu, J. Howard Pratt, Nancy J. Brown

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

An rs3890011 variant of CYP4A11, which is in linkage disequilibrium with the loss-of-function variant rs1126742, is associated with hypertension in humans. In mice, Cyp4a deficiency results in salt-sensitive hypertension through activation of ENaC. We tested the hypothesis that the rs3890011 variant is associated with blood pressure response to drugs acting via the ENaC pathway. African Americans with volume-dependent, resistant hypertension were randomized to treatment with placebo, spironolactone, amiloride, or combination. Blood pressure responses were analyzed by CYP4A11 genotypes. Rs3890011 (GG:GC:CC = 20:35:28) and rs1126742 (TT:TC:CC = 45:31:7) were in linkage disequilibrium (D' = 1, r = 0.561). Expected small number of rs1126742 CC homozygotes precluded analysis of the effect of this genotype on treatment responses. Spironolactone reduced blood pressure in rs3890011 GG and GC individuals, but not in CC homozygotes (P =.002), whereas amiloride reduced blood pressure similarly in all rs3890011 genotypes. The antihypertensive effects of spironolactone and amiloride were comparable in GG and GC participants, but only amiloride reduced pressure in CC homozygotes (-6.3 ± 7.3/-3.2 ± 4.0 vs. +6.8 ± 7.9/+4.8 ± 8.6 mm Hg, P <.01/<.05). The aldosterone response to spironolactone was also blunted in the CC genotype. In individuals homozygous for the CYP4A11 rs3890011 C allele, blood pressure is resistant to mineralocorticoid receptor antagonism, but sensitive to ENaC inhibition, consistent with ENaC activation. Studies in a larger population are needed to replicate these findings.

Original languageEnglish
Pages (from-to)475-480
Number of pages6
JournalJournal of the American Society of Hypertension
Volume8
Issue number7
DOIs
StatePublished - 2014

Fingerprint

Mineralocorticoid Receptors
Spironolactone
African Americans
Amiloride
Blood Pressure
Homozygote
Genotype
Linkage Disequilibrium
Hypertension
Aldosterone
Antihypertensive Agents
Salts
Alleles
Placebos
Pressure
Therapeutics
Pharmaceutical Preparations
Population

Keywords

  • Amiloride
  • epithelial sodium channel
  • hypertension
  • spironolactone

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Internal Medicine

Cite this

Genetic variation in CYP4A11 and blood pressure response to mineralocorticoid receptor antagonism or ENaC inhibition : An exploratory pilot study in African Americans. / Laffer, Cheryl L.; Elijovich, Fernando; Eckert, George J.; Tu, Wanzhu; Pratt, J. Howard; Brown, Nancy J.

In: Journal of the American Society of Hypertension, Vol. 8, No. 7, 2014, p. 475-480.

Research output: Contribution to journalArticle

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