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on January 7, 2008

Hypertension. 2008
Published online before print January 7, 2008, doi: 10.1161/HYPERTENSIONAHA.107.102574
A more recent version of this article appeared on February 1, 2008
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Submitted on October 9, 2007
Revised on November 4, 2007

Bradykinin Type 2 Receptor BE1 Genotype Influences Bradykinin-Dependent Vasodilation During Angiotensin-Converting Enzyme Inhibition

Gary P. Van Guilder; Mias Pretorius; James M. Luther; J. Brian Byrd; Kevin Hill; James V. Gainer; and Nancy J. Brown*

From the Division of Clinical Pharmacology (G.P.V.G., J.M.L., J.B.B., K.H., J.V.G., N.J.B.), Departments of Medicine and Pharmacology, and Department of Anesthesiology (M.P.), Vanderbilt University Medical Center, Nashville, Tenn; and the Veterans’ Affairs Medical Center (M.P., J.V.G.), Nashville, Tenn.

* To whom correspondence should be addressed. E-mail: nancy.j.brown{at}vanderbilt.edu.

Abstract—To test the hypothesis that the bradykinin receptor 2 (BDKRB2) BE1+9/-9 polymorphism affects vascular responses to bradykinin, we measured the effect of intra-arterial bradykinin on forearm blood flow and tissue-type plasminogen activator (t-PA) release in 89 normotensive, nonsmoking, white American subjects in whom degradation of bradykinin was blocked by enalaprilat. BE1 genotype frequencies were +9/+9:+9/-9:-9/-9=19:42:28. BE1 genotype was associated with systolic blood pressure (121.4±2.8, 113.8±1.8, and 110.6±1.8 mm Hg in +9/+9, +9/-9, and -9/-9 groups, respectively; P=0.007). In the absence of enalaprilat, bradykinin-stimulated forearm blood flow, forearm vascular resistance, and net t-PA release were similar among genotype groups. Enalaprilat increased basal forearm blood flow (P=0.002) and decreased basal forearm vascular resistance (P=0.01) without affecting blood pressure. Enalaprilat enhanced the effect of bradykinin on forearm blood flow, forearm vascular resistance, and t-PA release (all P<0.001). During enalaprilat, forearm blood flow was significantly lower and forearm vascular resistance was higher in response to bradykinin in the +9/+9 compared with +9/-9 and -9/-9 genotype groups (P=0.04 for both). t-PA release tended to be decreased in response to bradykinin in the +9/+9 group (P=0.08). When analyzed separately by gender, BE1 genotype was associated with bradykinin-stimulated t-PA release in angiotensin-converting enzyme inhibitor–treated men but not women (P=0.02 and P=0.77, respectively), after controlling for body mass index. There was no effect of BE1 genotype on responses to the bradykinin type 2 receptor–independent vasodilator methacholine during enalaprilat. In conclusion, the BDKRB2 BE1 polymorphism influences bradykinin type 2 receptor–mediated vasodilation during angiotensin-converting enzyme inhibition.


Key words: bradykinin • genotype • vasodilation • angiotensin-converting enzyme • plasminogen activators




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