Consilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum9487910.26442/2075-1753_19.10.49-52Research ArticleThe importance of polymorphisms of the ABCB1 and CYP3A5 genes in predicting the efficacy and safety of amlodipine in patients with arterial hypertension of 1-2 degreeMorozovaT. Etemorozova@gmail.ruShikhN. V-SychevD. A-KalleE. G-RigikovaK. A-I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian FederationRussian Medical Academy of Continuous Professional Education of the Ministry of Health of the Russian Federation151020171910495228122021Copyright © 2017, Consilium Medicum2017Purpose. Increase of efficacy and safety of pharmacotherapy of AH 1-2 degree for personalization of choice of amlodipine dosage regimens based on genotyping according to ABCB1, CYP3A5. Materials and methods. Antihypertensive efficacy and tolerability of amlodipine was evaluated in 100 patients with AH 1-2 degree at the age of 49 to 67 years (compare age 53.9-10.9), depending on the genotypes of the ABCB1 and CYP3A5 genes. Results. Detection of the TT genotype by the polymorphic marker C3435T of the ABCB1 gene predicts an excellent antihypertensive efficacy of amlodipine (sensitivity 36.8%, specificity 90.3%), and therefore its initial dose may be 5 mg/day; detection of the HS genotype - lower antihypertensive efficacy (sensitivity 32.7%, specificity 86.6%), and therefore it is advisable to prescribe amlodipine at a dose of 10 mg/day. The detection of the GG genotype by the polymorphic marker A6986G of the CYP3A5 gene is associated with a higher risk of developing NDP (sensitivity 28.8%, specificity 92.7%), which makes undesirable growth to amlodipine from 5 to 10 mg. Occlusion. Carrying of different genotypes ABCB1 on polymorphic marker C3435T is associated with indicators of antihypertensive efficacy of amlodipine, and carriage of various CYP3A5 genotypes by polymorphic marker A6986G - with safety parameters for long-term use.arterial hypertensionamlodipineefficacysafetypharmacogeneticsABCB1 geneCYP3A5 genegene polymorphismартериальная гипертензияамлодипинэффективностьбезопасностьфармакогенетикаген АВСВ1ген CYP3А5полиморфизм генов[Чазова И.Е., Жернакова Ю.В., Ощепкова Е.В. и др. Распространенность факторов риска сердечно-сосудистых заболеваний в российской популяции больных артериальной гипертонией. Кардиология. 2014; 10: 4-12.][2013 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31 (7): 1281-357.][Клинические рекомендации «Диагностика и лечение артериальной гипертонии». 2013. http://www.cardioweb.ru/klinicheskie-rekomendatsii][2016 European Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J 2016; 37: 2315-81. DOI: 10.1093/eurheartj/ehw106][Леонова M.B., Белоусов Д.Ю., Штейнберг Л.Л. и др. Анализ фармакотерапии артериальной гипертонии по результатам исследования ПИФАГОР III. Фарматека 2010;(8): 87-95.][Кукес В.Г., Сычев Д.А., Фейсал Аль-Ахмад, Дмитриев В.А. Влияние индивидуальных особенностей пациентов на риск развития нежелательных лекарственных реакций. Вестн. Росздравнадзора. 2011; 6: 59-63.][Kim K.A, Park P.W, Park J.Y. Effect of ABCB1 (MDR1) haplotypes derived from G2677T/C3435T on the pharmacokinetics of amlodipine in healthy subjects. Br J Clin Pharmacol 2007; 63 (1): 53-8. Epub 2006 Jul 21.][Guo C, Pei Q.I, Tan H. et al. Effects of genetic factors on the pharmacokinetics and pharmacodynamics of amlodipine in primary hypertensive patients. Biomed Rep 2015; 3 (2): 195-200.][Huang Y, Wen G, Lu Y et al. CYP3A4*1G and CYP3A5*3 genetic polymorphisms alter the antihypertensive efficacy of amlodipine in patients with hypertension following renal transplantation. Int J Clin Pharmacol Ther 2016.][Дрибноходова О.П., Миронов К.О., Дунаева Е.А., Шипулин Г.А. Полиморфизмы генов, кодирующих транспортеры лекарственных средств ABCB1 и ABCG2, и исследование их методом пиросеквенирования. Эксперим. и клин. фармакология. 2012; 75 (10): 29-36.]