Objective. To assess the influence of traditional cardiovascular risk factors and polymorphism of the renin-angiotensin-aldosterone system genes on the development of carotid atherosclerosis in patients with arterial hypertension (AH).

Materials and methods. Clinical and genetic analysis was performed in 201 patients with AH (111 men and 90 women) whose mean age was 48.4±10.9 years. Clinical examinations with determination of the salt sensitivity threshold and filling in a questionnaire on nutrition, electrocardiography, biochemical blood test, ultrasonography of the carotid arteries were performed. Genotyping of polymorphism of angiotensin-converting enzyme ACE (I/D) genes, angiotensinogen AGT (М235Т), angiotensin II receptors type 1 AGTR1 (A1166C), and type 2 AGTR2 (C3123A), aldosterone synthase CYP11B2
(C(-344)T), REN (19-83 G/A) was provided using the polymerase chain reaction.

Results. The ultrasound examinations revealed atherosclerotic plaques (ASP) in the carotid arteries in 55 patients (27.4%). Age over 45 years (p<0.001), male sex (p=0.009), an increased threshold of the salt sensitivity (p=0.024), an increased blood glucose (p=0.002), the fresh vegetables (p=0.029) and fruits (p=0.006) insufficient consumption, an increased waist circumference (p=0.001) as well as smoking combined with the carriage of the CT/TT genotypes C(-344)T polymorphism of the CYP11B2 gene (p=0.035) were the factors associated with the carotid ASP in patients with AH. Based on the multiple regression analysis results, independent indicators increasing the likelihood of carotid atherosclerotic lesions in patients with AH were specified as age over 45 years (OR=11.8; 95% CI=5.8—17.3), combination of smoking with CT/TT genotypes polymorphism C(-344)T of the CYP11B2 gene (OR=9.7; 95% CI=2.5—15.7), insufficient consumption of fresh fruit (OR=9.1; 95% CI=2.4—33.3), and an increased blood glucose (OR=3.2; 95% CI=1.2—8.7).

Conclusion. In this study, a synergistic effect of interaction between smoking and C(-344)T polymorphism of the CYP11B2 gene influencing on carotid atherosclerotic lesions in patients with AH was obtained. Age, insufficient intake of fresh fruits, and increased blood glucose were also independent cardiovascular risk factors associated with the carotid atherosclerotic plaques.