Systemic hypertension is a major cause of morbidity and mortality worldwide. The development of this disease is influenced by multiple factors, some targeted genes, such angiotensin-converting enzyme (ACE) system genes and their polymorphisms has been related, there is evidence about the resistance for some antihypertensive drug with the Insertion/deletion (I/D) polymorphism. The relationship between these polymorphism and therapeutic response to antihypertensive drugs has not been studied in the Maya indigenous population of Mexico.

OBJECTIVES: The objective was to associate the response to captopril, an antihypertensive drug, with the genotype of the insertion/deletion polymorphisms of the angiotensin-converting enzyme (ACE) in indigenous individuals from Chiapas with systemic arterial hypertension.

METHODS: This was an observational, analytical, prospective, and longitudinal study. Data of Men and females older than 18 years old from “Hospital de las Culturas” from a period between June 2013 to June 2014 were included.

RESULTS: A total of 176 patients were included, of whom 68.75% (n=121) were indigenous of Mayan descent, with 33.06% (n=40) suffering from systemic hypertension. Most indigenous individuals (82.64%, n=100) were illiterate or had a basic education, and 79.34% (n=96) were farmers (men) and housewives (women). The most prevalent polymorphism in the indigenous population was the I/D polymorphism (55.93%, n=66), followed by the D/D allele (29.67%, n=35) and the I/I allele (14.40%, n=17). The D/D and I/D polymorphisms were more frequent in the group of hypertensive indigenous individuals (89.74%) but less frequent in the group of non-hypertensive mestizos (75%). Captopril response was similar in both groups of hypertensive individuals (indigenous and mestizo), with the need for more than two antihypertensive agents to achieve effective pharmacological treatment.

CONCLUSIONS: There is a higher prevalence of the Deletion allele in the indigenous population of Mayan descent with systemic arterial hypertension. Further multicenter studies are needed to explore the pharmacogenomics of antihypertensive drugs in diverse populations.