Angiotensin-converting enzyme gene I/D polymorphism and carotid artery disease in renovascular hypertension

Citation
A. Losito et al., Angiotensin-converting enzyme gene I/D polymorphism and carotid artery disease in renovascular hypertension, AM J HYPERT, 13(2), 2000, pp. 128-133
Citations number
31
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
AMERICAN JOURNAL OF HYPERTENSION
ISSN journal
0895-7061 → ACNP
Volume
13
Issue
2
Year of publication
2000
Pages
128 - 133
Database
ISI
SICI code
0895-7061(200002)13:2<128:AEGIPA>2.0.ZU;2-S
Abstract
There is evidence linking the activation of the renin-angiotensin system (R AS) with target organ damage in renovascular hypertension (RVH). A genetic association of the DD genotype of the angiotensin-converting enzyme (ACE) g ene with cardiovascular complications has been found in various clinical co nditions. The aim of our study was to determine whether the insertion/delet ion (I/D) polymorphism of the ACE gene is associated with the high prevalen ce of target organ damage reported in RVH. A total of 65 atherosclerotic pa tients (age 68.2 +/- 5.2 years) with RVH and 49 atherosclerotic patients (a ge 68.0 +/- 6.3 years) with essential hypertension (EH) were sequentially e nrolled when attending the outpatient clinic for specialist assessment of t heir vascular disorder. Cardiac, renal, and vascular involvement were asses sed in both groups and blood was taken for genetic analysis. Patients with RVH had a higher prevalence of left ventricular hypertrophy (LVH), carotid artery disease, and albuminuria than those with EH. In RVH, but not in EH, the DD genotype was significantly associated with severe arterial disease. In RVH, carotid disease (lumen narrowing >60%) was present in 62% of DD pat ients versus 25% of the other genotypes (OR = 4.90, 95% CI: 1.70-14.13). Su ch an association was also present in peripheral vascular disease: 72.4% in DD patients versus 41.6% in the other genotypes (OR = 3.67, 95% CI = 1.29- 10.36). Logistic regression analysis showed that the DD genotype was the st rongest predictor of risk of severe carotid disease. We conclude that, in a therosclerotic RVH, there is an association of the severity of vascular dis ease with the DD genotype of the ACE gene. (C) 2000 American Journal of Hyp ertension, Ltd.