原发性高血压血管紧张素转换酶基因多态性与性别的关系

目的　研究血管紧张素转换酶 (ACE)基因插入 缺失 (I D)多态性与不同性别原发性高血压 (EH)的关系。方法　应用聚合酶链反应技术分析 138例原发性高血压患者及 6 0名正常对照组的ACE基因型。结果　原发性高血压组缺失纯合子 (DD)基因型及D等位基因频率显著高于对照组 (P<0 .0 5 )。且男女两性相比 ,原发性高血压组男性DD基因型频率显著高于女性 (P <0 .0 5 ) ,收缩压水平亦显著高于女性 (P <0 .0 5 )。结论　原发性高血压与ACE基因I D多态性之间存在一种特殊的伴性关系。     

血管紧张素转化酶基因插入/缺失多态性与冠心病发病的关系

目的 :探讨血管紧张素转化酶 (ACE)基因多态性与冠心病 (CHD)发病的关系。方法 :以人基因组DNA为模板 ,应用聚合酶链式反应 (PCR)检测 5 0例CHD组和 5 6例正常对照组ACE基因第 16内含子插入 /缺失 (I/D)多态性 ,并按性别分组计算各组基因型和等位基因频率。结果 :①在CHD组中 ,ACE基因DD基因型和D等位基因频率分别为 36 %和 6 0 % ,正常对照组分别为 16 %和 4 1% ,两者相比差异有统计学意义 (P <0 .0 1)。②男性CHD组DD基因型和D等位基因频率均显著高于对照组 (均P <0 .0 5 )。女性CHD组DD基因型频率显著高于对照组 (P <0 .0 1) ,D等位基因频率与对照组比较差异无统计学意义。结论 :CHD与ACE基因I/D多态性有显著相关性 ,不论男性和女性 ,ACE基因DD基因型均可能是CHD发生发展过程中重要的危险因素之一。     

原发性高血压代谢综合征与血管紧张素转换酶基因插入/缺失多态性关系的探讨

目的 :探讨原发性高血压 (EH)代谢综合征与血管紧张素转换酶 (ACE)基因插入 /缺失多态性的关系。方法 :选取EH患者 2 0 2例 ,其中男 116例 ,女 86例 ,年龄 30～ 72 (5 9.5 4± 9.2 6 )岁。符合代谢综合征者 10 6例 ,非代谢综合征 96例。应用聚合酶链反应 (PCR)测定两组ACE基因插入 /缺失多态性。结果 :EH代谢综合征组与非代谢综合征组ACE基因DD、ID、II基因型间无显著相关性 (χ2 =2 .5 4 5 ,P 0 .0 5 )。代谢综合征组ACE多态性基因型与腰围、高密度脂蛋白胆固醇 (HDL C)密切相关 (P <0 .0 1) ;与腰围 /臀围、三酰甘油 (TG)密切相关 (P <0 .0 5 ) ;与血压、血糖、胰岛素无关 (P 0 .0 5 )。代谢综合征组ACE基因DD、ID基因型腰围较II基因型显著增加 (P <0 .0 1,<0 .0 5 ) ;DD基因型腰围 /臀围、TG较II基因型显著增加 (P <0 .0 5 ) ;ACE基因DD基因型HDL C较II基因型显著降低 (P <0 .0 5 ) ;ACE基因DD、ID、II基因型间血压、血糖、胰岛素差异无统计学意义 (P 0 .0 5 )。结论 :EH代谢综合征与ACE基因多态性无显著相关性。但是代谢综合征患者肥胖、脂代谢紊乱与ACE基因多态性密切相关 ,而血压水平、胰岛素敏感性却与ACE基因多态性无关。     

肾素-血管紧张素系统基因多态性与原发性高血压左心室肥厚关系的探讨

目的　探讨肾素 血管紧张素系统 (RAS)基因多态性与原发性高血压左心室肥厚 (EH LVH)的相关性以及在EH LVH产生中的多基因协同作用。方法　对 10 9例原发性高血压病 (EH)患者 ,采用聚合酶链反应 (PCR)以及聚合酶链反应 限制性片段长度多态性方法检测血液白细胞染色体DNA中血管紧张素转换酶 [ACE(I D) ]、血管紧张素原 [AGT(M2 35T) ]和血管紧张素Ⅱ 1型受体 [AT1 R(A116 6C) ]基因多态性 ;利用超声心动图检测左心室质量 (LVM)并计算左心室质量指数 (LVMI)。结果　ACE(I D)基因多态性D等位基因频率在EH LVH组中明显增高 (χ2 =4 .6 9,P=0 .0 30 ) ,男性EH患者中 ,ACE(I D)基因型构成比与LVH有关联 (χ2 =9.5 5 ,P =0 .0 0 8)。协同存在AGT TT型时 ,ACE(I D)基因多态性与EH LVH有关 (χ2 =6 .2 2 ,P =0 .0 4 4 ) ,且D等位基因在EH LVH明显增高 (χ2 =6 .91,P =0 .0 0 9) ,该类EH患者发生LVH的相对危险度增高 (OR :2 .5 0 ,95 %CI:1.2 5～ 5 .0 0 )。结论　ACE(I D)基因多态性D等位基因可能是LVH的独立危险因子。ACE基因多态性与AGT基因多态性之间的协同效应表明 ,同时携带AGT TT型时 ,具有ACE(I D)基因多态性D等位基因的EH患者更易发生LVH。     

ACE I/D基因多态性与武汉地区原发性高血压代谢综合征关系的探讨

目的:探讨武汉地区原发性高血压(EH)代谢综合征(MS)与血管紧张素转换酶(ACE)基因插入/缺失(I/D)多态性的关系.方法:701例武汉地区汉族人群分为3组,其中血压正常对照组303人,EH患者398例,其中EH患者中符合代谢综合征者189例,不伴随代谢综合组209例.应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)法测定3组人群中ACE I/D基因多态性.结果:①ACE各基因型频率在正常对照组与EH(包括MS与非MS组)组间差异无统计学意义;②ACE Ⅱ基因型EH合并MS患者的胆固醇水平明显高于DD基因型.结论:ACE基因多态性与武汉地区原发性高血压无关,但D等位基因频率明显低于某些西方国家人群;对于EH合并代谢综合征的患者,其胆固醇水平和ACE Ⅱ基因型明显相关.     

血管紧张素转换酶基因多态性与原发性高血压的关系

采用多聚酶链反应 ( PCR)技术检测了 154例汉族男性原发性高血压患者 ( EH组 ) ACE基因第 16内含子中 2 87bp DNA片段的插入 /缺失 ( I/ D)多态性 ,并与 183例健康查体者 (对照组 )进行比较。结果显示 ,两组年龄、甘油三酯 ( TG)、胆固醇 ( CH)、高密度脂蛋白胆固醇 ( HDL - C)、Apo A1、Apo B和血糖 ( Glu)均无显著性差异。对照组 ACE基因 I/ D多态 DD、 D、 基因型频率分别为 0 .2 2 4、0 .4 86、0 .2 90 ,其 D和 等位基因频率分别为 0 .4 67和 0 .533。 I/ D多态分布符合 Hardy- Weinberg法则 ,达到遗传平衡 ,具有群体代表性。EH组中无 EH家族史 ( 97例 )和有家族史者 ( 57例 )的 DD、 D、 基因型频率分别为 0 .351、0 .4 4 3、0 .2 0 6和 0 .4 0 4、0 .4 38、0 .158,D和 等位基因频率分别为 0 .572、0 .4 2 8和0 .62 3、0 .377。EH组无和有家族史者基因型 DD和等位基因 D均显著高于对照组 (分别为 P<0 .0 2 5,P<0 .0 2 5;P<0 .0 0 1,P<0 .0 0 5) ,但两组之间基因型和等位基因分布无显著性差异。认为汉族男性 EH的发生与 ACE基因 I/ D多态性相关联 ,基因型 DD和等位基因 D可能是 EH病的易感因素     

血管紧张素转换酶基因多态性与非杓型高血压的关系

目的研究血管紧张素转换酶 ( ACE)基因插入 /缺失 ( I/ D)多态性与非杓型高血压 ( EH)的关系。方法　 1应用聚合酶链反应 ( PCR)方法扩增 5 0例正常人、99例高血压患者的 ACE基因上 2 87bp片段 ,根据插入 ( I)或 /缺失( D)来判断其多态性。 2高血压患者行 2 4h动态血压监测 ( ABPM) ,根据 ABPM结果分为杓型 EH组和非杓型 EH组。结果　 1非杓型组与健康对照组相比 ,其 D等位基因及 DD基因型显著升高。 2非杓型组与杓型组相比 ,其 D等位基因及 DD基因型显著升高。3杓型组与健康对照组相比 ,ACE基因型和等位基因频率无显著性差异。结论　ACE基因多态性与非杓型高血压有关联性 ,DD基因型提示可能与高血压昼夜节律改变有关     

ACE基因I/D多态性与原发性高血压和高血压性脑出血的关系

目的研究血管紧张素转换酶（ACE）基因插入/缺失（I/D）多态性的分布及其与原发性高血压（EH）、高血压性脑出血（CH）之间的关系。方法采用常规酚—氯仿抽提法提取外周血基因组DNA,PCR检测ACE基因I/D多态性基因型频率及等位基因频率。结果 EH、CH患者及健康对照者ACE基因DD基因型频率分别为17.95%、17.55%、6.45%;D等位基因的分布频率分别是45.51%、45.18%、33.06%。与健康对照比较,EH和CH患者间ACE基因DD基因型频率和D等位基因频率均显著增高（P〈0.05）,但EH和CH患者间无统计学差异。结论 ACE基因DD基因型和D等位基因可能是EH和CH的遗传易感基因。     

RAS三种不同基因多态性与原发性高血压的相关性

目的 探讨肾素—血管紧张素系统(RAS) 血管紧张素原(AGT)基因T704C多态性、血管紧张素转换酶(ACE)基因I/D多态性及血管紧张素Ⅱ的1型受体(AT1R)基因A1166-C多态性与原发性高血压（EH）的关系.方法 采用PCR及PCR-限制性片段长度多态性(PCR-RFLP)方法,对220例EH患者（EH组）和1 004例非原发性高血压患者（NEH组）ACE基因Alu I/D多态性、AGT基因T704C多态性、AT1R基因A1166-C多态性进行基因型检测,计算等位基因频率.结果 两组AGT基因型及ACE基因型、等位基因频率均有显著差异（P分别 ＜0.01、0.05、0.05）;EH组TC-II、TC-AA、II-AA联合基因型频率显著低于NEH组（P均＜0.05）,CC-ID、CC-DD 、CC-AA、CC-AC+CC联合基因型频率显著高于NEH组(P均 ＜0.01).结论 携带AGT 基因CC基因型、ACE基因D等位基因者可能为发生EH易感人群;TC-II、TC-AA、II-AA联合基因型对EH的发生可能起负协同作用,而CC-ID、CC-DD、CC-AA、CC-AC+CC联合基因型可能起正协同作用.     

性别因素对原发性高血压候选基因研究的影响作用

目的探讨研究样本中的性别因素对原发性高血压（EH）候选基因研究结果的影响。方法应用聚合酶链反应这一分子生物学研究方法,分析EH组患者及正常血压对照组（两组中男性女性人数相等）人群血管紧张素转换酶（ACE）基因插入／缺失（I／D）多态性,进而探讨性别比例对该类研究结论的可能影响。结果男性EH组DD基因型频率显著高于男性对照组（x^2=6．98,P=0．004）,D等位基因频率在男性EH组亦较男性对照组显著增高（x^2=6．87,P=0．009）,而ID和II基因型频率在男性EH组和男性对照组间差异无统计学意义（P〉0．05）。女性EH组与女性对照组比较,各基因型和等位基因频率分布差异均无统计学意义（P〉0．05）;男性EH组中的DD基因型分布比例与女性EH组中的DD基因型分布比例相比有显著统计学意义（x^2=4．06,P=0．044）。此外,EH组中男性DD型者的收缩压及脉压水平均显著高于ID型和II型者（P均〈0．05）,但舒张压在3种基因型间差异无统计学意义（P〉0．05）。同时,EH组II、ID基因型的男性的收缩压、舒张压、脉压差异均无统计学意义（P〉0．05）。女性患者中,各基因型间收缩压、舒张压及脉压的水平差异均无统计学意义（P〉0．05）。结论男性中的DD基因型成员与EH（尤其在收缩压、脉压）的关联可能比男性中的II、ID基因型以及所有的女性更为密切。性别可能作为一个混杂因素,对包括ACE基因I／D多态性在内的诸多EH候选基因与EH的相关性研究的结论产生影响。     

Angiotensin converting enzyme gene polymorphism and activity in Turkish patients with essential hypertension

Studies in various ethnic groups have shown contradictory evidence on the association of the angiotensin converting enzyme (ACE) insertion/deletion (I/D) polymorphism with essential hypertension. We conducted a case-control study in Samsun, Turkey, to examine the association between ACE genotype, ACE serum activity, and blood pressure. Serum ACE activity was measured and ACE I/D polymorphism performed in 165 hypertensive and 143 normotensive subjects. Genomic DNA was extracted from blood samples and amplified by polymerase chain reaction (PCR). PCR primers were flanking the polymorphic region in intron 16 of the ACE gene. The distribution of the DD, ID, and II ACE genotypes was 65, 77, and 23 in hypertensive patients and 42, 82, and 19 in normotensive subjects (P > .05). The estimated frequency of the insertion allele was 0.37 in hypertensive and 0.42 in normotensive subjects. Nevertheless, sensitivity analysis, based on positive family history and severity of hypertension, suggested that significant associations existed between more homogeneous groups of hypertensives and normotensives (P < .05). ACE genotype influenced ACE activity and the highest level was in DD genotype, being the lowest in II genotype. ACE serum levels were significantly higher in hypertensives as compared with normotensives (P < .01). A modest correlation was observed between blood pressure and ACE among hypertensive persons (r = 0.25, P < .05) and this did persist in multivariate analysis (P < .05 for systolic blood pressure and P < .005 for diastolic blood pressure). These data suggest that ACE DD genotype may have predisposing effects on severe hypertensives and cases with positive family history, and that ACE may be one of the independent factors on hypertension.     

Angiotensin-converting enzyme D/I gene polymorphism and age-related changes in pulse pressure in subjects with hypertension

Background- Few studies have examined the possible influence of gene polymorphisms on the increase of systolic blood pressure (SBP) and pulse pressure (PP) with age, although in older populations, SBP>160 mm Hg or PP>60 mm Hg are strong mechanical factors predicting cardiovascular mortality. METHODS AND RESULTS: This cross-sectional study involved 315 men and 154 women with either systolic-diastolic or isolated systolic hypertension. Using polymerase chain reaction, the angiotensin-converting enzyme (ACE) D/I gene polymorphism was investigated separately in men and women, enabling us to determine the relationships between age and PP, SBP, and diastolic blood pressure (DBP) for each genotype in each population. In men, most of which were under 50 years of age, the slope of the age-PP and age-SBP (but not age-DBP) relationships differed significantly between genotypes (P=0.0096 and 0.0175). The interslope difference was unmodified after adjustments involving all of the following factors together: plasma glucose, cholesterol, creatinine, potassium, body weight, tobacco consumption, mean blood pressure, and previous antihypertensive therapy. Adjustment of the two latter parameters alone significantly attenuated the interslope difference. Based on logistic regressions, the DD genotype was shown to independently predict a PP>60 mm Hg but not a SBP>160 mm Hg. CONCLUSIONS: In men, the ACE D/I gene polymorphism independently modulates age-related increase of PP, and potentially modulates the resulting cardiovascular risk. This finding requires the development of long-term follow-up.     

血管紧张素转换酶基因多态性与原发性高血压病心肌纤维化的关系

目的　探讨血管紧张素转换酶 ( ACE)基因多态性与原发性高血压病 ( EH)心肌纤维化的关系。方法　以多聚酶链反应 ( PCR)方法检测 168例 EH患者的 ACE基因型 ;放射免疫法检测血清 型前胶原 ( PC )、透明质酸( HA)和层粘蛋白 ( LN)。结果　高血压病心肌纤维化组 DD基因型和 D等位基因频率分别为 0 .42 9和 0 .60 ,显著高于非纤维化组 0 .18和 0 .42 1( P<0 .0 5 )。DD型与 II型比较心肌质量指数、PC 显著升高 ,差异有显著性 ( P<0 .0 5 )。结论　 ACE基因 DD型可能是高血压病心肌纤维化的重要危险因素     

冠心病与血管紧张素转换酶和内皮型一氧化氮合酶基因多态性及交互作用的临床研究

目的联合对冠心病患者血管紧张素转换酶（ACE）基因多态性和内皮型一氧化氮合酶（eNOS）基因G894T多态性进行分析,探讨基因多态性与冠心病的关系和交互作用及遗传学机制在冠心病发病及预后中的临床意义。方法应用聚合酶链反应-限制性片段长度多态性（PCR—RFLP）分析技术检测236例冠心病患者及190例正常人ACE和eNOS两种基因多态性。同时测定血脂、血糖、体重指数（BMI）、左室射血分数（LVEF）和血压。结果冠心病组ACE基因DD型频率[36％（86／236）]显著高于对照组[19％（36／190）,P〈0．01],Ⅱ型频率[27％（64／236）]显著低于对照组[49％（93／190）,P〈0．05]。冠心病组DD型甘油三酯（TG）[（2．2±1．7）mmol／L]显著高于Ⅱ型TG[（1．6±0．8）mmol／L和ID型TG[（1．7±0．9）mmol／L,均P〈0．05],DD型高密度脂蛋白胆固醇[HDL—C（1．2±0．4）mmol／L]显著低于Ⅱ型HDL—C[（1．3±0．3）mmol／L,P〈0．05],DD型血糖[（6．2±1．7）mmol／L]和BMI[（25．7±2．8）kg／m^2]显著高于ID型[血糖：（5．6±1．3）mmol／L,BMI：（24．8±3．1）kg／m^2。,P〈0．05],DD型LVEF（56％±14％）显著低于Ⅱ型LVEF（62％±15％）和ID型LVEF（61％±14％）,均P〈0．05。收缩压、舒张压、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL—C）、糖尿病组与非糖尿病组、急性冠状动脉综合征组与非急性冠状动脉综合征组、单支病变组与多支病变组在ACE和eNOS基因不同基因型之间差异均无统计学意义。冠心病组eNOS基因GT型频率[28％（67／236）]显著高于对照组[17％（32／190）,P〈0．01],GG型频率与对照组比较,差异无统计学意义。TG、HDL—C、血糖、BMI和LVEF在eNOS基因不同基因型之间差异均无统计学意义（均P〉0．05）。携带DD型患冠心病的概率是携带Ⅱ型的1．74倍（P〈0．01）,携带GT型患冠心病的概率是携带GG型的1．73倍（P〈0．05）。两种基因对患冠心病的交互作用显示为如同时携带Ⅱ型和GG型,患冠心病的概率是37．9％,而同时携带DD型和GT型患冠心病的概率是77．8％。结论ACE基因多态性和eNOS基因多态性与冠心病及某些危险因素显著相关,同时携带DD型和GT型两种易患基因型时,患冠心病的概率明显增加,具有显著的遗传倾向。     

血管紧张素转化酶基因多态性对血清血管紧张素转化酶水平及血脂的影响

为探讨血管紧张素转化酶基因多态性对本地人群高血压患者和正常人血清血管紧张素转化酶及血脂水平的影响,采用聚合酶链反应技术,对118例高血压患者和98例正常人的血管紧张素转化酶基因插入/缺失多态性进行分型,并检测血清血管祭张素转化酶活性及血脂含量。结果发现,高血压组血管紧张素转化酶三种基因型(缺失纯合子型、插入纯合子型和杂合子型)及插入/缺失等位基因的频率与正常对照组比较差异无统计学意义(X2=0.468,P=0.791;X2=0.379,P=0.538)。血清血管紧张素转化酶活性在三种基因型之间差异有显著性意义(F=17.107,P=0.000)。高血压组总胆固醇、低密度脂蛋白胆固醇、脂蛋白(a)高于正常对照组(P<0.05);高血压组三种基因型之间血脂各指标含量及正常对照组三种基因型之间总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和载脂蛋白B含量差异有显著性意义(P<0.05)。此结果提示,血管紧张素转化酶基因多态性与血清血管肾张素转化酶活性及血脂含量有关,缺失纯合子型高血压患者血清血管紧张素转化酶活性最高且易患高脂血症。     

Distribution of different HLA antigens in Greek hypertensives according to the angiotensin-converting enzyme genotype

The angiotensin-converting enzyme (ACE) insertion/deletion polymorphism is an independent risk factor for cardiovascular disease. It has also been suggested that some HLA genes may contribute to the genetic susceptibility to essential hypertension. So far, an association between ACE polymorphism and HLA antigens in arterial hypertension has not been reported. We have studied 94 subjects with newly diagnosed essential hypertension, 49 men and 45 women (mean age, 52.3 ± 11.3 years), as well as 104 randomly selected, age- and gender-matched normotensive individuals (54 men and 50 women, mean age 48.7 ± 10.8 years). Both cohorts originated from the Greek population and lived in the greater Athens area. The ACE genotype was analyzed by polymerase chain reaction. HLA class I and II antigens were studied by serologic and molecular techniques.The prevalence of the ACE genotypes did not differ significantly between hypertensives and normal individuals. The casual blood pressure levels and the average ambulatory blood pressure levels were similar among the three ACE genotypes. Hypertensives with the ACE-DD genotype were characterized by an increased prevalence of the HLA-A2 antigen (50% v 31.4%, P < .005) and DR6 (16.7% v 11.4%, P < .01) in comparison to the normotensive subjects with the ACE-DD genotype. HLA-A24 was found more frequently among the hypertensives with the ACE-ID genotype than in the normal controls with the same genotype (35.5% v 26.4%, P < .05). ACE-DD genotype is associated with a high prevalence of specific HLA antigens. The coexistence of the ACE-DD genotype with certain HLA phenotypes could reveal a distinct hypertensive population with increased risk for cardiovascular events.     

Relation between the angiotensin-converting enzyme insertion/deletion polymorphism and blood pressure in Japanese male subjects

Inconsistent results have been reported regarding the association of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and hypertension. Recent studies of population-based samples of three different areas in Japan presented conflicting results regarding this association. We, thus, investigated the relation between the ACE I/D polymorphism and blood pressure (BP), or the frequency of hypertension, respectively, in 706 Japanese male subjects who participated in the health check-up programme of our hospital. The ACE I/D polymorphism was determined by the polymerase chain reaction technique. Of 706 subjects, 203 were found to have hypertension and the other 503 were found to be normotensive. In all subjects, the frequencies of the DD, ID, and II genotypes were 0.123, 0.432, and 0.445, respectively, and the allelic frequency of the D allele was 0.339. In the younger subjects aged <50 years (n=264), neither systolic nor diastolic BP differed significantly among the genotypes. Conversely, in the older subjects aged > or =50 years (n=442), the systolic BP was significantly higher by 5.9 mmHg in the subjects with the ID genotype than those with the II genotype (P<0.01), and the diastolic BP was significantly higher in the subjects with the DD and ID genotypes by 5.1 and 3.3 mmHg, respectively than those with the II genotype (P<0.05 for each), although age, BMI, percentage of smoking habits, drinking habits, or the use of antihypertensive drugs did not differ significantly among the genotypes. In addition, in the older subjects, the hypertensive subjects showed significantly higher frequencies of the DD and ID genotypes and the D allele than the normotensive subjects. These results demonstrated that there was no significant association of the ACE I/D polymorphism with BP or a prevalence of hypertension in younger Japanese men aged <50 years but there was in older Japanese men aged > or =50 years.     

Relationship between polymorphism of the angiotensin-converting enzyme gene and the response to angiotensin-converting enzyme inhibition in hypertensive patients.

The aim of this study was to investigate the relationship between polymorphism of the anglotensin-converting enzyme (ACE) gene and the blood pressure response to ACE inhibition in a hypertensive cohort. Imidapril (5-10 mg/day) or benazepril (10-20 mg/day) was administered for 6 weeks to 517 essential hypertensives. ACE gene polymorphism was examined by the polymerase chain reaction (PCR) method and the patients were classified as having the 190-bp deletion homozygous (DD) genotype, the 490-bp insertion homozygous (II) genotype, or the 490-bp insertion, 190-bp deletion heterozygous (ID) genotype. The achieved change in systolic and diastolic blood pressure (SBP and DBP) was analyzed for association with genotypes at the ACE gene locus. The DD genotype was observed in 132 patients (25.5%), the ID genotype in 255 patients (49.3%), and the II genotype in 130 patients (25.2%). The SBP reductions in the patients with the DD genotype, II genotype, and ID genotype were -14.5 +/- 12.7 mmHg, -14.3 +/- 13.1 mmHg and -14.0 +/- 12.2 mmHg, respectively (p = 0.94). The DBP reductions in the patients with the DD genotype, II genotype, and ID genotype were -8.7 +/- 7.4 mmHg, -8.7 +/- 7.7 mmHg and -8.5 +/- 6.7 mmHg, respectively (p = 0.96). There was no significant association between the ACE gene polymorphisms and the response to ACE inhibition. These results suggest that ACE genotype does not predict the blood pressure-lowering response to antihypertensive treatment with ACE inhibition.     

Angiotensin-converting enzyme gene polymorphism and its association with essential hypertension in a Tibetan population.

There is strong evidence to support the idea that the renin-angiotensin system (RAS) plays an important role in the pathogenesis of essential hypertension (EH) and its complications. However, existing data about the association of angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism with blood pressure is conflicting, mainly due to racial differences and environmental exposure status. We therefore conducted a case control study to observe the relationship between ACE I/D polymorphism and EH in a Tibetan population who live in relatively isolated areas and are genetically homogeneous. The study was conducted at stable residential communities in the urban district of Lhasa, the capital of the Tibet autonomous region, China, and 106 unrelated EH patients and 135 normotensIve subjects were recruited. PCR, PCR/RFLP and PCR-SSCP were carried out to study the association between RAS genes and EH. Frequencies for the DD, ID and II genotypes were 27, 47 and 29 in hypertensive subjects, and 15, 60 and 48 in normotensive subjects, respectively. Derived allele frequencies for the I and D alleles were 0.51 and 0.49 in hypertensive subjects and 0.64 and 0.36 in normotensive subjects. There were significant differences in genotype distribution and derived allele frequency between these two groups. The genotype and allele frequencies of the ACE gene differed significantly between hypertensive and normotensive females (p>0.05), but there were no differences in males. In females, the DBP and MAP level were significantly higher for the DD than for the ID and II genotype, and SBP was significantly higher for the DD than for the II genotype. But in males, there were no significant differences in blood pressure among ACE genotypes. The results showed a significant association between the D allele of the ACE gene and hypertension in Tibetan women but not in Tibetan men.