Gene polymorphisms of the renin-angiotensin system and age-related changes in systolic and diastolic blood pressure in subjects with hypertension |
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| Authors: | Rudnichi Annie Safar Michel E Lajemi Malika Benetos Athanase |
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| Affiliation: | 1. Diagnosis Center (AR, MES, ML), Hôtel-Dieu Hospital, Paris, France;2. the Geriatric Center (AB), Brabois Hospital, Nancy, France;1. Department of Pharmacology and Therapeutics, Trinity Centre and Hypertension Clinic, St. James’s Hospital, Dublin, Ireland;1. Department of Nursing (J-CT, C-CK), Taipei Medical University–Wan Fang Hospital, Taipei, Taiwan;;2. Department of Nursing (J-CT), Taipei Medical University, Taipei, Taiwan;3. Department of Medicine (J-CL, P-FK, PC), Taipei Medical University, Taipei, Taiwan;;4. Division of Clinical Pharmacology (BT), Chinese University of Hong Kong, Hong Kong, Hong Kong;5. Department of Medicine (J-WC), Taipei Veteran General Hospital, Taipei, Taiwan;1. Division of Cardiology (MJB, FF, HY, JT), Harbor-UCLA Medical Center Research and Education Institute, Torrance, California, USA;2. Pulse Metric Inc. (JT, TF), San Diego, California, USA;1. Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Cattedra di Medicina Interna e Centro Ipertensione, University of Palermo, Palermo, Italy;1. Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London, UK;2. Clinical Trials and Evaluation Unit, Royal Brompton Hospital, London, UK;3. Department of Trauma and Orthopaedic Surgery, and Keele University School of Medicine, Keele, Staffordshire, England UK;4. Clinical Cardiology Division, Beth Israel Deaconess Medical Center and Harvard Clinical Research Institute, Boston, Massachusetts, USA;1. Department of Geriatrics (PC, LO, CDS, MC, VC, VM), 1st Institute of Medicine, “La Sapienza” University, Rome, Italy;2. Department of Internal Medicine (SM, PDM, AS), 1st Institute of Medicine, “La Sapienza” University, Rome, Italy;3. Central Institute for Health (FC), Rome, Italy |
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| Abstract: | BACKGROUND: Few studies have examined to what extent genes might modulate the changes of systolic and diastolic blood pressure (BP) with age although, in older populations, systolic BP and diastolic BP vary with age in opposite directions. METHODS: This study involved 205 men and 99 women with either systolic-diastolic or isolated systolic hypertension. Age was > 50 years. Using polymerase chain reaction, four gene polymorphisms related to the renin-angiotensin system were independently investigated in men and women. Adjustments to cardiovascular and renal risk factors as well to the sodium/potassium extracellular space ratio were performed. RESULTS: Regarding the angiotensin-converting enzyme (ACE) gene polymorphism, in men > 50 years of age, the slope (mm Hg per unit of age) of the age-diastolic BP (and not age-systolic BP) relationships significantly (P = .0092) differed between genotypes: - 0.79 +/- 0.15 (P < .0001) for the DD genotype, -0.53 +/- 0.10 for the ID genotype (P < .0001), and -0.23 +/- 0.11 for II genotypes (P = NS). Such findings were not observed in the female population in which the age-diastolic BP curves were substantially flatter than in men. No comparable results were observed for gene polymorphisms related either to angiotensinogen or to angiotensin II type 1 receptor. CONCLUSIONS: In men > 50 years of age, the ACE gene polymorphism modulates the physiologic age-induced reduction of diastolic BP. The D allele might contribute to enhance this reduction, a finding that needs confirmation using prospective studies. |
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