Lopez-Contreras J, Blanco F, Borras X, Carreras F, et al
Relation between deletion polymorphism of the ACE gene and left ventricular hypertrophy in hypertensive treated men
12th Annual ASH Meeting
Am J Hypertens (Apr) 10:59A 1997

The ACE deletion/deletion (DD) genotype may be associated with an elevated risk of LVH.  The present study was designed to determine if this relationship occurs in middle-age men with treated essential hypertension.  

96 consecutive male patients age under 70 participated in the study.  ACE genotype was determined by PCR and patients classified on the basis of their ACE genotype as deletion/deletion (DD), deletion/insertion (DI) or insertion/insertion (II). Left ventricular mass was determined by blinded observers.  13 patients were excluded (11 because of a poor echographic window, 1 because of significative aortic insufficiency and 1 because of dilated cardiomyopathy).  Clinical characteristics, LVM index (LVMI) and relative wall thickness (RWT) among the 3 groups were compared by analysis of variance followed by the Tukey test.  Of the 83 evaluable patients, 39 had the DD, 33 the DI, and 11 the II genotype.  

Duration of hypertension was longer in the DI subgroup.  No differences were noted among the 3 groups in severity of hypertension, duration of treatment, number of antihypertensive drugs, BP control, LVMI, or RWT.  The authors conclude that ACE genotype in middle age men with treated essential hypertension does not predict the extent of left ventricular hypertrophy.

Comment: ACE gene polymorphism is being extensively investigated and in some studies can be correlated with propensity to end- organ damage.   However, these authors failed to find an association with cardiac structural abnormalities.  The clinical importance of genotyping hypertensive patients is at present unclear. (David J. Leehey, M.D., Loyola University at Chicago)

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12th Annual ASH Meeting
H: Pathophysiology : Genetics
H: Pathophysiology : Heart in hypertension