Kario K, Kanai N, Saito K, Nago N, Matsuo T, Shimada K
Ischemic stroke and the gene for angiotensin-converting
enzyme in Japanese hypertensives
(May) 93:1630-1633 1996
Objective: Genes that influence the renin-angiotensin system may be
associated with risk of vascular disease. The ACE gene is known to exist in
two allelic forms - the I (insertion) and D (deletion) alleles. The D
is associated with higher serum ACE levels, which would increase angiotensin
II levels and effect. This study investigated whether ACE gene polymorphism
is associated with stroke risk in Japanese hypertensives.
Methods and Results: The ACE I/D genotype was identified in 228
and 104 normotensive Japanese subjects. Presence of stroke was determined
MRI. The ACE-D allele frequency was significantly higher (P < 0.001) in the
138 hypertensives with clinically silent or overt stroke (0.47) than in the
hypertensives without stroke (0.31) or control (0.34) groups. This increase
was due to an increase in the precentage of patients with the DD genotype.
This association was independent of other risk factors including ECG-LVH.
Conclusions: This study demonstrates a positive association between
ACE-D allele and stroke in Japanses hypertensives. This genetic factor may
be an independent risk factor for stroke in hypertensive patients. The
mechanism may be increased angiotensin-associated vasoconstriction, cellular
hypertrophy, and thrombosis.
(David J. Leehey, M.D., Loyola University at Chicago)
For original abstract from the AHA,