HDCN Article Review/Hyperlink

Kario K, Kanai N, Saito K, Nago N, Matsuo T, Shimada K

Ischemic stroke and the gene for angiotensin-converting enzyme in Japanese hypertensives

Circulation (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 allele 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 hypertensive and 104 normotensive Japanese subjects. Presence of stroke was determined by 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 the 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, click here