Is it the relationship between ACE gene insertion-deletion polymorphism and hipotensive effect and reduction of pulse pressure after treatment with ACE inhibitor?

Abstract

Background The recent years studies in spite of large number of papers concerning the genetic aspect of essential hypertension, especially insertion-deletion polymorphism of ACE gene, show us controversial results and many problems are still unsolved. One of these problems is the role of insertion/deletion polymorphism of ACE gene in the reduction of blood pressure after hypotensive treatment and its influence on cardiovascular complications. The aim of the study was to search dependence between insertion-deletion polymorphism of ACE gene and reduction of blood pressure and assessment of pulse pressure changes after treatment with ACE inhibitor patients with mild-to-moderate essential hypertension.
Material and methods The study included 64 patients with mild-to-moderate essential hypertension (41 male and 23 female) without history of myocardial infarction, stroke, heart failure, and renal failure. The mean age was 40.48 ± 16.39 years. Before treatment the blood samples for genetic analysis (polymerase chain reaction) were taken. Then each patient received perindopril in dose 4 mg/d once a day in the morning. After one month, patients with poor blood pressure control received doubled dose of perindopril. Before treatment, after 4 weeks and after 8 weeks of treatment withACEI the blood pressure measurement with traditional method and ABPM were performed.
Results The ACE genotype distribution was: II n = 17 (27%), ID n = 29 (45%), DD n = 18 (28%). There were no statistically significant differences in reduction of blood pressure after treatment with perindopril between genotypes both in traditional method measurement and ABPM. The reduction of pulse pressure both in traditional measurements and ABPM after 8 weeks of treatement was significantly bigger (respectively p = 0,027 and p = 0,036) for DD genotype.
Conclusions The insertion/deletion polymorphism of ACE gene is not related to reduction of blood pressure after treatment with ACE inhibitor in patients with mild-to-moderate essential hypertension. There is a statistically significant reduction of pulse pressure after treatment with ACE inhibitor in patients with mild-to-moderate essential hypertension. This reduction is significantly higher in patients with DD genotype comparing with II and ID genotypes.
Arterial Hypertension 2007, vol. 11, no 5, pages 384-394.