Vol 15, No 5 (2011)
Original paper
Published online: 2011-12-13

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Does treatment with angiotensin converting enzyme inhibitor influence on insulin resistance connect with ACE gene insertion/deletion polymorphism?

Karolina Niklas, Arkadiusz Niklas, Jerzy Głuszek
Nadciśnienie tętnicze 2011;15(5):299-311.

Abstract

Background Hiperinsulinemia and insulin resistance often observed in patients with hypertension are connected with elevated cardiovascular risk. DD genotype of insertion/ deletion (I/D) polymorphism of ACE gene is also known for similar properties. The aim of the study was to determine and compare insulin resistance in patients with mild or moderate essential hypertension before and after 8 week period of treatment with ACE inhibitor according to I/D polymorphism of ACE gene.
Material and methods The study comprised 64 patients with mild-to-moderate essential hypertension (41 male and 23 female) without coexisting illness. The mean age of study group was 40.48 ± 16.39 years. Before treatment the blood samples for laboratory investigation and genetic analysis (polymerase chain reaction) were taken. Then patients received 4 mg perindopril once a day. After 4 weeks patients with poor blood pressure control received doubled dose of perindopril. Before treatment, after 4 weeks and after 8 weeks of treatment with ACE-I the blood pressure measurement with traditional method and ABPM were performed. After 8 weeks of treatment with ACE inhibitor further blood samples for laboratory investigation were taken.
Results The ACE genotype distribution was: II — n = 17 (27%), ID — n = 29 (45%), DD — n = 18 (28%). Any significant changes in insulin resistance after 8 weeks of treatment with ACE-I were not observed. But there is a negative correlation between insulin resistance before treatment and reduction of blood pressure in ABPM.
Conclusions Insulin resistance is independent on I/D polymorphism of ACE gene and does not change significantly after 2 months of treatment with perindopril. There is a negative correlation between basal insulin resistance and reduction of blood pressure in ABPM.
Arterial Hypertension 2011, vol. 15, no 5, pages 299–311

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