Influence of ACE gene I/D polymorphism on change in fibrinogen level after treatment with ACEI and its relationship with body mass and lipid profile in patients with arterial hypertension

Abstract

Background Obesity and dyslipidaemia are connected with
high cardiovascular risk. The similar disadvantageous dependence
can be observed in patients with elevated serum
level of procoagulant factors as fibrinogen. DD genotype
of insertion/deletion (I/D) polymorphism of ACE gene is
also known for similar properties. The aim of the study
was to find the relationship between obesity and
dyslipidaemia and serum fibrinogen level and also to assess
polymorphism of ACE gene influence on fibrinogen
level in patients with essential hypertension and fibrinogen
level changes after treatment with ACEI.

Material and methods The study included 64 patients with
essential hypertension (41 male and 23 female). 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 perindopril in dose 4 mg/d once a
day. After 4 weeks patients with poor blood pressure control
received doubled dose of perindopril. 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%). The
positive correlations between serum fibrinogen level and
BMI (r = 0.256, p = 0.04), total cholesterol (r = 0.414,
p = 0.0007) and LDL (r = 0.410, p = 0.0008) were observed.
The significant reduction of serum fibrinogen level
for whole group was observed (p = 0.003): the biggest in
DD subgroup (p = 0.028), then in ID subgroup (p =
0.066) and the smallest in II subgroup (p = 0.286).
Conclusions There is dependence between serum fibrinogen
level and BMI, total cholesterol and LDL in overweight
patent with essential hypertension. Serum fibrinogen level
in untreated patients is not depended on ACE gene polymorphism.
Serum fibrinogen level reduction after treatment
with ACEI is connected with allel D presence.