Renin angiotensin system blockage associates with insertion/deletion polymorphism of angiotensin-converting enzyme in patients with hypertensive emergency

Vilela-Martin, Jose F., Vaz-de-Melo, Renan O., Cosenso-Martin, Luciana N., Kuniyoshi, Cristina H., Yugar-Toledo, Juan C., Pinhel, Marcela A. S., de Souza, Gisele F., Souza, Doroteia R. S., Pimenta, Eduardo, Moreno, Heitor and Cipullo, Jose P. (2013) Renin angiotensin system blockage associates with insertion/deletion polymorphism of angiotensin-converting enzyme in patients with hypertensive emergency. DNA and Cell Biology, 32 9: 541-548. doi:10.1089/dna.2012.1951


Author Vilela-Martin, Jose F.
Vaz-de-Melo, Renan O.
Cosenso-Martin, Luciana N.
Kuniyoshi, Cristina H.
Yugar-Toledo, Juan C.
Pinhel, Marcela A. S.
de Souza, Gisele F.
Souza, Doroteia R. S.
Pimenta, Eduardo
Moreno, Heitor
Cipullo, Jose P.
Title Renin angiotensin system blockage associates with insertion/deletion polymorphism of angiotensin-converting enzyme in patients with hypertensive emergency
Journal name DNA and Cell Biology   Check publisher's open access policy
ISSN 1044-5498
1557-7430
Publication date 2013-08
Year available 2013
Sub-type Article (original research)
DOI 10.1089/dna.2012.1951
Open Access Status
Volume 32
Issue 9
Start page 541
End page 548
Total pages 8
Place of publication New Rochelle, NY, United States
Publisher Mary Ann Liebert
Collection year 2014
Language eng
Formatted abstract
Hypertensive crisis (HC) stands out as a form of acute elevation of blood pressure (BP). It can manifest itself as hypertensive emergency (HE) or hypertensive urgency (HU), which is usually accompanied with levels of diastolic BP ≥120 mmHg. Angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism may influence manifestations of HC. Thus, this study evaluated the influence of ACE I/D polymorphism in individuals with HC. A total of 187 patients admitted with HC (HU [n=69] and HE [n=118]) and 75 normotensive individuals were included in the study. Peripheral blood was drawn for a biochemical and genetic analysis of the ACE I/D polymorphism by Polymerase Chain Reaction. HC group showed higher systolic BP, body mass index (BMI), glycemia, creatinine, and lower high-density lipoprotein (HDL) cholesterol compared with normotensive individuals. The use of renin–angiotensin system (RAS) blockers was more frequent in the HU group than in the HE group (p=0.020). The II genotype was more predominant in normotensive and HU individuals than among HE individuals (18.7%, 11.6%, and 2.5%, respectively; p=0.004). Higher BMI and glycemia were associated with HC in the logistic regression model. ACE II genotype (odds ratio [OR] 0.14; 95% confidence interval [CI] 0.04–0.51) and HDL cholesterol were protective for the development of HE. ACE II genotype was present in the HU group, compared with the HE group (OR 0.18; 95% CI 0.04–0.88). This study shows an association between the low prevalence of ACE I/D polymorphism II genotype and a greater occurrence of HE in Brazilian individuals. The lower blockage of RAS, which was detected in the HE group, may interact with the low frequency of II genotype, conferring an increased risk for HE.
Keyword Hardy-Weinberg equilibrium
Blood pressure
Malignant hypertension
Cardiovascular disease
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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