Abstract

BackgroundThe absence of nocturnal blood pressure dipping (ND) identified by 24-h ambulatory blood pressure monitoring (ABPM) correlates with a worse cardiovascular prognosis. The renin–angiotensin system influences blood pressure levels and the occurrence of target organ damage (TOD). Thus, the aim of this study was to correlate the angiotensin-converting enzyme gene (ACE) insertion/deletion (I/D) polymorphism with the 24-h blood pressure profile and TOD in hypertensive individuals.Methods155 non-diabetic hypertensive individuals on antihypertensive treatment underwent ABPM. Peripheral blood samples were drawn for biochemistry and genetic analysis of the ACE I/D polymorphism by polymerase chain reaction. ND was defined as ≥10 % differences in the mean systolic blood pressure (BP) during wakefulness and sleep.ResultsThere were no differences in clinical or biochemical variables or TOD in respect to ND status, except for higher BP levels during sleep (p < 0.001) in non-dippers. There was significant difference in the prevalence of left ventricular hypertrophy (LVH) between ACE genotypes (II: 13.0 %; ID: 34.1 %; DD: 46.5 %; p value = 0.024) with an increased risk in carriers of the DD genotype (OR = 5.80; IC 95 % 1.50–22.44; p value = 0.011). Carriers of the D allele had higher systolic BP during wakefulness and by ABPM (p < 0.05), higher left ventricular mass (117.3 ± 50.0 vs. 100.3 ± 25.7; p value = 0.017) and higher prevalence of LVH (37.4 vs. 12.5 %; OR = 4.14; 95 % IC: 1.17–14.65; p value = 0.028), compared to the II genotype.ConclusionsThe DD genotype is associated with a higher prevalence of LVH. The presence of the D allele appears to be associated with higher mean 24-h and wake systolic BP measured by ABPM in hypertensive patients under antihypertensive treatment.

Highlights

  • The absence of nocturnal blood pressure dipping (ND) identified by 24-h ambulatory blood pres‐ sure monitoring (ABPM) correlates with a worse cardiovascular prognosis

  • Hypertension (HT) is a highly prevalent disease associated with increased risk of target organ damage (TOD), including myocardial infarction, stroke and left ventricular hypertrophy (LVH)

  • The variability in plasma angiotensin-converting enzyme gene (ACE) levels is directly related to the I/D polymorphism; the I allele is associated with a reduced level of this enzyme and lower concentrations of angiotensin II in tissues [5], a condition that apparently protects against TOD

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Summary

Introduction

The absence of nocturnal blood pressure dipping (ND) identified by 24-h ambulatory blood pres‐ sure monitoring (ABPM) correlates with a worse cardiovascular prognosis. The renin–angiotensin system influences blood pressure levels and the occurrence of target organ damage (TOD). The aim of this study was to correlate the angiotensin-converting enzyme gene (ACE) insertion/deletion (I/D) polymorphism with the 24-h blood pressure profile and TOD in hypertensive individuals. This research studied the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism, which is characterized by the presence (insertion) or absence (deletion) of an Alu repetitive sequence of 287 base pairs (bp) in intron 16 of the ACE gene [5]. The variability in plasma ACE levels is directly related to the I/D polymorphism; the I allele is associated with a reduced level of this enzyme and lower concentrations of angiotensin II in tissues [5], a condition that apparently protects against TOD

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