Abstract
This chapter discusses the recent progress made in the molecular genetics of the renin–angiotensin system genes with a special emphasis on human hypertension. The renin–angiotensin system consists of four main proteins: (1) renin, (2) angiotensinogen, (3) angiotensin I-converting enzyme (ACE), and (4) angiotensin II receptors. Neither the renin nor the ACE genes contribute to a large extent to genetic hypertension, at least in humans. Molecular variants of the angiotensinogen gene constitute inherited predispositions to essential hypertension in humans and are likely to be involved in some cases of pregnancy-induced hypertension. An ACE gene polymorphism associated with an increase in plasma and tissular ACE levels appears to be a strong marker of coronary and cardiac disease. This shows that some molecular variants of angiotensinogen or of ACE are associated with an increased plasma or tissue angiotensinogen and ACE levels, respectively. This genetically chronic overstimulation of the renin system favors kidney sodium reabobsorption, vascular hypertrophy, and/or increase sympathic nervous system activity and predispose to the development of common cardiovascular diseases.
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