title: Angiotensin converting enzyme insertion/deletion polymorphism and the risk of heart failure in hypertensive subjects.
abstract: OBJECTIVE
  Cardiac angiotensin-I converting enzyme (ACE) activity is influenced by the ACE I/D polymorphism. Evidence suggests that the DD-genotype may be a risk factor for cardiac hypertrophy and heart failure, especially in hypertensive subjects. We assessed the relation between the ACE I/D polymorphism and the risk of incident heart failure in normotensive and hypertensive subjects.
  
  
  RESULTS
  We investigated 4264 normotensive and 2174 hypertensive participants of the Rotterdam Study, a population based prospective cohort study. All subjects were available for follow-up from 1990 until 2000. Incidence rates (IR) of heart failure in normotensive subjects were the same over all genotype strata (10 per 1000 person-years). In hypertensive subjects, the IR increased with the number of D-alleles present (II: IR=13, ID: IR=18 and DD: IR=20 per 1000 person-years). Hypertensive subjects carrying the II-genotype did not have an increased risk of heart failure compared to normotensive II subjects. However, hypertensive subjects carrying one or two copies of the D-allele did have a significantly increased risk of heart failure (ID: RR: 1.4 (1.1-1.9) and DD: RR: 1.5 (1.2-2.1)).
  
  
  CONCLUSIONS
  Our findings suggest that the ACE I/D polymorphism may play a modifying role in the development of heart failure in hypertensive subjects.
authors.affiliation: Genetic Epidemiology Unit, Department of Epidemiology, Eramus Medical Centre Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
authors.forename: Anna F C
authors.initials: AF
authors.lastname: Schut
authors.forename: Gysèle S
authors.initials: GS
authors.lastname: Bleumink
authors.forename: Bruno H Ch
authors.initials: BH
authors.lastname: Stricker
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
authors.forename: Huibert A P
authors.initials: HA
authors.lastname: Pols
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Deckers
authors.forename: Jaap
authors.initials: J
authors.lastname: Deinum
authors.forename: Cornelia M
authors.initials: CM
authors.lastname: van Duijn
mesh_terms: D000368:Aged; D000483:Alleles; D001794:Blood Pressure / Q000235:genetics; D004251:DNA Transposable Elements / Q000235:genetics; D004812:Epidemiologic Methods; D005260:Female; D005838:Genotype; D006333:Heart Failure / Q000235:genetics*; D006801:Humans; D006973:Hypertension / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D016133:Polymerase Chain Reaction / Q000379:methods; D011110:Polymorphism, Genetic; D017384:Sequence Deletion
chemical_list: D004251:DNA Transposable Elements; D007703:Peptidyl-Dipeptidase A