Angiotensin converting enzyme insertion/deletion polymorphism and the risk of heart failure in hypertensive subjects.
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.
Schut
Anna F C
AF
Genetic Epidemiology Unit, Department of Epidemiology, Eramus Medical Centre Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
Bleumink
Gysèle S
GS
Stricker
Bruno H Ch
BH
Hofman
Albert
A
Witteman
Jacqueline C M
JC
Pols
Huibert A P
HA
Deckers
Jaap W
JW
Deinum
Jaap
J
van Duijn
Cornelia M
CM
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
D004251:DNA Transposable Elements; D007703:Peptidyl-Dipeptidase A