[Increasing menace of cardiovascular diseases in the era of obesity].
Epidemiological reports show that about half of all adults suffer from hypertension, and the incidence of diabetes mellitus, dyslipidemia and obesity is markedly increasing in Japan. Recent progress in gene determination has shown that lifestyle-related diseases, including hypertension, are multigenetic diseases. In particular, renin-angiotensin genes play an important role in the pathogenesis of hypertension. Upregulation of the transcription of angiotensinogen and angiotensin-converting enzyme genes increases blood pressure and cardiovascular organ damage through increased levels of angiotensin II. In this review, I first introduce the history of the recognition, understanding and the development of treatment for hypertension. Secondly, the basic relationship of the pathogenesis between hypertension and the new concept of metabolic syndrome will be shown, and the usefulness of angiotensin II receptor antagonist for hypertensive patients with obesity and/or metabolic syndrome. Finally, I will reveal the utility of gene diagnosis for acute myocardial infarction and cerebral infarction by detecting the polymorphism of renin-angiotensin genes. On the other hand, the positive correlation between blood pressure and body mass index is affected by the Gln27Glu genotype of the beta2-adrenoceptor gene. These studies investigating the gene-environmental relationship will contribute to the development of tailor-made medicine in the future.
Second Department of Internal Medicine, Ehime University School of Medicine, Touon 791-0295.
Jitsuo
J
Higaki
D052242:Adiponectin; D005786:Gene Expression Regulation; D005838:Genotype; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000235:genetics / Q000517:prevention & control / Q000628:therapy; D007564:Japan / Q000453:epidemiology; D008019:Life Style; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000235:genetics / Q000517:prevention & control; D020412:Multifactorial Inheritance; D009765:Obesity / Q000453:epidemiology*; D010597:Pharmacogenetics; D011110:Polymorphism, Genetic; D018343:Receptors, Adrenergic, beta-2 / Q000235:genetics; D012084:Renin-Angiotensin System / Q000235:genetics; D014158:Transcription, Genetic / Q000235:genetics
D052242:Adiponectin; D018343:Receptors, Adrenergic, beta-2