Do angiotensin-converting enzyme (ACE) inhibitors enhance the effect of exercise rehabilitation in patients with hypertension and ACE DD and DI genotypes?
OBJECTIVE
To test whether pharmacologic angiotensin-converting enzyme (ACE) inhibition in carriers of the ACE DD or DI (D, deletion; I, insertion of 287 base pairs) genotypes can simulate the genetic advantage of the II genotype and thereby enhance the conditioning effects of aerobic exercise.


METHODS
Nonrandomized controlled trial.


METHODS
Pulmonary institute.


METHODS
Twelve sedentary men with controlled hypertension (5 with DD genotype, 7 with DI genotype; age, 53+/-7y) treated by ACE inhibitors (study group) and 10 patients (8 men, 2 women; 2 with DD genotype, 8 with DI genotype; age, 54+/-10y) who were treated by other antihypertensive drugs (controls).


METHODS
Exercise training.


METHODS
Training effect was measured by maximal oxygen uptake (Vo(2)max) anaerobic threshold (Vo(2AT)), and the corresponding work rates (WR) (in watts)-WRmax and WR(AT)-before and after 10 weeks of training.


RESULTS
Vo(2)max increased by a mean of 10% (200mL/min) and WRmax by 14% (25W) in each group (P<.001). Vo(2AT) and WR(AT) tended to increase more in the study group (Vo(2AT): 10% [186+/-35mL/min] vs 5% [100+/-1mL/min]; P<.006; WR(AT): 19% [19+/-2W] vs 12% [11+/-3W]; P<.03; respectively).


CONCLUSIONS
This study did not show an enhancement of exercise-related conditioning by pharmacologic ACE inhibition among hypertensive patients with ACE DD and DI genotypes, comparable to the advantage conferred by the II genotype.
Duzli
Yaniv
Y
Pulmonary Institute, The Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Grossman
Ehud
E
Gaides
Mark
M
Segev
Shlomo
S
Gal
Norit
N
Ben-Dov
Issahar
I
D015308:Anaerobic Threshold / Q000502:physiology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D015444:Exercise; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D017353:Gene Deletion; D005838:Genotype; D006801:Humans; D006973:Hypertension / Q000235:genetics* / Q000503:physiopathology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*
D000806:Angiotensin-Converting Enzyme Inhibitors; D007703:Peptidyl-Dipeptidase A