title: Renin angiotensin system gene polymorphisms modify angiotensin-converting enzyme inhibitors' effect on cognitive function: the health, aging and body composition study.
abstract: OBJECTIVE
  To investigate the effect of polymorphisms in renin angiotensin system genes on the association between angiotensin-converting enzyme inhibitor (ACEI) exposure and global and executive cognitive function in the Health, Aging and Body Composition study.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Community.
  
  
  METHODS
  Three thousand seventy-five participants: mean age 73.6, 58% Caucasian, 52% female, 15% taking ACE-Is, 8 years of follow-up.
  
  
  METHODS
  The outcomes were longitudinal change in Executive Clock Drawing Test-1 (CLOX1), the Digit Symbol Substitution test, and the Modified Mini-Mental State Examination. The genetic polymorphisms included angiotensin-converting enzyme insertion deletion (ACEID) in the ACE gene and the M235T and 6AG polymorphisms in the angiotensinogen (AGT) gene.
  
  
  RESULTS
  For the CLOX1 outcome, there was significant interaction between 6AG and M235T polymorphisms in the AGT gene and angiotensin-converting enzyme inhibitors (ACE-Is) in Caucasian participants (P=.01 for both polymorphisms) independent of blood pressure levels. Specifically, ACE-I exposure was protective against CLOX1 score decline in carriers of the AA genotype of the 6AG and the CC genotype of the M235T (for the ACE-I vs non-ACE-I groups, P=.01 for 6AG and P=.005 for M235T) but not the other genotypes. These associations were not significant with other cognitive tests, with ACEID, or in African Americans.
  
  
  CONCLUSIONS
  ACE-Is may provide a protective effect on executive function in Caucasians with AGT gene polymorphisms known to be associated with greater renin angiotensin system activity. If confirmed in a pharmacogenetic trial, ACE-Is may be found to have additional cognitive protection in a select group of elderly individuals.
authors: Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02131, USA. Ihabhajjar@hrca.harvard.edu
authors: Ihab
authors: I
authors: Hajjar
authors: Stephen
authors: S
authors: Kritchevsky
authors: Anne B
authors: AB
authors: Newman
authors: Rongling
authors: R
authors: Li
authors: Kristine
authors: K
authors: Yaffe
authors: Eleanor M
authors: EM
authors: Simonsick
authors: Lewis A
authors: LA
authors: Lipsitz
mesh_terms: D000368:Aged; D000375:Aging / Q000235:genetics; D000704:Analysis of Variance; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D000808:Angiotensinogen / Q000235:genetics; D001823:Body Composition / Q000235:genetics; D003072:Cognition Disorders / Q000175:diagnosis / Q000235:genetics* / Q000517:prevention & control; D015331:Cohort Studies; D005260:Female; D017353:Gene Deletion; D005787:Gene Frequency; D005838:Genotype; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic; D012084:Renin-Angiotensin System / Q000235:genetics*; D012307:Risk Factors; D044465:White People / Q000235:genetics
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000808:Angiotensinogen; D007703:Peptidyl-Dipeptidase A