Carotid remodeling of hypertensive subjects and polymorphism of the angiotensin-converting enzyme gene / 中华医学杂志(英文版)

ABSTRACT

<p><b>BACKGROUND</b>This study was designed to investigate the relationships between changes in the structure and function of carotid arteries and angiotensin converting enzyme (ACE) gene polymorphism in Chinese hypertensive subjects.</p><p><b>METHODS</b>Multiplex polymerase chain reaction amplification was used to evaluate the ACE gene insertion/deletion (I/D) polymorphism. High-resolution B-mode ultrasound examinations were performed to detect parameters of carotid artery remodeling.</p><p><b>RESULTS</b>Intima-media thickness (IMT) was significantly different among the DD, ID and II genotypes of ACE (DD > ID > II, P < 0.05). Carotid internal diameter, distensibility and stiffness were similar among the DD, ID and II genotypes of ACE (P > 0.05) in hypertensive subjects. The frequency of the DD gene and D allele of ACE were higher in patients with thickening carotid than in patients with normal carotid (70.4% vs 24.1%, and 79.5% vs 40.5%, respectively, P < 0.001). In multiple stepwise regression analysis, independent risk factors for increased carotid IMT in hypertensive subjects were ACE genotypes (P < 0.001), age (P < 0.001) and carotid internal diameter (P = 0.032). Moreover, triglycerides and total cholesterol were higher in patients with the DD genotype than in those with the II genotype (P < 0.05).</p><p><b>CONCLUSIONS</b>The I/D polymorphism of the ACE gene was related to IMT, but not to internal diameter, distensibility and stiffness of the carotid in Chinese hypertensive subjects. ACE gene polymorphism was a main risk factor for increased carotid IMT. These results may imply that there is a link between lipid metabolism and ACE genotype polymorphism in Chinese hypertensive subjects.</p>