Association of DD genotype of angiotensin-converting enzyme gene (I/D) polymorphism with hypertension among a North Indian population
Hypertension, a major risk factor for cardiovascular diseases, is among the leading causes of morbidity and mortality worldwide. Genetic predisposition to the risk of developing hypertension due to angiotensin-converting enzyme (ACE) gene insertion(I)/deletion(D) polymorphism (through altered serum ACE activity) is well documented among various populations. The present study investigated the possible association between ACE (DD) genotype and hypertension using a nested case-control study design including 451 individuals (of either sex in the age group 30–65 years) from a rural North Indian population practicing agriculture and lacto-vegetarianism. Blood Pressure was classified using JNC-7 criterion. Age- and sex-matched individuals were selected from normotensive (N-122), pre-hypertensive (N-123), hypertensive not on medication (N-122), and hypertensive on medication (N-84) categories. Amplification of DNA and genotyping of PCR product was done using standard protocols. From the analysis, comparatively higher frequency of individuals with DD genotype in the hypertensive category was observed, indicating a possible relation between DD genotype and hypertension. The odds ratio analysis revealed 2.225 (1.13–4.37)-fold significant increased risk for hypertension among cases, validating the vulnerability of individuals with DD genotype towards hypertension. Thus, the present study highlights the increased risk for developing hypertension due to ACE DD genotype in the studied population.
KeywordsHypertension Pre-hypertension ACE I/D polymorphism Cardiovascular disorders Lacto-vegetarian diet
The authors would like to acknowledge Department of Biotechnology, Ministry of Science of Technology, Government of India, for financial assistance and all the participants in the present study for their cooperation. The authors would also like to express sincere gratitude to Prof. P. K. Ghosh and Prof. V. R. Rao for their timely suggestions during the entire study period.
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Conflict of interest
The authors declare that they have no conflict of interest.
Informed consent was obtained from all individual participants included in the study.
- Bhat RU, Arora A, Unnikrishnan B, Holla R (2015) Modifiable risk factors for myocardial infarction among hypertensive patients visiting outpatient clinics of tertiary care hospitals in coastal South India. Asian J Pharm Clin Res 8(6):204–206Google Scholar
- Bloom D, Fonseca CE, Candeias V, Adashi E, Bloom L, Gurfein L, Llopis JE, Lubet A, Mitgang E, Carroll OJ, Saxena A (2014) Economics of non-communicable diseases in India: the costs and returns on investment of interventions to promote healthy living and prevent, treat and manage NCDs. World Economic Forum. Harvard School of Public Health, CambridgeGoogle Scholar
- CSELS 2017 available at https://phgkb.cdc.gov/HuGENavigator/phenoPedia.do?firstQuery=Hypertension&cuiID=C0020538%20%20&typeSubmit=GO&check=y&which=2&pubOrderType=pubD Accessed on Dec 22 2016
- Erdmann J, Linsel-Nitschke P, Schunkert H (2010) Genetic causes of myocardial infarction. Dtsch Arzebl Int 107:694–699Google Scholar
- Fiuza-Luces C, Ruiz JR, Rodríguez-Romo G, Santiago C, Gómez-Gallego F, Cano-Nieto A, Garatachea N, Rodríguez-Moreno I, Morán M, Lucia A (2011) Is the ACE I/D polymorphism associated with extreme longevity? A study on a Spanish cohort. J Renin-Angiotensin-Aldosterone Syst 12(3):202–207CrossRefPubMedGoogle Scholar
- JNC-7 (2004) available at https://www.nhlbi.nih.gov/files/docs/guidelines/jnc7full.pdf Accessed 21 Dec 2016
- Key TJ, Fraser GE, Thorogood M, Appleby PN, Beral V, Reeves G, Burr ML, Chang-Claude J, Frentzel-Beyme R, Kuzma JW, Mann J (1999) Mortality in vegetarians and nonvegetarians: detailed findings from a collaborative analysis of 5 prospective studies. Am J Clin Nutr 70(3):516–524Google Scholar
- Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, AlMazroa MA, Amann M, Anderson HR, Andrews KG, Aryee M (2013) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease study. Lancet 380(9859):2224–2260CrossRefGoogle Scholar
- Martinez E, Puras A, Escribano J, Sanchis C, Carrión L, Artigao M, Divison JA, Masso J, Vidal A, Fernández JA (2000) Angiotensin-converting enzyme (ACE) gene polymorphisms, serum ACE activity and blood pressure in a Spanish-Mediterranean population. J Hum Hypertens 14(2):131–135CrossRefPubMedGoogle Scholar
- Rinaldi M (2012) I/D ACE gene polymorphism distribution in the world and human prehistoric migrations. J Biol Res – Boll Soc It Biol Sper 85(1):168–169Google Scholar
- Sayed-Tabatabaei FA, Oostra BA, Isaacs A, Van Duijn CM, Witteman JC (2006) ACE polymorphisms. Circ Res 98(9):1123–1133Google Scholar
- Shanmuganathan R, Kumaresan R, Giri P (2014) Prevalence of angiotensin converting enzyme (ACE) gene insertion/deletion polymorphism in South Indian population with hypertension and chronic kidney disease. J Postgrad Med 61(4):230–234Google Scholar
- WHO 2015 available at http://www.who.int/features/qa/82/en/ Accessed 21 Dec 2016
- Zarouk WA, Hussein IR, Esmaeil NN, Raslan HM, Reheim HA, Moguib O, Emara NA, Aly AA, Hamed M (2011) Association of angiotensin converting enzyme gene (I/D) polymorphism with hypertension and type 2 diabetes. Bratisl Lek Listy 113(1):14–18Google Scholar