ANGIOTENSIN-I-CONVERTING-ENZYME INSERTION DELETION POLYMORPHISM - CLINICAL IMPLICATIONS/

Since the identification of an Insertion/Deletion polymorphism in the ACE gene, numerous studies have evaluated the potential risk of the DD genotype in cardiovascular disease and hypertension. The report of ma ny conflicting publications reveals a strong need for reviewing the mo st important data. There is evidence of the absence of an association between the ACE polymorphism and hypertension in Caucasians. In blacks a positive association between the 13 allele and high blood pressure was seen, Japanese studies show discrepant results. Several studies sh owed no association between the ACE polymorphism and the risk of myoca rdial infarction. However, in certain subpopulations, such as low risk patients or coronary care unit patients, an increased risk of myocard ial infarction in DD type is present. and a meta-analysis supports thi s proposition. Because of conflicting data, the potential association between the ACE polymorphism and coronary artery disease, cerebrovascu lar disease, left ventricular hypertrophy, hypertrophic and idiopathic dilated cardiomyopathy, carotid artery disease and diabetic and immun oglobin A nephropathy, remains inconclusive.