Hypertensive left ventricular remodeling and ACE-gene polymorphism

Objective:To evaluate the relationship between ACE-gene polymorphism and le ft ventricular geometry in never treated hypertensives. Methods: We enrolle d 200 hypertensive outpatients that underwent clinical and ambulatory blood pressure measurements, echocardiographic evaluation and analysis for inser tion (I)/deletion (D) polymorphism by PCR. Patients with normal or increase d (>125 g/m(2) in males and >110 g/m(2) in females) left ventricular mass w ere considered to have concentric remodeling or concentric left ventricular hypertrophy if their relative wall thickness was greater than or equal to 0.45. Results: The left ventricular mass index values (g/m(2)) were 135+/-3 0 in DD genotype, 124+/-26 in ID genotype, and 116+/-30 in II genotype (DD vs. ID P<0.005; DD vs. II P<0.05), and were unrelated to blood pressure. Ni nety-six patients presented left ventricular hypertrophy (48.0%): 51 with c oncentric and 45 with eccentric hypertrophy. The eccentric left ventricular hypertrophy was detected in 32 (36.8%) DD patients, in ten (10.5%) ID pati ents (P<0.05), and in three (16.6%) II patients. The relative septal thickn ess was 0.43+/-0.09 in DD genotype, 0.45-0.08 in LD genotype, and 0.43+/-0. 10 in II genotype. In DD and ID genotypes, the relative posterior wall thic kness (0.37+/-0.07 vs. 0.41+/-0.07; P<0.0001) and the end-diastolic left ve ntricular internal dimension (52.8+/-3.3 mm vs. 48.3+/-2.8 mm; P<0.0001) we re statistically different. Conclusions: The DD genotype of the ACE-gene is associated with an increased left ventricular mass and with a significantl y higher prevalence of eccentric left ventricular hypertrophy, when compare d to ID genotype. (C) 1999 Elsevier Science B.V. All rights reserved.