Angiotensin-converting enzyme gene deletion polymorphism determines an increase in frequency of migraine attacks in patients suffering from migraine without aura

Many authors have reported an association between the angiotensin-convertin g enzyme (ACE)-D allele and coronary heart disease and other cardiovascular diseases. The mechanism underlying the positive associations between the A CE-D alleles and diseases are not yet clear. Previous reports showed an ass ociation between migraine without aura and ACE-D allele polymorphism. The s tudy is aimed to evaluate if the DD genotype could also be associated with the frequency and duration of migraine without aura. In 302 patients suffer ing from migraine without aura (at least for 1 year), with no history of ca rdiovascular diseases and major risk factors for ischemic events, the genot ypes of the ACE gene, plasma ACE activity, and the frequency (weekly) and d uration of migraine attacks were evaluated. No drugs were given before (4 w eeks) and during the study. The same evaluations were performed in 201 subj ects without migraine. The molecular biologist and the physician evaluating the patient data were blinded to the clinical history and ACE-DD gene dete rmination. Genotypes were determined by polymerase chain reaction amplifica tion. Plasma ACE activity was performed by the HPLC method. The groups were similar for sex, age and smoking habit (migraines: 302 patients (200 F/102 M), mean age 37.8 +/- 8.2 years; control: 201 subjects (127 F/74 M), mean age 37.5 +/- 9.3 years). Patients with migraine without aura showed higher incidence of the ACE-DD gene (48.34%) than control subjects (37.32%), p < 0 .05. The frequency of migraine (average attacks per week) was higher in pat ients with DD (2.11 +/- 1.9) than in patients with ID (1.54 +/- 1.44), p < 0.05. No difference in duration of migraine attacks (hours per week) was ob served. Plasma ACE activity was increased in patients with the ACE-DD gene. Our data suggest that ACE-DD gene polymorphism could have an important rol e in determining migraine attacks and the frequency of these attacks. Furth er data are needed through further studies, especially on the biomolecular level. Copyright (C) 2000 S. Karger AG, Basel.