RELATIONSHIP BETWEEN THE RESPONSE TO THE ANGIOTENSIN-CONVERTING ENZYME-INHIBITOR IMIDAPRIL AND THE ANGIOTENSIN-CONVERTING ENZYME GENOTYPE

Insertion (I)/deletion (D) polymorphism of the angiotensin converting enzyme (ACE) gene has been reported to be involved in various cardiova scular diseases. We investigated prospectively whether the response to the ACE inhibitor imidapril varied according to the ACE genotype or p lasma ACE activity in Japanese hypertensive patients. The study popula tion consisted of 57 hypertensive patients, After a 4-week observation period, imidapril was administered at a dose of 5 mg/day and blood pr essure was measured every 2 weeks for 6 weeks. The plasma ACE activity in patients with the DD or ID genotype was significantly higher than that in patients with the II genotype. Neither the reduction nor the p ercent reduction in systolic blood pressure was significantly differen t between patients with either the DD or ID genotype and patients with the II genotype (DD or ID v II, 18.8 +/- 2.4 v 20.2 +/- 3.3 mm Hg; P = NS, 10.9 +/- 1.4 v 11.7 +/- 1.9%; P = NS, respectively). However, bo th the reduction and the percent reduction in diastolic blood pressure tended to be higher in patients with the II genotype (DD or ID v II, 7.9 +/- 1.2 v 12.4 +/- 2.2 mm Hg; P = .0569, 8.1 +/- 1.2 v 12.4 +/- 2. 2%; P = .0569, respectively). The reduction in diastolic blood pressur e was inversely correlated with plasma ACE activity (r = 0.301, P = .0 253). In conclusion, the response to imidapril in hypertensive patient s is determined at least in part by the ACE genotype. (C) 1997 America n Journal of Hypertension, Ltd.