ACE insertion/deletion polymorphism and cardiovascular structural phenotypes in a general population

It has been suggested that an angiotensin converting enzyme insertion/deletion polymorphism (ACE I/D) may be associated to conditions of increased cardiovascular risk: several groups, including ourselves, reported associations of left ventricular mass (LVM) or common carotid artery intima-media thickness (CC_IMT) with ACE DD genotype; in this study we examine further the relationships of both cardiovascular phenotypes with ACE I/D in the same subjects of general population. In 216 subjects (age 50-64) randomly selected from the general population of Vobarno (Italy), LVM and CC_IMT were assessed by M-mode echocardiography (Penn convention) and B-mode ultrasound, respectively; the ACE/ID genotype was determined by electrophoresis of PCR amplified DNA fragments. The relationship of ACE I/D with cardiovascular phenotypes was examined by taking into account the effects of several potential confounding variables (sex, age, body mass index, blood pressure, glycemia, serum cholesterol, smoking habit, …) by multiple regression analysis. LVM was similar in the three ACE I/D genotypes, whereas CC_IMT resulted significantly higher in the DD subjects compared with heterozygotes and II homozygotes (DD vs (ID + II), p < 0.01; DD vs ID vs II, p<0.02) (see table) The results of this study suggest that ACE I/D polymorphism may be a marker more specifically associated with vascular growth than to cardiac growth. An association between ACE DD genotype and development of cardiac hypertrophy is not confirmed in our study population.