From the Department of Medicina Sperimentale e Clinica "G.
Salvatore" at Catanzaro, University of Reggio Calabria, Italy.
Correspondence to Francesco Perticone, MD, Department of Medicina Sperimentale e Clinica, Policlinico Mater Domini, Via Tommaso Campanella, 88100 Catanzaro, Italy. E-mail perticone{at}unicz.thebrain.net
Abstract—The
response of the forearm vasculature to acetylcholine (7.5, 15, and 30
µg/min, each for 5 minutes) and sodium nitroprusside (0.8, 1.6, and
3.2 µg/min, each for 5 minutes) was evaluated in 32 never-treated
hypertensive outpatients (17 men and 15 women, aged 43±7 years) and in
24 normotensive control subjects (14 men and 10 women, aged 42±6
years). Drugs were infused into the brachial artery, and forearm blood
flow was measured by strain-gauge plethysmography. In both hypertensive
and normotensive groups, a deletion (D)/insertion
(I) polymorphism in intron 16 of the
angiotensin-converting enzyme (ACE) gene was
determined by polymerase chain reaction. The response to acetylcholine
was significantly reduced in hypertensive patients versus control
subjects: at the highest dose (30 µg/min), forearm blood flow was
13.9±6.3 mL · 100 mL tissue-1 ·
min-1 in hypertensives versus 27.1±9.7 mL · 100 mL
tissue-1 · min-1 in the controls
(P<.001); similarly, vascular resistance was 10.6±5.6
U in hypertensive patients and 4.9±1.9 U in normotensive subjects. In
the hypertensive group, the patients with DD
genotype showed significantly less
endothelium-dependent vasodilation compared with
ID+II genotypes (at the highest
dose of acetylcholine, forearm blood flow was 12.1±4.2 versus
17.0±4.1 mL · 100 mL tissue-1 ·
min-1) (P<.005). The vasodilator effect of
sodium nitroprusside infusions was not statistically different in
DD and ID+II hypertensive
patients. In conclusion, our data suggest that ACE
polymorphism affects endothelium-dependent
vasodilation in hypertensive patients and confirm that hypertensive
patients had a blunted response to the
endothelium-dependent agent acetylcholine.
© 1998 American Heart Association, Inc.
Scientific Contributions
Angiotensin-Converting Enzyme Gene Polymorphism Is Associated With Endothelium-Dependent Vasodilation in Never Treated Hypertensive Patients
Key Words: angiotensin-converting enzyme • polymorphism • endothelium • hypertension, essential
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