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(Circulation. 1999;100:e85.)
© 1999 American Heart Association, Inc.

Circulation Electronic Pages

Insertion/Deletion Polymorphism of the Angiotensin-Converting Enzyme Gene and Hypertension

Nancy Liyou, BSc, PhD; Leon Simons, MD, FRACP; Anthony Johnson, MD, MPH, FRACP

The Department of Medicine, University of Queensland, Princess Alexandra Hospital, Brisbane, Australia

	Introduction

 
To the Editor:

Recently, an analysis was performed using a prospective, longitudinal, population-based sample in which the insertion/deletion (I/D) polymorphism of the ACE gene was postulated as a sex-specific candidate gene for hypertension.¹ A significant association between hypertension in males and the ACE DD genotype was observed after adjustment for all confounders (OR 1.59, P=0.02), whereas linkage between the DD genotype and diastolic blood pressure (DBP) in men was significant only when adjusted for age alone (P=0.03 and P=0.16 after and before adjustment for age alone, respectively).

In contrast, an independent prospective, population-based study found no association between the ACE I/D polymorphism and hypertension, nor was there any sex stratification with regard to allele or genotype.² Adjustment for several potential confounders did not affect this result for isolated systolic hypertension (systolic blood pressure [SBP] 160 mm Hg, DBP 90 mm Hg) (II versus DD OR 1.06; I versus D OR 1.09) or systolic-diastolic hypertension (SBP 160 mm Hg, DBP 90 mm Hg) (II versus DD OR 1.19; I versus D OR 1.16).

O'Donnell et al¹ used the Framingham cohort, which has a large sample size (n=3095/1044 sib pairs) and allowed use of both association analyses and pedigree-based linkage analyses, which provides considerable power to the study. The Dubbo cohort subset used by Johnson et al² is smaller (n=33) but epidemiologically superior, with a sound geographical definition.³

The most obvious differences between these studies are the definition of high blood pressure and the criteria used to classify . . . [Full Text of this Article]