Research Highlights

• Subject Categories:
  • Clinical medicine
  • Genetics

Published online: 23 May 2007 | doi:10.1038/nchina.2007.84

Hypertension: Losing inhibition

John Fox

Introduction

Chinese researchers led by Rutai Hui¹ at the Chinese Academy of Medical Sciences and Peking Union Medical College in Beijing, have identified genetic mutations that might increase the risk and impair the treatment of hypertension, particularly in women.

Hypertension, commonly known as high blood pressure, affects about one billion people worldwide and is a leading cause of cardiovascular disease. Although hypertension is treatable, the individual response to antihypertensive drugs can vary owing to many factors including race, gender and genetic variations.

The renin-angiotensin system (RAS) is an important regulator of blood-pressure control. Suppressing RAS with angiotensin-I-converting-enzyme (ACE) inhibitors is a common treatment for hypertension. ACE2, a recently discovered RAS component, has been found to counterbalance the multiple functions of ACE. Hui and co-workers ran two case-control studies and a clinical trial of 3,408 untreated hypertensive patients randomized to different antihypertensive drugs, including an ACE inhibitor captopril. They found women carrying the ACE2 gene have a 1.6-fold risk of hypertension, and that this risk was almost doubled in those who also had an ACE DD genotype. Blood pressure reduction with captopril was also significantly lower in women with the ACE2 gene.

Further work is continuing to ascertain the association of ACE2 with the clinical response to treatment in cardiovascular disease.

The authors in this work are from:
Hypertension Division, Department of Cardiology, Ministry of Education and Sino-German Laboratory for Molecular Medicine, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Key Laboratory for Clinical Cardiovascular Genetics, Ministry of Education and Sino-German Laboratory for Molecular Medicine, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

References

1. Fan, X. et al. Polymorphisms of ACE2 gene are associated with essential hypertension and antihypertensive effects of captopril in women. Clin. Pharmacol. Ther. (2007).  | Article |