Angiotensin-converting enzyme gene polymorphism, carotid intima-media thickness, and left ventricular mass index in adolescent hypertension

Purpose. The aim of this study was to determine whether a positive correlation exists between the DID genotype of angiotensin-converting enzyme (ACE) and the carotid intima-media thickness (IMT) or left ventricular mass index (LVMI) in adolescents with hypertension. Methods. We studied 120 hypertensive and 58 normotensive (control) adolescents. ACE gene polymorphism was determined by a standardized method. The IMT was measured in the common carotid arteries, and the LVMI was calculated on transthoracic echocardiography. The severity of hypertension was graded according to the results of ambulatory blood pressure monitoring as white coat, borderline, or proven hypertension. The association between ACE gene polymorphism and the obtained parameters was analyzed using analysis of variance and chi-square testing. Results. Both the IMT and LVMI were higher in hypertensive than in control adolescents. In hypertensive subjects, no relationship was found between the different ACE genotypes and the IMT: the mean ( standard deviation) IMT in patients with the DD genotype was 0.57 +/- 0.11 mm; in those with the DI genotype, 0.53 +/- 0.01 mm; and in those with the 11 genotype, 0.55 +/- 0.01 mm. The LVMI was also similar in all 3 ACE genotypes: DID, 106.7 +/- 32.3 g/m(2); DI, 102.2 +/- 38.1 g/m(2); and 11, 103.2 +/- 26.3 g/m(2). The severity of hypertension as assessed by ambulatory blood pressure monitoring was independent of the ACE genotype. Conclusions. Target-organ damage (left ventricular hypertrophy and carotid atherosclerosis) is detectable in adolescents with hypertension and, in those subjects, ACE genotype polymorphism is not correlated with the severity of target-organ damage as measured by IMT and LVIVII. (C) 2004 Wiley Periodicals, Inc. J.