Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:3.4.15.1 (ACE)
 18,300 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

More women than men eventually develop hypertension in the United States due to their higher numbers and longer longevity. The white coat hypertension is also more common in women. Alcohol, obesity and oral contraceptives are important causes of rise in blood pressure among women. On the other hand, hormone replacement therapy may decrease cardiovascular mortality in the postmenopausal woman. Women with left ventricular hypertrophy are at a greater risk of death than men. Fibromuscular hyperplasia and primary aldosteronism are more common as causes of secondary hypertension in women. Nonpharmacologic therapy, such as weight reduction, exercise, salt and alcohol reduction, should always be tried prior to medical treatment of hypertension and are very useful adjunctive measures in controlling hypertension. ACE inhibitors and angiotensin receptor blockers are contraindicated in pregnancy and should be avoided in women with childbearing potential. Hypertension remains a major public health problem among black women. Although the antihypertensive drug therapy seems to benefit white women the least, proportionately more of them comply with their antihypertensive therapy. Hypertension is the most common chronic medical condition requiring visits to the physicians, as well as prescription medications, in the United States. The epidemiology, clinical course, response to treatment and ultimate outcome of essential hypertension may vary with gender. More women than men eventually develop hypertension in the US due to their higher numbers and longer longevity.
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PMID:Hypertension in women. 1092 86

Patients with essential arterial hypertension either have or do not have compelling reasons for specific drug classes. Patients lacking a compelling reason for a specific drug class are those without target organ damage (e.g. left ventricular hypertrophy, microalbuminuria, proteinuria, atherosclerosis) and without comorbidities. In these patients antihypertensive treatment can be initiated with Diuretics and perhaps Betablockers. Calciumantagonists, ACE-Inhibitors and Angiotensin II-Receptorenblockers (Sartans) are unlikely to be superior. However, adverse effects, patient preferences and antihypertensive efficacy of a drug in the particular individual ultimately determine the "choice" of the medication. In patients with a compelling reason for an individual drug class, i.e., in patients with target organ damage (e.g. left ventricular hypertrophy, microalbuminuria, proteinuria) or very high cardiovascular risk (e.g. Diabetes) Angiotensin II-Receptorblockers or ACE-Inhibitors should be used initially. In many hypertensives blood pressure will normalize in response to a combination therapy only. Usually, addition of a low dose thiazide to another drug class is the most beneficial combination. In most patients resistant to therapy, a 24-h-ambulatory blood pressure measurement to exclude white coat hypertension or a white coat component, evaluation of medication compliance, non-pharmacological measures and the tailored use of diuretics and other optimizations of therapy will lead to success.
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PMID:[Modern therapy of hypertension]. 1470 54

Although polymorphisms in renin-angiotensin-aldosterone (RAA) system genes for angiotensinogen (AGT M235T), angiotensin-converting enzyme (ACE I/D), angiotensin II type 1 receptor (AT1 A/C1166), and aldosterone synthase (CYP11B2-344T/C) have been major targets for genetic investigation in association with essential hypertension (EH), the influence of these genetic factors is still to be determined. Because patients with young-onset EH are thought to possess a stronger genetic background than EH patients who show elevated BP relatively late in life, the targeted screening of hypertensive students in Tohoku University was completed for the selection of subjects for genetic investigation. Out of 16,434 students (12,794 males and 3,670 females) younger than 30, 22 students showed a high blood pressure (BP) (systolic and diastolic BP of 140 and/or 90 mmHg or greater, respectively, on two occasions and more than 135 and/or 85 mmHg, respectively, at a third measurement during casual BP measurements at the Tohoku University Health Center. These 22 students were asked to measure their BP at home (HBP). Six of the students had a systolic HBP of more than 135 mmHg and/or a diastolic HBP of more than 85 mmHg, and these students subsequently received medical examinations at Tohoku University Hospital and were diagnosed with EH. Genotyping for the four major genetic polymorphisms mentioned above was performed on the six students with EH and on 12 of the remaining 16 students whose HBP was within the normal range (white coat hypertension: WCH). Neither the EH nor the WCH students showed a different distribution of genotypes and allelic frequencies, compared to those found in the general Japanese population. Hence, the present study suggests that none of the major genetic polymorphisms in the RAA system strongly influence the onset of EH.
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PMID:Investigation of major genetic polymorphisms in the Renin-Angiotensin-aldosterone system in subjects with young-onset hypertension selected by a targeted-screening system at university. 1719 Jul 32