Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Consider renovascular hypertension (HT) when: Newly diagnosed hypertension presents with features that are atypical of essential hypertension; Resistant hypertension is associated with risk factors for atheroma; or Angiotensin-converting enzyme (ACE) inhibitor or angiotensin-II-receptor antagonist therapy is associated with increasing plasma creatinine levels. Atheromatous renovascular HT can often be managed medically, which includes intensive correction of cardiovascular risk factors. ACE inhibitors are probably second-line antihypertensives for patients with unilateral renal artery stenosis and two kidneys. First-line antihypertensives are diuretics, beta-blockers and calcium-channel blockers. Bilateral renal artery stenosis, or a unilateral stenosis in a patient with only one kidney, is an absolute contraindication to ACE inhibition.
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PMID:Renal artery stenosis: a disease worth pursuing. 1154 82

Molecular variants of individual components of the renin-angiotensin system (RAS) are thought to contribute to inherited predisposition towards essential hypertension. Polymorphisms in genes of angiotensinogen (AGT), angiotensin I-converting enzyme (ACE) and angiotensin II type 1 receptor (AT-1) have been related to differential responses to antihypertensive drugs. AT-1 receptor mediates the major pressor and trophic actions of angiotensin II (Ang II). At least 14 AT-1 polymorphisms have been described in the gene (AGT1R); in particular the +1166 A/C polymorphism has been associated with the severe form of essential hypertension. A relationship was suggested between this polymorphism and the humoral and renal hemodynamic responses to losartan, an antihypertensive drug acting as an AT-1 blocker. Variability in the individual response to AT-1 antagonists could also be due to variations in the pharmacokinetics of the drugs. This review presents current knowledge on Ang II-receptors and polymorphisms in AGT1R related to cardiovascular disease and antihypertensive therapy.
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PMID:Angiotensin II receptor polymorphisms in hypertension. Pharmacogenomic considerations. 1196 4

The genetic factors that contribute to the development of coronary artery disease (CAD) are poorly understood. It is likely that multiple genes that act independently or synergistically contribute to the development of CAD and the outcome. Recently, an insertion/deletion (I/D) polymorphism of the human angiotensin I-converting enzyme (ACE) gene, a major component of the reninangiotensin system (RAS), was identified. The association of the ACE gene D allele with essential hypertension and CAD has been reported in the African-American, Chinese, and Japanese populations. However, other studies have failed to detect such an association. It has been suggested that these inconsistencies may be due to the difference in backgrounds of the population characteristics. In the present study, we investigated the I/D polymorphism of the ACE gene in 103 subjects of both sexes, consisting of 59 normal controls and 44 patients with hypertension. The allele and genotype frequency were significantly different between the hypertensive and control groups (p < 0.01). Among the three ACE I/D variants, the DD genotype was associated with the highest value of the mean systolic blood pressure [SBP] and mean diastolic blood pressure [DBP] (p = < 0.05) in men, but not in women. In the overall population, the mean SBP and DBP was highest in DD subjects, intermediate in I/D subjects, and the least in II subjects
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PMID:Association between angiotensin I-converting enzyme gene polymorphism and hypertension in selected individuals of the Bangladeshi population. 1229 7

We studied the association of angiotensin I-converting enzyme (ACE) gene polymorphism with the depressor response to exercise therapy in 64 Japanese subjects with mild to moderate essential hypertension. Each subject performed 10 weeks of mild (lactate threshold intensity: approximately 50% maximum oxygen consumption) exercise therapy on a bicycle ergometer. Systolic blood pressure (SPB), diastolic blood pressure (DPB), and mean arterial pressure (MAP) were significantly decreased by exercise therapy in subjects with the ACE-II and ID genotypes but not in DD subjects. The time-by-genotype interaction effects were significant for DBP and MAP. According to a multiple logistic regression analysis, the age- and baseline plasma renin activity-adjusted relative risk (odds ratio) for the lack of a depressor response conferred by the D allele (assuming an additive effect) was 2.72 [95% confidence interval (CI), 1.07-6.91; p = 0.034]; for DD genotypes, as compared with the DI and II genotypes (assuming that the D allele is recessive), it was 11.7 (95% CI, 2.25-60.6; p = 0.003). ACE gene I/D polymorphism is associated with the depressor response of essential hypertensives to mild exercise therapy, which suggests that genetic features may underlie, at least in part, the heterogeneity of the depressor response in essential hypertensives to mild exercise therapy.
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PMID:Association of angiotensin-converting-enzyme gene polymorphism with the depressor response to mild exercise therapy in patients with mild to moderate essential hypertension. 1237 63

Left ventricular hypertrophy (LVH) is a major cardiovascular risk factor for morbidity and mortality. It is caused by arterial hypertension, although various hemodynamic and nonhemodynamic factors contribute to its development. Especially, the renin-angiotensin-aldosterone system is involved in the pathophysiology of LVH. The Treatment of Mild Hypertension study demonstrated that in mild essential hypertension, nonpharmacologic treatment is an effective tool for treating LVH. There are at least three major meta-analyses with several thousand patients examining the ability of antihypertensive drugs on the reversal of LVH. The results of these meta-analyses are very consistent. Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers achieve significantly better results than b-blockers. The most recently published Losartan Intervention For Endpoint reduction in hypertension study confirmed the superiority of angiotensin receptor blockers against b-blockers in a large-scale prospective trial. It also proves for the first time that regression of LVH is associated with better cardiovascular outcome.
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PMID:Are all antihypertensive drug classes equal in reducing left ventricular hypertrophy? 1237 66

Angiotensin-converting enzyme (ACE) inhibitors are the first-line therapeutic agents for treating hypertension in patients with the cardiometabolic syndrome and those with diabetes. ACE inhibitor therapy reduces both microvascular and macrovascular complications in diabetes and appears to improve insulin sensitivity and glucose metabolism. Several recent studies indicate that ACE inhibitor therapy reduces the development of type 2 diabetes in persons with essential hypertension, a population with a high prevalence of insulin resistance. ACE inhibitor therapy has been shown to improve surrogates of cardiovascular disease (eg, vascular compliance, endothelial-derived nitric oxide production, vascular relaxation and plasma markers of inflammation, oxidative stress, and thrombosis) and reduce cardiovascular disease, renal disease progression, and stroke. This article explores potential mechanism by which ACE inhibition reduces the development of diabetes, improves these surrogate markers, and reduces cardiovascular disease and renal disease.
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PMID:Mechanisms by which angiotensin-converting enzyme inhibitors prevent diabetes and cardiovascular disease. 1281 33

Hypertension is an important health problem throughout the world and a risk factor for many diseases. Angiotensin-converting enzyme (ACE), a component of the renin-angiotensin system, has an important role in the regulation of blood pressure. Zinc (Zn), a trace element with important biological functions, is located in the catalytic site of ACE. Calcium (Ca), magnesium (Mg), sodium (Na), and potassium (K) also appear to be involved in hypertension pathogenesis. In this study, plasma ACE activities and Cat, Cai, Mg, Na, K, and plasma/erythrocyte Zn levels of 20 untreated patients with essential hypertension and 28 healthy individuals were evaluated. Plasma ACE activities (p<0.05) and erythrocyte Zn concentrations (p<0.001) were significantly higher in patients with essential hypertension than values of the control group. No significant difference was found between plasma Zn concentrations of the groups (p>0.05). Plasma Cat (p<0.001) and Mg levels (p<0.05) in essential hypertension were significantly lower than those of controls. Plasma Na, K, and Cai levels remained normal in essential hypertension. There are complex associations between metals and arterial pressure. Ca and Mg deficiencies seem to be associated with increased prevalence of hypertension. Increases in erythrocyte Zn may have a future potential use for diagnosis of hypertension.
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PMID:Angiotensin-converting enzyme and metals in untreated essential hypertension. 1466 25

Angiotensin-converting enzyme (ACE) inhibitors are increasingly recognized as having an important role in the treatment of hypertension and/or end-organ disease. The sheer number of ACE inhibitors in the United States--now numbering 10 different chemical entities--has created a sense of comfort with these compounds, which is particularly evident when these compounds are used in the patient with essential hypertension; conversely, when comorbid conditions are present in the ACE inhibitor-treated patient, circumstances change and physician vigilance becomes more of a necessity. ACE inhibitor therapy in patients with either cardiac and/or renal disease is as much an art as it is a science, and even in the most skilled hands can prove a challenging undertaking. This review discusses the physiologic and non-physiologic basis for side effects with ACE inhibition.
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PMID:Angiotensin-converting enzyme inhibitors side effects--physiologic and non-physiologic considerations. 1524

The molecular mechanisms underlying essential hypertension are not fully elucidated. Although Benazepril is being widely used in antihypertensive medication, the agent is efficacious in only a portion of hypertensive patients. To evaluate the interaction of alpha-adducin gene Gly460Trp and angiotensin I-converting enzyme (ACE) gene I/D polymorphisms in regard to baseline blood pressure (BP) levels and the reductions of blood pressures after Benazepril treatment, we conducted an investigation of 954 Chinese hypertensive patients in Anhui province, China. We found that compared with the baseline systolic BP (SBP) of subjects with one ACE I allele and one alpha-adducin Trp allele, the baseline SBP of those with ACE DD and alpha-adducin Gly/Gly genotypes was significantly higher [Crude: beta(SE) = 7.83(3.09), p = .01; Adjusted: beta(SE) = 5.83(2.83), p = .04]. However, no associations were found between the interaction of ACE I/D and alpha-adducin Gly460Trp polymorphisms and the baseline diastolic BP or the BP response to Benazepril treatment. Our results suggested that the interaction effect of alpha-adducin Gly460Trp and ACE I/D polymorphisms might play a significant role in regulating baseline BP but not BP response to Benazepril.
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PMID:Associations of baseline blood pressure levels and efficacy of Benazepril treatment with interaction of alpha-adducin and ACE gene polymorphisms in hypertensives. 1577 32

1. The aim of the present study was to determine the effect of hypotensive therapy with a diuretic (hydrochlorothiazide) and an angiotensin-converting enzyme inhibitor (perindopril) on selected oxidative stress parameters in the blood of elderly patients with essential hypertension. 2. Studies were performed in 45 elderly patients with essential hypertension at baseline and after the 45th day of perindopril (n = 25) or hydrochlorothiazide (n = 20) therapy, as well as in 25 young and 25 elderly normotensive subjects. The following parameters were measured: systolic and diastolic blood pressure, nitric oxide (NO), carbonyl groups and malondialdehyde (MDA) concentrations, as well as the activity of ceruloplasmin (Cp) oxidase, Cu-Zn superoxide dismutase (SOD-1) and catalase (CAT). 3. The activity of SOD-1 and NO levels were reduced with age. 4. Compared with elderly controls, hypertensive subjects showed increases in baseline MDA, carbonyl group concentrations and Cp oxidase activity and decreases in NO levels and SOD-1 and CAT activities. 5. Treatment with perindopril, but not hydrochlorothiazide, resulted in significant increases in SOD-1 and CAT activities and decreases in MDA concentration and Cp oxidase activity. Both therapies decreased the level of carbonyl groups and increased NO levels. 6. Angiotensin-converting enzyme inhibitor therapy has significant anti-oxidant effects that may be important in the treatment of elderly patients with essential hypertension.
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PMID:Effects of perindopril and hydrochlorothiazide on selected indices of oxidative stress in the blood of elderly patients with essential hypertension. 1689 51


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