Clinical StudiesAssociation between angiotensin-converting enzyme gene polymorphisms and regression of left ventricular hypertrophy in patients treated with angiotensin-converting enzyme inhibitors☆
Section snippets
Entry criteria and screening
Between January 1992 and June 1996, we recruited 54 patients with left ventricular hypertrophy from a group of approximately 400 hypertensive patients seen in our department. All patients underwent routine laboratory studies, chest roentgenography, and electrocardiography. We selected subjects with essential hypertension based on the results of these laboratory tests and the guidelines of the World Health Organization (25). Hypertension was defined as systolic pressure >160 mm Hg or diastolic
Patient characteristics
No differences were seen in terms of age, gender, body dimensions, and systolic and diastolic blood pressure among the three genotypes (Table 1). All patients were treated with an ACE inhibitor (enalapril or lisinopril); some also required a calcium antagonist to reduce blood pressure adequately. The decreases in blood pressure were not different in the three groups. Mean left ventricular ejection fractions in the three groups at baseline were normal and did not change significantly during the
Discussion
Long-term therapy with ACE inhibitors reduced posterior and septal wall thickness and left ventricular mass index in hypertensive patients with moderate or severe left ventricular hypertrophy. However, the magnitude of regression of posterior wall thickness was significantly less in the DD group than in the ID and II groups, and regression of septal wall thickness and left ventricular mass index was less in the DD group than the II group. These results suggest that the regression of left
Acknowledgements
The authors gratefully acknowledge the technical assistance of Atsumi Ohnishi and Yuka Inoshita (Division of Hypertension and Atherosclerosis, The First Department of Internal Medicine, Osaka City University Medical School). We also gratefully acknowledge the valuable advice of Shinichiro Ueda, MD, PhD (The Second Department of Internal Medicine, Yokohama City University Medical School).
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Supported by a Grant-in-Aid for Scientific Research (572-690-231-646) from the Ministry of Education, Science and Culture, Japan.