Association of angiotensin converting enzyme gene insertion/deletion polymorphism with essential hypertension in south Indian population

Genetic,environmental and demographic factors contribute to the development of essential hypertension.Genetic polymorphism of Rennin-angiotensin-aldosterone system(RAAS)has been extensively studied to determine the genetic susceptibility to hypertension.The insertion/deletion(I/D)angiotensin converting enzyme(ACE)polymorphism has been established as a cardiovascular risk factor in some population,but its association with essential hypertension is controversial.This study sought to determine the association of I/D polymorphism of the ACE gene in south Indian essential hypertensive subjects.A total of 208 clinically diagnosed essential hypertensive patients without any associated diseases and 220 healthy control subjects were included in this study.Distribution and allelic frequency of Insertion(I)and Deletion(D)polymorphism at the 287 base pair Alu repeat sequence in the intron 16 of ACE gene were analyzed.The distribution of II,ID,DD genotypes of ACE gene was 28.3%,32.6%and 38.9%respectively in essential hypertensive patients and to 53.6%,26.3%and 20%in controls.The allele frequency for D allele is 0.58 in essential hypertension as compared to 0.34 of control subjects.The genotype and allele frequency of ACE gene polymorphism is significantly differed in patients when compared to controls.In conclusion,the I/D polymorphism of ACE gene is associated with Indian essential hypertension.

Mosaic theory revised:inflammation and salt play central roles in arterial hypertension

The mosaic theory of hypertension was advocated by Irvine Page~80 years ago and suggested that hypertension resulted from the close interactions of different causes.Increasing evidence indicates that hypertension and hypertensive end-organ damage are not only mediated by the proposed mechanisms that result in hemodynamic injury.Inflammation plays an important role in the pathophysiology and contributes to the deleterious consequences of arterial hypertension.Sodium intake is indispensable for normal body function but can be detrimental when it exceeds dietary requirements.Recent data show that sodium levels also modulate the function of monocytes/macrophages,dendritic cells,and different T-cell subsets.Some of these effects are mediated by changes in the microbiome and metabolome due to high-salt intake.The purpose of this review is to propose a revised and extended version of the mosaic theory by summarizing and integrating recent advances in salt,immunity,and hypertension research.Salt and inflammation are placed in the middle of the mosaic because both factors influence each of the remaining pieces.