Clinical study: risk factors
Association of angiotensinogen m235t and a(-6)g gene polymorphisms with coronary heart disease with independence of essential hypertension: the procagene study

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Abstract

OBJECTIVES

We examined the relationship between the angiotensinogen (AGT) gene M235T polymorphism, the variant promoter of the AGT gene A(-6)G and the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and coronary heart disease (CHD) in native Gran Canaria Island habitants, who have the highest rates of CHD in Spain.

BACKGROUND

Some studies subject that the ACE (I/D) polymorphism could be associated with CHD, while AGT (M235T) has been related to essential hypertension.

METHODS

We studied 304 subjects with angiographic evidence of coronary artery disease and a clinical diagnosis of myocardial infarction or unstable angina and 315 age- and gender-matched controls. Blood was drawn and DNA extracted. Angiotensin-converting enzyme (I/D) gene polymorphism was analyzed by polymerase chain reaction (PCR) and AGT gene polymorphisms by restriction fragment length polymorphism-PCR and mutagenically-separated PCR.

RESULTS

The ACE (I/D) polymorphism showed no association with CHD, whereas the frequency distribution of AGT (M235T) genotypes among patients and controls (235T: 29.1% and 19.0%; M235T: 48.5% and 50.2%; M235: 22.4% and 30.8%, respectively) was statistically different (p = 0.005) and not related to the presence of essential hypertension. Similar results were observed with the AGT A(-6)G polymorphism. In multiple logistic regression analysis, CHD odds ratio associated with 235T and M235 homozygotes were 1.7 (1.1 to 2.6) and 0.54 (0.36 to 0.82), respectively.

CONCLUSIONS

This study shows that genetic variation of the AGT (M235T), but not the ACE (I/D), genotypes contributes to the presence of CHD independently of blood pressure profile in a subset of the Spanish population with a high prevalence of cardiovascular disease.

Abbreviations

ACE
angiotensin-converting enzyme
AGT
angiotensinogen
BMI
body mass index
BP
blood pressure
CHD
coronary heart disease
CI
confidence interval
CVD
cardiovascular disease
I/D
insertion/deletion
Lp (a)
lipoprotein (a)
MI
myocardial infarction
OR
odds ratio
PCR
polymerase chain reaction
PROCAGENE
Prospective Cardiac Gene Study

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Supported by a grant from the Ministerio de Sanidad y Consumo, FIS 96/0662, Fundación Mapfre-Guanarteme and Ilmo, Colegio Oficial de Médicos, Las Palmas de Gran Canaria, Spain.