Angiotensin-Converting Enzyme Insertion/Deletion (ACE I/D) Gene Polymorphism as a Risk Factor for Essential Hypertension
DOI:
https://doi.org/10.35898/ghmj-741044Keywords:
Polymorphism, ACE gene, Insertion-deletion mutation, Blood pressure, HypertensionAbstract
Background: Hypertension is the leading cause of death globally due to its complications, including coronary heart disease and stroke. In 2018, hypertension cases in West Java were the second highest among all populations in Indonesia. Genetics is one of the unmodifiable risk factors for hypertension. Angiotensin-converting enzyme insertion/deletion (ACE I/D) gene polymorphism could affect ACE production in the renin-angiotensin-aldosterone system (RAAS), which is linked to the regulation of blood pressure.
Aims: To analyze ACE I/D gene polymorphism as a risk factor for hypertension in Cirebon.
Methods: An observational analysis with a case-control design was used in this study. Blood samples were collected from 30 hypertensive patients and 30 healthy individuals at Talun Health Center. DNA extraction was performed to evaluate polymorphisms using ARMS-PCR. Statistical analyses, including the Chi-square test, Fisher’s exact test, Mann-Whitney, and Kruskal-Wallis test, were conducted to compare the case and control groups. The odds ratio was calculated to see the risk of the assessed variables, including genotype, allele frequency, and the presence of ACE I/D gene polymorphism.
Results: In the case group, the frequency of the II genotype was 2 (6.7%), the ID genotype was 25 (83.3%), and the DD genotype was 3 (10.0%). In the control group, the frequency of the II genotype was 2 (6.7%), the ID genotype was 26 (86.7%), and the DD genotype was 2 (6.7%). Statistically, there was no significant association between ACE I/D gene polymorphisms in essential hypertension patients and healthy people (p=0.500; OR=1.556; 95% CI=0.241-10.049).
Conclusion: ACE I/D gene polymorphism was not significantly associated with essential hypertension in Cirebon, West Java, Indonesia.
Received: 25 September 2024 | Reviewed: 21 October 2024 |
Revised: 23 November 2024 | Accepted: 30 November 2024.
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References
Agustiani, Y., Anggie Nauli, H., & Masitha Arsyati, A. (2023). Hubungan antara Obesitas, Kebiasaan Merokok dan Aktivitas Fisik dengan Kejadian Hipertensi pada Lansia di Wilayah Kerja Puskesmas Gang Kelor. Promotor, 6(2), 141–149. https://doi.org/10.32832/pro.v6i4.277
Astutik, E., Puspikawati, S. I., Dewi, D. M. S. K., Mandagi, A. M., & Sebayang, S. K. (2020). Prevalence and Risk Factors of High Blood Pressure among Adults in Banyuwangi Coastal Communities, Indonesia. Ethiopian Journal of Health Sciences, 30(6), 941–950. https://doi.org/10.4314/ejhs.v30i6.12
Badan Penelitian Dan Pengembangan Kesehatan Kementerian Kesehatan RI. (2019). Laporan Riskesdas 2018 Nasional. In Kementerian Kesehatan Republik Indonesia. Jakarta: Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan RI.
Barley, J., Blackwood, A., Carter, N. D., Crews, D. E., Cruickshank, J. K., Jeffery, S., … Sagnella, G. A. (1994). Angiotensin converting enzyme insertion/deletion polymorphism. Journal of Hypertension, 12(8), 995. https://doi.org/10.1097/00004872-199408000-00014
Bawazier, L. A., Sja’bani, M., Haryana, S. M., Soesatyo, M. H. N. E., & Sadewa, A. H. (2010). Relationship of angiotensin converting enzyme gene polymorphism and hypertension in Yogyakarta, Indonesia. Acta Medica Indonesiana, 42(4), 192–198.
Bhelkar, S., Deshpande, S., & Mankar, S. (2019). Association between Stress and Hypertension among Adults More Than 30 Years: A Case-Control Study. National Journal of Community Medicine│Volume, 9(6), 430–433.
Birhan, T. A., Molla, M. D., Abdulkadir, M., & Tesfa, K. H. (2022). Association of angiotensin-converting enzyme gene insertion/deletion polymorphisms with risk of hypertension among the Ethiopian population. PLoS ONE, 17(11 November), 1–14. https://doi.org/10.1371/journal.pone.0276021
Burchard, E. G., Ziv, E., Coyle, N., Gomez, S. L., Tang, H., Karter, A. J., … Pérez-stable, E. J. (2003). The Importance of Race and Ethnic Background in Biomedical Research and Clinical Practice. The New England Journal of Medicine, 348(12), 1170–1175.
Dida, G. Y., Nayoan, C. R., & Sir, A. B. (2023). The Risk Factors of Hypertension Among the Elderly in the Working Area of Sikumana Primary Health Care Center. Journal of Public Health for Tropical and Coastal Region, 6(1), 21–29. https://doi.org/10.14710/jphtcr.v6i1.17541
Dinas Kesehatan Kabupaten Cirebon. (2021). Profil Kesehatan Kabupaten Cirebon Tahun 2021. Dinas Kesehatan Kabupaten Cirebon.
Eleni, S., Dimitrios, K., Vaya, P., Areti, M., Norma, V., & Magdalini, G. (2008). Angiotensin-I converting enzyme gene and I/D polymorphism distribution in the Greek population and a comparison with other European populations. Journal of Genetics, 87(1), 91–93. https://doi.org/10.1007/s12041-008-0013-7
Frisoli, T. M., Schmieder, R. E., Grodzicki, T., & Messerli, F. H. (2012). Salt and hypertension: Is salt dietary reduction worth the effort? American Journal of Medicine, 125(5), 433–439. https://doi.org/10.1016/j.amjmed.2011.10.023
Hadian, B., Zafarmohtashami, A., Chaghervand, Z., & Nouryazdan, N. (2022). Angiotensin-converting enzyme gene insertion/deletion polymorphism and hypertension disease. Archives of Physiology and Biochemistry, 128(5), 1165–1169. https://doi.org/10.1080/13813455.2020.1762225
Hidayat, T., & Milenia Saputri, R. (2023). Hubungan Tingkat Ketergantungan Nikotin Dengan Tekanan Darah Pada Kelompok Perokok Laki-Laki Dengan Hipertensi. Jurnal Ilmu Kesehatan Insan Sehat, 11(2), 52–57. https://doi.org/10.54004/jikis.v11i2.135
Ishigami, T., Iwamoto, T., Tamura, K., Yamaguchi, S., Iwasawa, K., Uchino, K., … Ishii, M. (1995). Angiotensin I Converting Enzyme (ACE) Gene Polymorphism and Essential Hypertension in Japan. 7061(94), 95–97.
Kumar, D. P. J., & Clark, M. L. (2021). Kumar and Clark’s Clinical Medicine (10th Ed; A. Feather, D. Randall, & M. Waterhouse, eds.). United Kingdom: Elsevier.
Liu, M., Yi, J., & Tang, W. (2021). Association between angiotensin converting enzyme gene polymorphism and essential hypertension: A systematic review and meta-analysis. JRAAS - Journal of the Renin-Angiotensin-Aldosterone System, 22(1). https://doi.org/10.1177/1470320321995074
Martínez, E., Puras, A., Escribano, J., Sanchis, C., Carrión, L., Artigao, M., … Fernández, J. A. (2000). Angiotensin-converting enzyme (ACE) gene polymorphisms, serum ACE activity and blood pressure in a Spanish-Mediterranean population. Journal of Human Hypertension, 14(2), 131–135. https://doi.org/10.1038/sj.jhh.1000958
Moreira, S. R., Nóbrega, O. T., Santana, H. A. P., Sales, M. M., Farinatti, P. T. V., & Simões, H. G. (2018). Impacto del polimorfismo I/D del gen de la Enzima Conversora de la Angiotensina en la presión sanguínea, variacion de la frecuencia cardíaca y óxido nítrico en respuesta a ejercicios aeróbicos en mayores hipertensos. Revista Andaluza de Medicina Del Deporte, 11(2), 57–62. https://doi.org/10.1016/j.ramd.2015.10.001
Mufaidah, S. (2019). Hubungan Imt, Usia Dan Kebiasaan Merokok Terhadap Kejadian Hipertensi Pada Nelayan Kub Pondok Layar. Journal of Community Mental Health and Public Policy, 1(2), 1–12. https://doi.org/10.51602/cmhp.v1i2.29
Muhadi. (2016). JNC 8 : Evidence-based Guideline Penanganan Pasien Hipertensi Dewasa. Cermin Dunia Kedokteran, 43(1), 54–59.
Ned, R. M., Yesupriya, A., Imperatore, G., Smelser, D. T., Moonesinghe, R., Chang, M. H., & Dowling, N. F. (2012). The ACE I/D polymorphism in US adults: Limited evidence of association with hypertension-related traits and sex-specific effects by race/ethnicity. American Journal of Hypertension, 25(2), 209–215. https://doi.org/10.1038/ajh.2011.182
Qadar Pasha, M. A., Khan, A. P., Kumar, R., Ram, R. B., Grover, S. K., Srivastava, K. K., … Brahmachari, S. K. (2002). Variations in angiotensin-converting enzyme gene insertion/deletion polymorphism in Indian populations of different ethnic origins. Journal of Biosciences, 27(1 SUPPL. 1), 67–70. https://doi.org/10.1007/bf02703684
Rahmadhani, M. (2021). Faktor-Faktor yang Mempengaruhi Terjadinya Hipertensi Pada Masyarakat di Kampung Bedagai Kota Pinang. Jurnal Kedokteran STM (Sains Dan Teknologi Medik), IV(I), 52–62. https://doi.org/10.30743/stm.v4i1.132
Rasyid, H., Bakri, S., & Yusuf, I. (2012). Angiotensin-converting enzyme gene polymorphisms, blood pressure and pulse pressure in subjects with essential hypertension in a South Sulawesi Indonesian population. Acta Medica Indonesiana, 44(4), 280–283.
Rezqi, E. G., Fathana, P. B., & Dirja, B. T. (2023). Hubungan perilaku merokok dan obesitas dengan kejadian hipertensi pada guru sman di kota mataram. Intisari Sains Medis, 14(1), 237–242. https://doi.org/10.15562/ism.v14i1.1569
Sayed-Tabatabaei, F. A., Oostra, B. A., Isaacs, A., Duijn, C. M. Van, & Witteman, J. C. M. (2006). ACE Polymorphisms. Lippincott Williams & Wilkins, 1123–1133. https://doi.org/10.1161/01.RES.0000223145.74217.e7
Setiati, S., Alwi, I., Sudoyo, A. W., Simadibrata K, M., Setiyohadi, B., & Syam, A. F. (2014). Buku Ajar Ilmu Penyakit Dalam. In Interna Publishing (Edisi 6). Jakarta: Interna Publishing.
Starkova, K. G., Dolgikh, О. V., Kazakova, О. А., & Legostaeva, Т. А. (2022). ACE I/D genetic polymorphism as a risk factor of essential hypertension. Health Risk Analysis, 7(3), 169–175. https://doi.org/10.21668/health.risk/2022.3.16.eng
Sudayasa, I. P., Husdaningsih, F., & Alifariki, L. O. (2023). Polymorphism of Gene ACE I/D and Family History of Hypertension as the predisposition of Hypertension. Malaysian Journal of Medicine and Health Sciences, 18(2), 236–241. https://doi.org/10.47836/mjmhs.19.2.34
Tchelougou, D., Kologo, J. K., Karou, S. D., Yaméogo, V. N., Bisseye, C., Djigma, F. W., … Simpore, J. (2015). Renin-angiotensin system genes polymorphisms and essential hypertension in Burkina Faso, West Africa. International Journal of Hypertension, 2015. https://doi.org/10.1155/2015/979631
Tortora, G. J., & Derrickson, B. (2014). Principles of Anatomy and Physiology. In Physiotherapy (14th ed., Vol. 86). United States of America: John Wiley & Sons, Inc. https://doi.org/10.1016/s0031-9406(05)60992-3
Utami, S. L., Simamora, D., Idawati, I., & Widjaja, J. H. (2024). ACE I/D and A2350G Polymorphisms are Correlated with Body Mass Index, but Not with Body Weight and Essential Hypertension: Study in Javanese Postmenopausal Women. Molecular and Cellular Biomedical Sciences, 8(2), 96. https://doi.org/10.21705/mcbs.v8i2.426
Wang, L., Song, T. T., & Dong, C. W. (2023). Association between Interactions among ACE Gene Polymorphisms and Essential Hypertension in Patients in the Hefei Region, Anhui, China. Journal of the Renin-Angiotensin-Aldosterone System : JRAAS, 2023, 1159973. https://doi.org/10.1155/2023/1159973
Wang, X., Wang, S., Lin, R., Jiang, X., Cheng, Z., Turdi, J., … Wen, H. (2004). GNB3 gene C825T and ACE gene I/D polymorphisms in essential hypertension in a Kazakh genetic isolate. Journal of Human Hypertension, 18(9), 663–668. https://doi.org/10.1038/sj.jhh.1001700
World Health Organization. (2023). Hypertension. Retrieved January 10, 2024, from World Health Organization website: https://www.who.int/news-room/fact-sheets/detail/hypertension
World Health Organization. (2024). Global Health Estimates: Life expectancy and leading causes of death and disability. Retrieved January 10, 2024, from World Health Organization website: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates
Xu, J., Chen, J., Li, Y., Zhang, D., & Li, X. (2020). Association of angiotensin-converting enzyme gene insertion/deletion polymorphism and obstructive sleep apnoea in a Chinese population: A meta-analysis. JRAAS - Journal of the Renin-Angiotensin-Aldosterone System, 21(2). https://doi.org/10.1177/1470320320934716
Zambrano, A. K., Cadena-Ullauri, S., Guevara-Ramírez, P., Ruiz-Pozo, V. A., Tamayo-Trujillo, R., Paz-Cruz, E., … Doménech, N. (2023). Genetic diet interactions of ACE: the increased hypertension predisposition in the Latin American population. Frontiers in Nutrition, 10(October). https://doi.org/10.3389/fnut.2023.1241017
Zhang, L., Miyaki, K., Araki, J., Song, Y., Kimura, T., Omae, K., & Muramatsu, M. (2006). Interaction of angiotensin I-Converting enzyme insertion-deletion polymorphism and daily salt intake influences hypertension in Japanese men. Hypertension Research, 29(10), 751–758. https://doi.org/10.1291/hypres.29.751
Zhang, X., Wang, Y., Zheng, Y., Yuan, J., Tong, J., Xu, J., … Li, X. (2022). Effect of ACE, ACE2 and CYP11B2 gene polymorphisms and noise on essential hypertension among steelworkers in China: a case–control study. BMC Medical Genomics, 15(1), 1–10. https://doi.org/10.1186/s12920-022-01177-0
Zhang, Y., Shi, F., Yu, Z., Yang, A., Zeng, M., Wang, J., … Ma, X. (2019). A cross-sectional study on factors associated with hypertension and genetic polymorphisms of renin-angiotensin- aldosterone system in Chinese hui pilgrims to hajj. BMC Public Health, 19(1223), 1–11. https://doi.org/10.1186/s12889-019-7357-1
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