Daily sodium intake influences the relationship between angiotensin-converting enzyme gene insertion/deletion polymorphism and hypertension in older adults
Daily sodium intake influences the relationship between angiotensin-converting enzyme gene insertion/deletion polymorphism and hypertension in older adults
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DOI：
10.1111/jch.13224
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发表时间：
2018-03-01
影响因子：
2.8
通讯作者：
Pereira, Rafael
中科院分区：
文献类型：
--
作者：
Freire, Ivna V.;Casotti, Cezar A.;Pereira, Rafael
血管紧张素转换酶(I/D)基因插入/缺失(I/D)基因多态性已被广泛报道与高血压相关，但大多数研究没有考虑环境/行为因素。本研究旨在探讨血管紧张素转换酶基因插入/缺失基因多态性、环境/行为因素与社区老年人高血压的关系。来自巴西巴伊亚州艾卡拉的所有居住在社区的老年人都被邀请参加这项研究。排除后，234名老年参与者被提交给数据收集，其中包括社会人口学、生活方式和健康状况问卷、临床评估和抽血。通过聚合酶链式反应检测血液样本中的基因多态性，并将患者分为II或D等位基因携带者(ID和DD两种基因型)。高血压的定义是通过对病情的自我报告，并经降压药物治疗证实。使用卡方检验来确定每个因变量(即，基因、高血压诊断和高血压用药患者的血压状态)组之间的比例差异。高血压患病率为59.3%，与糖尿病、肥胖有关，与血管紧张素转换酶基因插入/缺失多态性无关。然而，II基因携带者，一种盐敏感基因，表现出明显更高的估计钠摄入量。此外，在服用药物的老年高血压患者中，II基因携带者的血压控制较差，尽管D等位基因携带者接受了类似的降压药物治疗，但估计的钠摄入量更高。我们的结果为遗传和环境/行为因素的相互作用在老年患者高血压的发生中以及在用药治疗的老年高血压患者的血压控制中提供了新的证据。
The angiotensin-converting enzyme insertion/deletion (I/D) gene polymorphism has been widely reported as being associated with hypertension; however, most studies do not consider environmental/behavioral factors. This study aimed to investigate the relationship among angiotensin-converting enzyme insertion/deletion gene polymorphism, environmental/behavioral factors, and hypertension in community-dwelling elderly individuals. All community-dwelling older adults from Aiquara, Bahia, Brazil, were invited to take part in this study. After exclusions, 234 elderly participants were submitted to a data collection, which included sociodemographics, lifestyle and health status questionnaires, clinical assessment, and blood withdrawal. From the blood samples, the gene polymorphism was identified through polymerase chain reaction and patients grouped as II or D allele carriers (ID and DD genotypes). Hypertension was defined by self-report of the condition and confirmed by antihypertensive drug treatment. Chi-square test was used to identify differences in the proportions distributed between groups of each dependent variable (ie, genotype, diagnosis of hypertension, and blood pressure state from medicated patients with hypertension). The prevalence of hypertension was 59.3% and was associated with diabetes mellitus and obesity, but not with angiotensin-converting enzyme insertion/deletion gene polymorphism. However, carriers of the II genotype, a salt-sensitivity genotype, exhibited a significantly greater estimated sodium intake. In addition, among medicated elderly patients with hypertension, II genotype carriers exhibited poor blood pressure control, despite similar antihypertensive drug treatment in D allele carriers, while exhibiting a greater estimated sodium intake. Our results provide new evidence regarding the interaction of genetic and environmental/behavioral factors in the genesis of hypertension among elderly patients, as well as in blood pressure control in medicated elderly patients with hypertension.