Association of renin–angiotensin–aldosterone system gene polymorphisms with left ventricular hypertrophy in patients with heart failure with preserved ejection fraction: A case–control study

ABSTRACT

Background: Heart failure with preserved ejection fraction (HFpEF) has close ties with hypertension, though risk factors to the development of HFpEF in hypertensive patients are not fully understood. Left ventricular hypertrophy (LVH) signifies the susceptibility toward diastolic heart dysfunction, and genetic determinants of LVH as a result may serve as risk predictors for HFpEF in hypertension. We investigated the role of three renin–angiotensin–aldosterone system (RAAS) gene polymorphisms in the development of LVH in hypertensive patients with a diagnosis of HFpEF. Methods: A total of 176 hypertensive patients with a diagnosis of HFpEF were divided to cases with LVH and controls without. rs4343 and rs4291 of angiotensin-converting enzyme (ACE) and rs5186 of angiotensin receptor type 1 were genotyped using PCR-RFLP method. Results: Genotypes and allele frequencies were significantly different between the case and control groups for rs4343 and rs4291, whereas no difference was observed for rs5186.Conclusion: Increased ACE activity explains the significant association of rs4343 and rs4291 polymorphisms with LVH in the carriers. Furthermore, findings support the pathophysiologic links between RAAS and increased LV mass in hypertension and suggest a genetic susceptibility to HFpEF. Such polymorphisms may serve as risk predictors of HFpEF in hypertensive patients.

KEYWORDS:

• ACE
• AGTR1
• cardiovascular
• genetic variation
• Hypertension

Acknowledgments

The authors thank Fasa NCD Research Center staff for helping them in finding the cases alongside the process of Fasa Registry of Systolic Heart Failure (FaRSH) enrollment.

Declaration of interest

The authors report no conflicts of interest.

Funding

This study was funded by Fasa University of Medical Sciences (grant numbers 93050, 93043 and 93121).

Additional information

Funding

This study was funded by Fasa University of Medical Sciences (grant numbers 93050, 93043 and 93121).