Association Between ACE I/D Gene Polymorphism and Dyslipidemia in Hypertensive Patients with Ischemic Heart Disease Complication Among Ethiopian Population

Abstract

Background

Ischemic heart disease (IHD) is characterized by lesions in major coronary arteries produced by the atherosclerotic phenomenon. IHD is currently thought to be a complicated disorder, and studies have revealed that, in addition to the usual traditional risk factors, genetic factors also play major roles in its occurrence. Due to the intricate interactions between genetic and environmental risk factors, the link between ACE polymorphisms and other risk variables in IHD is not fully characterized. The purpose of this study was to look at how ACE gene I/D polymorphism and dyslipidemia affect the risk of developing IHD complications in hypertensive patients.

Methods

A hospital-based case–control study of 70 hypertensive IHD patients and 70 age- and sex-matched healthy controls was conducted. Clinical parameters were measured to assess the associated risk factors. Deoxyribonucleic acid (DNA) was isolated from blood samples, and the ACE I/D genotypes were identified using polymerase chain reaction (PCR) and analyzed by agarose gel electrophoresis.

Results

Our analysis showed that the ACE-DD genotype (OR = 2.72, 95% CL = 1.11–6.64; P < 0.05) and D allele (OR = 1.93, 95% CL = 1.18–3.13; P < 0.05) are considerably higher in patients than controls. Our study also identified dyslipidemia, which was found to be considerably greater in patients than controls (OR = 4.69, 95% CL = 1.86–11.82; P < 0.001), indicating that it is a major risk factor for the onset and progression of IHD.

Conclusion

The ACE I/D gene of the DD genotype and the D allele have been linked to an increased risk of developing hypertensive IHD complications. Moreover, dyslipidemia is a risk factor for the onset of ischemic heart disease.

Keywords:

• angiotensin-converting enzyme
• blood pressure
• coronary artery disease
• genotype
• hyperlipidemia

Abbreviations

ACE, angiotensin-converting enzyme; BMI, body mass index; IHD, ischemic heart disease; DNA, deoxyribonucleic acid; DBP, diastolic blood pressure; EDTA, ethylenediaminetetraacetic acid; FBG, fasting blood glucose; HDL, high-density lipoprotein; HTN, hypertension; I/D, insertion/deletion; LDL, low-density lipoprotein; PCR, polymerase chain reaction; RAAS, renin–angiotensin–aldosterone system; SBP, systolic blood pressure; TC, total cholesterol; TG, triglyceride; T2DM, type 2 diabetes mellitus.

Data Sharing Statement

The corresponding author can provide the data used and/or analyzed during the current study upon request.

Ethics Approval and Consent to Participate

The study protocol was approved by the University of Gondar Institutional Review Board (IRB) for Ethics in Human Research (Ref. VP/RTT/05/1016/2022). Study participants were recruited only after informed written consent was obtained from each of them. All the data were obtained anonymously and treated confidentially. All the procedures for data collection were conducted according to the principles of the Helsinki Declaration.

Acknowledgments

We would like to give our heartfelt thanks to the Debre Tabor Referral Hospital diagnostic laboratory and the University of Gondar molecular biology laboratory staff for the support we needed to do this study.

Author Contributions

Both authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable or all aspects of the work.

Disclosure

The authors report no conflicts of interest.