Two genotypes increase risk of heart attack

Angiotensin converting enzyme (ACE) and the angiotensin II type 1 receptor (AT₁ R A1166C) gene polymorphism have both been associated with an increased risk of heart attack or stroke. It is not known, however, if an interaction between these two polymorphisms is responsible. In a paper published in April Heart, a team from University of Groningen, Netherlands confirms that the ACE-DD and AT₁ R-CC genotypes interact to increase the risk of ischaemic events (Heart 2001, 85:458-462).

Van Geel et al genotyped 750 male patients who were participating in the lipid-lowering regression trial, REGRESS (regression growth evaluation statin study). Patients who carried both the ACE-DD and AT₁ R-CC genotype had significantly more ischaemic events during the two-year follow-up period than those carrying other genotype combinations (p=0.035, Mantel-Haenszel test for linear association).

Increased angiotensin II activity in these patients stimulates adhesion molecule expression and increases oxidative stress. This enhances inflammation in the ...