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Female sex and angiotensin-converting enzyme (ace) insertion/deletion polymorphism amplify the effects of adiposity on blood pressure

Chiriacò, Martina ; Tricò, Domenico ; Leonetti, Simone ; Petrie, John R. ; Balkau, Beverley ; Højlund, Kurt ; Pataky, Zoltan ; Nilsson, Peter M. LU and Natali, Andrea (2022) In Hypertension 79(1). p.36-46
Abstract

The pathophysiological link between adiposity and blood pressure is not completely understood, and evidence suggests an influence of sex and genetic determinants. We aimed to identify the relationship between adiposity and blood pressure, independent of a robust set of lifestyle and metabolic factors, and to examine the modulating role of sex and Angiotensin-Converting Enzyme (ACE) insertion/deletion (I/D) polymorphisms. In the Relationship Between Insulin Sensitivity and Cardiovascular Disease (RISC) study cohort, 1211 normotensive individuals, aged 30 to 60 years and followed-up after 3.3 years, were characterized for lifestyle and metabolic factors, body composition, and ACE genotype. Body mass index (BMI) and waist circumference... (More)

The pathophysiological link between adiposity and blood pressure is not completely understood, and evidence suggests an influence of sex and genetic determinants. We aimed to identify the relationship between adiposity and blood pressure, independent of a robust set of lifestyle and metabolic factors, and to examine the modulating role of sex and Angiotensin-Converting Enzyme (ACE) insertion/deletion (I/D) polymorphisms. In the Relationship Between Insulin Sensitivity and Cardiovascular Disease (RISC) study cohort, 1211 normotensive individuals, aged 30 to 60 years and followed-up after 3.3 years, were characterized for lifestyle and metabolic factors, body composition, and ACE genotype. Body mass index (BMI) and waist circumference (WC) were independently associated with mean arterial pressure, with a stronger relationship in women than men (BMI: R=0.40 versus 0.30; WC: R=0.40 versus 0.30, both P<0.01) and in individuals with the ID and II ACE genotypes in both sexes (P<0.01). The associations of BMI and WC with mean arterial pressure were independent of age, sex, lifestyle, and metabolic variables (standardized regression coefficient=0.17 and 0.18 for BMI and WC, respectively) and showed a significant interaction with the ACE genotype only in women (P=0.03). A 5 cm larger WC at baseline increased the risk of developing hypertension at follow-up only in women (odds ratio, 1.56 [95% CI, 1.15-2.10], P=0.004) and in II genotype carriers (odds ratio, 1.87 [95% CI, 1.09-3.20], P=0.023). The hypertensive effect of adiposity is more pronounced in women and in people carrying the II variant of the ACE genotype, a marker of salt sensitivity.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adiposity, Angiotensin-converting enzyme, Blood pressure, Body mass index, Sex characteristics, Waist circumference
in
Hypertension
volume
79
issue
1
pages
11 pages
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:34689596
  • scopus:85121005600
ISSN
0194-911X
DOI
10.1161/HYPERTENSIONAHA.121.18048
language
English
LU publication?
yes
id
fb479fc8-2e17-4cfc-8de3-a8253bfc13a4
date added to LUP
2022-01-26 11:11:35
date last changed
2025-03-10 01:48:18
@article{fb479fc8-2e17-4cfc-8de3-a8253bfc13a4,
  abstract     = {{<p>The pathophysiological link between adiposity and blood pressure is not completely understood, and evidence suggests an influence of sex and genetic determinants. We aimed to identify the relationship between adiposity and blood pressure, independent of a robust set of lifestyle and metabolic factors, and to examine the modulating role of sex and Angiotensin-Converting Enzyme (ACE) insertion/deletion (I/D) polymorphisms. In the Relationship Between Insulin Sensitivity and Cardiovascular Disease (RISC) study cohort, 1211 normotensive individuals, aged 30 to 60 years and followed-up after 3.3 years, were characterized for lifestyle and metabolic factors, body composition, and ACE genotype. Body mass index (BMI) and waist circumference (WC) were independently associated with mean arterial pressure, with a stronger relationship in women than men (BMI: R=0.40 versus 0.30; WC: R=0.40 versus 0.30, both P&lt;0.01) and in individuals with the ID and II ACE genotypes in both sexes (P&lt;0.01). The associations of BMI and WC with mean arterial pressure were independent of age, sex, lifestyle, and metabolic variables (standardized regression coefficient=0.17 and 0.18 for BMI and WC, respectively) and showed a significant interaction with the ACE genotype only in women (P=0.03). A 5 cm larger WC at baseline increased the risk of developing hypertension at follow-up only in women (odds ratio, 1.56 [95% CI, 1.15-2.10], P=0.004) and in II genotype carriers (odds ratio, 1.87 [95% CI, 1.09-3.20], P=0.023). The hypertensive effect of adiposity is more pronounced in women and in people carrying the II variant of the ACE genotype, a marker of salt sensitivity. </p>}},
  author       = {{Chiriacò, Martina and Tricò, Domenico and Leonetti, Simone and Petrie, John R. and Balkau, Beverley and Højlund, Kurt and Pataky, Zoltan and Nilsson, Peter M. and Natali, Andrea}},
  issn         = {{0194-911X}},
  keywords     = {{Adiposity; Angiotensin-converting enzyme; Blood pressure; Body mass index; Sex characteristics; Waist circumference}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{36--46}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Hypertension}},
  title        = {{Female sex and angiotensin-converting enzyme (ace) insertion/deletion polymorphism amplify the effects of adiposity on blood pressure}},
  url          = {{http://dx.doi.org/10.1161/HYPERTENSIONAHA.121.18048}},
  doi          = {{10.1161/HYPERTENSIONAHA.121.18048}},
  volume       = {{79}},
  year         = {{2022}},
}