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The association between circulating angiotensin-converting enzyme and cardiovascular risk in the elderly: A cross-sectional study.
Linköping University, Department of Medical and Health Sciences, Pharmacology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.
Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Thoracic and Vascular Surgery in Östergötland.
Linköping University, Department of Medical and Health Sciences, Physiology. Linköping University, Faculty of Health Sciences.
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2011 (English)In: jraas. Journal of the renin-angiotensin-aldosterone system, ISSN 1470-3203, E-ISSN 1752-8976, Vol. 12, no 3, 281-289 p.Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: A polymorphism in the angiotensin-converting enzyme gene (ACE I/D polymorphism) has been associated with increased risk for cardiovascular disease (CVD). This polymorphism affects the level of circulating ACE, but there is great individual variation, even between those with the same genotype. Few previous studies have investigated the link between circulating ACE and cardiovascular risk. The aim of this study was to investigate this association, and to examine the relationship between ACE level, ACE genotype and CVD.

MATERIALS AND METHODS: The study population consisted of 322 men and 350 women aged 69-87. Plasma ACE level was determined using enzyme-linked immunosorbent assay (ELISA), and ACE genotype was analysed using PCR followed by gel electrophoresis.

RESULTS: In men, ACE levels increased with increasing number of cardiovascular risk factors (p = 0.003). There was a significant association in men between increased ACE level and both diabetes (p = 0.007) and smoking (p = 0.037).

CONCLUSIONS: This study shows that cardiovascular risk factors (such as smoking and diabetes) are associated with higher levels of circulating ACE in men. High ACE levels may represent one of the cellular mechanisms involved in producing the vascular damage associated with cardiovascular risk factors.

Place, publisher, year, edition, pages
SAGE , 2011. Vol. 12, no 3, 281-289 p.
Keyword [en]
Cardiovascular risk factors, dibetes, endothelium, genetics, smoking
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-67208DOI: 10.1177/1470320310391326ISI: 000294450600019PubMedID: 21273224OAI: oai:DiVA.org:liu-67208DiVA: diva2:408311
Note
Funding Agencies|Cardiovascular Inflammatory Research Center, Linkoping, Sweden||Swedish Research Council|
1216
|Elanora Demeroutis Foundation, Linkoping, Sweden|
LIO-28471
|Goljes Memorial Foundation, Sweden|
LA2009-0119
|Medical Research Council of South East Sweden|
FORSS-34931
|Available from: 2011-04-04 Created: 2011-04-04 Last updated: 2013-09-26Bibliographically approved
In thesis
1. Angiotensin-converting enzyme in cardiovascular function and dysfunction
Open this publication in new window or tab >>Angiotensin-converting enzyme in cardiovascular function and dysfunction
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Angiotensin-converting enzyme (ACE) is a key enzyme in the renin-angiotensin system, converting angiotensin I to the vasoactive peptide angiotensin II, and degrading bradykinin. Angiotensin II is a multifunctional peptide, acting on a number of different tissues. A common genetic variation in the gene encoding ACE; ACE I/D polymorphism influences the level of ACE in the circulation, and has been linked to increased risk for cardiovascular disease. This thesis aimed to explore the connection between ACE and cardiovascular function and dysfunction.

The impact of nicotine and nicotine metabolites on ACE in cultured human endothelial cells was studied. Nicotine as well as nicotine metabolites induced increased ACE activity in cultured human endothelial cells. In elderly men a higher ACE level was seen in smokers compared to non-smokers. Furthermore, diabetes was associated with higher circulating ACE. Increased ACE level may represent a cellular mechanism which contributes to vascular damage.

Elderly men carrying the ACE D allele had higher abdominal aortic stiffness compared to men carrying the I/I genotype. Our data suggest that the mechanism by which the ACE D allele modulates aortic wall mechanics is independent of circulating ACE levels. Previous studies have indicated a link between the D allele and abdominal aortic aneurysm. Increased aortic stiffness suggests impaired vessel wall integrity, which combined with local hemodynamic and/or inflammatory factors may have a role in aneurysm formation.

Subjects with left ventricular dysfunction had higher levels of circulating ACE compared to those with normal left ventricular function, while there was no association between ACE and central hemodynamics. ACE might play a role in the pathogenesis of left ventricular dysfunction and our findings suggest a direct effect on the heart rather than affecting central blood pressure.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 73 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1224
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-67215 (URN)978-91-7393-243-1 (ISBN)
Public defence
2011-04-15, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2011-04-04 Created: 2011-04-04 Last updated: 2012-01-09Bibliographically approved

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Ljungberg, LizaAlehagen, UrbanLänne, TosteBjörck, HannaDe Basso, RachelDahlström, UlfPersson, Karin
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PharmacologyFaculty of Health SciencesCardiologyDepartment of Cardiology UHLPhysiologyDepartment of Thoracic and Vascular Surgery in Östergötland
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