This study targeted two candidate genes from the best known regulator of blood pressure; the rennin angiotensin system; the ACE gene I/D polymorphism and the angiotensinogen M235T polymorphism. The study aimed to determine the genotypes trend between two different populations; the primary hypertensive patients, and the normal populations. 126 subjects were involved in this study (86 primary hypertensive patients and 40 normal individuals). All demographic factors were considered and analyzed. Insertion/deletion polymorphisms of the ACE gene were determined by an assay based on the polymerase chain reaction (PCR). Polymorphism analysis using PCR-RFLP procedure was used to identify the missense mutation M235T of the AGT gene. All significant data was collected using standardized case report form. The association of the different genotypes and the subjects’ condition was analyzed using the chi squared and odds ratio analyses. In the pooled analysis of both groups, it was shown that the polymorphisms in these genes were significantly associated with the incidence of primary hypertension, p<0.05. Results also showed that the D allele of the ACE gene may be associated with increased risk of primary hypertension (p<0.05, O.R: 3.0 [C.I: 1.25 – 5.35]). The angiotensinogen M235T polymorphism also showed a significant result; the T allele is associated with increased risk of primary hypertension (p<0.05, O.R: 2.56[C.I: 1.55 – 5.28]). This knowledge of the candidate genes of rennin angiotensin system has rendered it possible to show that gene polymorphism in symphony leads to the individual risk of primary hypertension.
Keywords: ACE, M235T, rennin, hypertension
Study site: University Kebangsaan Malaysia Medical Center and International Medical University Cardiology Clinic
Subclinical changes that occur in the heart at an early age may provide valuable information to outline prevention strategies for cardiovascular diseases. Heart rate variability (HRV) reflects regulation of autonomic balance, heart, and vascular tone, which are the determinants of blood pressure. Therefore, this study aimed to determine the difference in heart rate variability (HRV) of Malay male young adult with their BMI and adiposity level. MATERIALS AND METHODS:A total of 201 Malay male young adult aged between 19 to 24 years old were screened and their BMI and adiposity level were measured. Three non-invasive tests; Valsalva Manoeuvre, orthostatic response and 30/15 ratio of heart rate were performed. Short term HRV time and frequency domains were recorded. RESULTS:Despite few significant differences in HRV parameters of overweight/obese subjects, the result is inconclusive to conclude any reduced variability. However, those with high adiposity regardless of their BMI reported significantly lower mean of R-R SD in time domain and lower mean of LF/HF ratio in frequency domain. The orthostatic reflex results revealed that high adiposity subjects had significantly lower mean of LF and HF. A decrement of -0.28 ms2HF/LF during Valsalva manoeuvre, -0.35 LF ms2in orthostatic reflex and 0.33 ms2in orthostatic reflex per 1% of body fat percentage were observed. CONCLUSION: HRV parameters were inversely proportional to the adiposity level which was suggestive of modulation of sympathetic function can occur at an early age.