Association of angiotensin-converting enzyme gene polymorphism with pregnancy-induced hypertension

Background. To investigate the potential association of angiotensin-converting enzyme (ACE) gene polymorphism and serum ACE activity with pregnancy-induced hypertension (PIH). Methods. The ACE genotype was identified and serum ACE activity was measured in 50 primigravidae with PIH and 50 normotensive primigravidae. These subjects were followed up to delivery and perinatal outcome noted. Results. ACE DD genotype was found in 60% of subjects with PIH but only in 30% of normotensive subjects (P = 0.004). The odds ratio for developing hypertension in subjects with DD genotype was 3.5. The incidence of D allele of ACE gene was significantly higher in hypertensive subjects (0.74) than in normotensive subjects (0.56, P = 0.011). The odds ratio for developing hypertension in subjects with D allele was 2.24. However, the ACE genotype was similar in different categories of PIH and did not affect the perinatal outcome. The mean ACE activity in the hypertensive subjects (32.4 IU/l) and the normotensive subjects (23.7 IU/l) was similar (P = 0.092). The ACE activity did not differ significantly according to ACE genotype. Conclusions. We noticed an excess of DD genotype and D allele in ACE gene in PIH. However, this polymorphism does not correlate with the severity of hypertension or perinatal outcome. Serum ACE levels do not correlate with the ACE gene polymorphism or the development of PIH.