The Association of Angiotensin-converting Enzyme I/D and Angiotensinogen M235T Polymorphism Genes with Essential Hypertension: A Meta-analysis

BACKGROUND: Essential or primary hypertension in developing countries has become a major problem. Recent hypertension-related research has revealed susceptibility genes in genome-wide association studies. Several studies have associated angiotensin-converting enzyme (ACE) I/D and angiotensinogen (AGT) M235T polymorphisms with essential hypertension, but results have been inconsistent. AIM: This meta-analysis aimed to clarify the association of AGT and ACE polymorphisms with the risk of primary hypertension. METHODS: PubMed, Embase database, Medline, Google Scholar, and Scopus.com, as well portal Garuda (www. garuda.ristekdikti.go.id) and Cochrane were used to retrieve all publications from 2006 to 2020 relating risk factors for hypertension with ACE I/D and AGT M235T polymorphisms. The meta-analysis was conducted from January to April 2020. All association studies were identified and data extracted from each study. Revman 5.3 software was used for meta-analysis to estimate odds ratios (OR) after extracting data and evaluating the quality of the enrolled studies. RESULTS: Twenty-seven studies (totaling 5105 patients and 5196 controls) were identified. The overall effect suggested ACE I/D was significantly associated with primary hypertension (OR: 95 confidence interval = 1.51 1.29–1.77, p = 0.004). There was no association between AGT M235T with the risk of essential hypertension. CONCLUSION: This meta-analysis found a significant association between ACE I/D gene polymorphisms with primary hypertension susceptibility. However, the AGT M235T gene had no association with the risk of primary hypertension. The Adrenoreceptor-beta/Renin-angiotensin System A allele should be considered a risk factor for essential hypertension. © 2021 Agus Wibowo, Pramudji Hastuti, Vinayanti Susanti.