Why the study?
Are genetic polymorphisms in the renin-angiotensin system associated with cerebral small vessel disease?
Are genetic polymorphisms in the renin-angiotensin system associated with cerebral small vessel disease?
Genetic variants in the renin-angiotensin system are not strong overall risk factors for cerebral small vessel disease, though the AGT -20C allele may increase risk for ischaemic leukoaraiosis in hypertensive patients.
RAS polymorphisms should not guide SVD risk assessment; leaves open possible AGT -20C association with ischaemic leukoaraiosis in hypertensives.
BACKGROUND: Genetic variation in the renin-angiotensin system (RAS) has been implicated in stroke, particularly the small vessel disease (SVD) subtype. Furthermore, there may be two distinct subtypes of cerebral SVD, isolated lacunar infarction (ILI) and ischaemic leukoaraiosis (ILA). METHODS: 300 patients with well-phenotyped SVD and 600 controls were genotyped for five polymorphisms in the angiotensinogen (AGT) gene and eight polymorphisms within the angiotensin-converting enzyme (ACE) gene. RESULTS: AGT and ACE polymorphisms and haplotypes were no more common in SVD cases as a whole or the two subtypes. Amongst hypertensives only, an AGT promoter polymorphism (-20A-->C), was associated with the ILA subtype (multivariate odds ratio 1.716, 95% confidence interval 1.073-2.746, p = 0.024). CONCLUSIONS: RAS genetic variants are not strong risk factors for cerebral SVD. The AGT -20C allele may be a risk factor for the leukoaraiosis subtype amongst hypertensives.
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Gormley et al. (2006) studied this question.
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