Impact of the angiotensin-converting enzyme 2 gene polymorphism on essential hypertension in the southern region of Bangladesh

Background: Hypertension (HTN) is a major global health issue influenced by genetic, environmental and demographic factors. The angiotensin-converting enzyme 2 (ACE2), important for blood pressure regulation, has been linked to HTN in different ethnic populations, but research among the southern Bangladeshi population is unavailable. The aim of the study: This study aimed to evaluate the impact of the ACE2 gene G8790A polymorphism on essential HTN, considering epidemiological factors and gender-specific association. Materials and methods: A case-control study was conducted with 260 hypertensive and 234 healthy individuals from Chittagong Medical College, Bangladesh, to genotype the ACE2 G8790A polymorphism by the PCR-RFLP method. Physical, epidemiological and biochemical parameters were assessed to understand their relationship with genetic variations. Results: The study revealed a significant association between the ACE2 AG heterozygous genotype and HTN in females (OR = 15.44, 95% CI 3.56–67.02, P < 0.001) with no similar risk in males (P = 0.742). No significant correlation was identified between the ACE2 polymorphism and biochemical factors. HTN patients had significantly higher levels of serum creatinine (male: 25.11% vs 1.30%; female: 23.97% vs 0%; P < 0.001) and urine albumin (male: 3.40% vs 0%; female: 5.70% vs 0%; P < 0.001) than controls. The low level of HDL cholesterol was noted in HTN patients (male: 49.00% vs 24.78%, female: 48.40% vs 10.25%; P < 0.001). Conclusion: HTN patients with ACE2 gene mutant variants (AG and AA) showed a higher prevalence of diabetes and CVD. This is the first study to highlight a significant gender-specific association between the ACE2 G8790A heterozygous genotype and HTN in Bangladeshi women, offering a potential gender-based biomarker for managing HTN.