Angiotensin-converting enzyme 2 polymorphisms and cardiovascular risk

摘要

We read with interest the meta-analysis performed by Y. Li, analysing the angiotensin-converting enzyme (ACE) gene insertion/deletion polymorphism and its association with essential hypertension in the Chinese population. The association between genes of the 'classic', ACE-mediated renin-angiotensin system (RAS) with hypertension has been extensively studied and has yielded important insights. However, an area of more recent interest concerns the ACE structural homologue, ACE2. The discovery of this enzyme in 2000 has opened up research into an 'alternate arm' of the RAS, which in many cases opposes the deleterious effects of the 'classic' arm. In this regard, ACE2 has emerged as a critical regulator of heart function, at least partly because it hydrolyses angiotensin II to the truncated peptide angi-otensin 1-7, which is reported to have vasodilatory and anti-fibrotic effects.