OBJECTIVETo study the relationship between angiotensin-converting enzyme 2 (ACE2) gene G9570A polymorphisms and the clinical outcome of stroke patients with essential hypertension (EH) in South China Han population.

METHODThe ACE2 gene polymorphisms were detected in 141 stroke patients with EH and 156 patients with EH using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The genetic marker was tested for its association with the baseline measurements and clinical outcomes of the patients over a median follow-up period of 22 months. As the ACE2 gene is X-linked, analyses were performed for male and female patients separately.

RESULTSThe A allele frequency in the stroke patients was significantly different from that in the EH patients, and the AA allele frequency in the female patients was significantly different between the two groups (P<0.01). Kaplan-Meier model analysis showed that ACE2 gene polymorphism was not associated with the the patients' prognosis (P>0.05). Multivariate Cox's proportional hazard regression model identified age (RR=1.057, 95%CI: 1.020, 1.095), blood glucose (RR=1.575, 95%CI: 1.178, 2.104), hypertriglyceridemia (RR=1.947, 95%CI: 1.503, 2.780), blood creatinine (RR=1.034, 95%CI: 1.001, 1.068), and blood uric acid (RR=1.056, 95%CI: 1.002, 1.097) as the risk factors associated with the mortality.

CONCLUSIONStroke occurs more likely in hypertensive patients carrying the A/AA allele than those carrying other alleles. The ACE2 gene G9570A polymorphisms may be associated with the occurrence of stroke in EH patients in South China, but may not have a strong correlation to the prognosis.