Therapeutic implications of ACE-gene polymorphism

The serum concentration of the angiotensin converting enzyme (ACE) depends on the individual genotype. Thus, ACE levels might be higher (DD-genotype), intermediate (ID) or low (II). Pre-therapeutic determination of the genotype might therefore optimize therapy with ACE-inhibitors or angiotensin II blockers. However, although numerous interventional studies have been performed they are hampered by a low number of included patients and have often yielded differing results. Thus, in order to overcome current controversies larger multicenter studies are warranted before recommending a general testing for genotype prior to initiation of therapy which interferes with the rennin-angiotensin-aldosterone system.