{"id":5478,"date":"2026-04-20T14:19:20","date_gmt":"2026-04-20T12:19:20","guid":{"rendered":"https:\/\/cvja.co.za\/journal\/?p=5478"},"modified":"2026-04-20T14:19:20","modified_gmt":"2026-04-20T12:19:20","slug":"cvja-2026-006","status":"publish","type":"post","link":"https:\/\/cvja.co.za\/journal\/cvja-2026-006\/","title":{"rendered":"Association of ACE I\/D and ACE (rs4343) polymorphism with MACE development in hypertensive patients"},"content":{"rendered":"    <div id=\"article\">                                                                                                                        \r\n        <div id=\"title-container\">                                                                                                    \r\n        <div id=\"authors-title\">                                                                                                            \r\n        <!--Aurthors under Title-->                                                                                                            \r\n            \r\nAlija Baig, Syed Muhammad Mukarram Shah, Asif Jan, Malik Faisal, Aiman Begum, Aftab Ullah, Haseenullah Shah, Zakiullah\r\n<\/div>        \r\n<\/div>                                                                                                                            \r\n            <div id=\"copyright\">\r\n        <strong>Copyright:<\/strong> Clinics Cardive Publishing (Pty) Ltd. publisher\r\n        of Cardiovascular Journal of Africa.<\/div>\r\n    <div style=\"clear: both;\"><\/div>                                                                                                                                \r\n        <div id=\"article-abstract\">                                                                                                            \r\n            <div id=\"abstract-title\">                                                                                                        \r\n                    Abstract                                                                                                                \r\n                <\/div>                                                                                                                        \r\n                                                                                                                                \r\n            <div id=\"abstract-content\">                                                                                                        \r\n            <!--Content of Abstract Article-->                                                                                                \r\n            <!--<strong>\"Abstract titles\":<\/strong>-->                                                                                        \r\n            <!--<br\/> at the end of each section!!-->                                                                                        \r\n                                                                                                                                                     \r\n\r\n        <strong>Objective:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\nCardiovascular diseases remain a leading cause of morbidity and mortality worldwide. The angiotensin-converting enzyme (ACE) insertion\/deletion (I\/D) and ACE rs4343 polymorphism have been considered important and extensively studied for their association with cardiovascular conditions. This study investigates the association of this variant with the development of major adverse cardiovascular events (MACE) in hypertensive patients of Khyber Pakhtunkhwa, Pakistan.\r\n<br \/>   \r\n\r\n        <strong>Methods:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\nThis prospective cohort study conducted over two years (2022\u20132023), included 429 adult patients (aged 30\u201370 years) with cardiovascular risk factors or established cardiovascular disease. Baseline demographic, clinical, and laboratory data were collected. Blood samples were analysed for ACE I\/D and ACE (rs4343) polymorphisms using polymerase chain reaction (PCR). Participants were followed up for 12 months to monitor MACE occurrence. The study protocol was approved by the institutional ethics committee. Data were analysed using SPSS software for relevant descriptive and inferential statistics.\r\n<br \/>\r\n                \r\n                <strong>Results:<\/strong>                                                                                                    \r\nMean age of the patients was 60.4 years, with 51.3% being male. ACE ID heterozygous variant was most prevalent (67.6%), followed by the II (Insertion) (28%), and the DD (deletion) (4.4%). Significant associations were observed between the ID genotype and specific cardiovascular parameters, particularly ejection fraction (p = 0.019) and pulmonary artery hypertension (p = 0.008). Most participants (69.2%) had hypertension for over 10 years, and 78.1% were aware of their condition. Genotypes and allele frequencies were also found to be considerably non-contrasting between the case and control groups for ACE (rs4343).\r\n<br \/>\r\n                                                                                                                                                                                                                                                                        \r\n                                                                                                                                                \r\n        <strong>Conclusion:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\nThe findings demonstrate significant associations between ACE I\/D polymorphism and cardiovascular events in patients with hypertension. The rs4343 variant carries no significant affinity for hyperactive ACE, which causes MACE in the subjects of this study.\r\n<br \/>    \r\n                                                                                                        \r\n\r\n                                                                                                                                                \r\n            <\/div>                                                                                                                            \r\n        <\/div>                                                                                                                                    \r\n                                                                                                                                        \r\n                                                                                                                                                \r\n        <div id=\"keywords\">                                                                                                                    \r\n                                                                                                                                            \r\n            <strong>Keywords:<\/strong>                                                                                                        \r\n                                                                                                                                            \r\n            <strong>ACE gene polymorphism, cardiovascular disease, major adverse cardiovascular events (MACE), Khyber Pakhtunkhwa population, genotype-guided therapy<\/strong>                                                                                                                                                                                                                    \r\n                                                                                                                                                \r\n        <\/div>                                                                                                                                    \r\n                                                                                                                                                \r\n    <div id=\"publish-info\">                                                                                                                    \r\n                                                                                                                                \r\n    <strong>Submitted:<\/strong> March 26, 2025; <!--Month day, year; -->    \r\n    <strong>Accepted:<\/strong> December 12, 2025; <!--Month day, year; -->                                                                            \r\n    <strong>Published:<\/strong> April 17, 2026<!--Month day, year; -->                                                                                                                            <br \/>                                                            \r\n        <em>Cardiovasc J Afr 2025; <b>37<\/b>: 139-145<!--pg no. till pg no. \"eg. 4-7\"--><\/em>\r\n        <br \/><strong>Volume 37, Issue 2<\/strong> <br \/>                                                                            \r\n        <\/div>                                                                                                                            \r\n                                                                                                                                        \r\n    <div id=\"DOI\">                                                                                                                    \r\n            DOI Citation Reference: dx.doi.org\/10.5830\/CVJA-2026-006<!--DOI number-->                                                                \r\n        <\/div>                                                                                                                            \r\n                \r\n                <div id=\"author-affiliation\">                                                                                                \r\n\r\n\r\n<strong>Department of Pharmacy, University of Swabi, Swabi, Khyber Pakhtunkhwa, Pakistan\r\n<\/strong>    <br \/>                                                                            \r\nAlija Baig<br \/> \r\nSyed Muhammad Mukarram Shah\r\n\r\n<br \/><br \/>     \r\n\r\n<strong>Department of Pharmacy, University of Peshawar, 25000, Khyber Pakhtunkhwa, Pakistan\r\n\r\n<\/strong>    <br \/>                                                                            \r\nAsif Jan<br \/>\r\nAiman Begum<br \/>\r\nAftab Ullah<br \/>\r\nHaseenullah Shah<br \/>\r\nZakiullah\r\n\r\n<br \/><br \/>   \r\n\r\n<strong>District Headquarter Hospital, Charsadda, 24430, Khyber Pakhtunkhwa, Pakistan\r\n<\/strong>    <br \/>                                                                            \r\nAsif Jan\r\n\r\n<br \/><br \/>   \r\n\r\n<strong>Cardiology Ward, Lady Reading Hospital, Peshawar, 25000, Khyber Pakhtunkhwa, Pakistan\r\n<\/strong>    <br \/>                                                                            \r\nMalik Faisal\r\n\r\n<br \/><br \/>   \r\n\r\n<strong>Department of Pharmacy, Abasyn University Peshawar, 25000, Khyber Pakhtunkhwa, Pakistan\r\n<\/strong>    <br \/>                                                                            \r\nAftab Ullah\r\n\r\n<br \/><br \/>   \r\n\r\n                [soshsc hide=\"logged\"]\r\n                <strong>You need to be <a style=\"color: #c80c44;\" href=\"https:\/\/cvja.co.za\/journal\/member-login\/\" target=\"_blank\" rel=\"noopener\">logged in to view and download<\/a> the full text PDF version. <a style=\"color: #c80c44;\" href=\"https:\/\/cvja.co.za\/journal\/register\/\" target=\"_blank\" rel=\"noopener\">Register for a free account?<\/a><\/strong> <br \/><br \/>[\/soshsc]\r\n                \r\n                \r\n                \r\n                <\/div>\r\n    \r\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide. The angiotensin-converting enzyme (ACE) insertion\/deletion (I\/D) and ACE rs4343 polymorphism have been considered important and extensively studied for their association with cardiovascular conditions. This study investigates the association of this variant with the development of major adverse cardiovascular events (MACE) in hypertensive patients of Khyber Pakhtunkhwa, Pakistan.<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[44,110],"tags":[],"class_list":["post-5478","post","type-post","status-publish","format-standard","hentry","category-cardiovascular-topics","category-volume-37-issue-2"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Association of ACE I\/D and ACE (rs4343) polymorphism with MACE development in hypertensive patients - Cardiovascular Journal of Africa<\/title>\n<meta name=\"description\" content=\"Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide. The angiotensin-converting enzyme (ACE) insertion\/deletion (I\/D) and ACE rs4343 polymorphism have been considered important and extensively studied for their association with cardiovascular conditions. This study investigates the association of this variant with the development of major adverse cardiovascular events (MACE) in hypertensive patients of Khyber Pakhtunkhwa, Pakistan.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cvja.co.za\/journal\/cvja-2026-006\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Association of ACE I\/D and ACE (rs4343) polymorphism with MACE development in hypertensive patients - Cardiovascular Journal of Africa\" \/>\n<meta property=\"og:description\" content=\"Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide. The angiotensin-converting enzyme (ACE) insertion\/deletion (I\/D) and ACE rs4343 polymorphism have been considered important and extensively studied for their association with cardiovascular conditions. This study investigates the association of this variant with the development of major adverse cardiovascular events (MACE) in hypertensive patients of Khyber Pakhtunkhwa, Pakistan.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cvja.co.za\/journal\/cvja-2026-006\/\" \/>\n<meta property=\"og:site_name\" content=\"Cardiovascular Journal of Africa\" \/>\n<meta property=\"article:published_time\" content=\"2026-04-20T12:19:20+00:00\" \/>\n<meta name=\"author\" content=\"Jaco Moolman\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Jaco Moolman\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/cvja.co.za\/journal\/cvja-2026-006\/\",\"url\":\"https:\/\/cvja.co.za\/journal\/cvja-2026-006\/\",\"name\":\"Association of ACE I\/D and ACE (rs4343) polymorphism with MACE development in hypertensive patients - Cardiovascular Journal of Africa\",\"isPartOf\":{\"@id\":\"https:\/\/cvja.co.za\/journal\/#website\"},\"datePublished\":\"2026-04-20T12:19:20+00:00\",\"author\":{\"@id\":\"https:\/\/cvja.co.za\/journal\/#\/schema\/person\/6bf8a30a039e93fd8112db707affb920\"},\"description\":\"Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide. 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