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Published in: BMC Medical Genetics 1/2017

Open Access 01-12-2017 | Research article

Renin-angiotensin system gene polymorphisms and high blood pressure in Lithuanian children and adolescents

Authors: Sandrita Simonyte, Renata Kuciene, Jurate Medzioniene, Virginija Dulskiene, Vaiva Lesauskaite

Published in: BMC Medical Genetics | Issue 1/2017

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Abstract

Background

Epidemiological studies have demonstrated the influence of environmental factors on HBP in the population of Lithuanian children, although the role of genetic factors in hypertension has not yet been studied. The aim of this study was to assess the distribution of AGTR1, AGT, and ACE genotypes in the Lithuanian child population and to determine whether these genotypes have an impact on HBP in childhood.

Methods

This cross-sectional study enrolled 709 participants aged 12–15 years. The subjects were genotyped for AGT (M235 T, rs699), AGTR1 (A1166C, rs5186), and ACE (rs4340) gene polymorphisms using real-time and conventional polymerase chain reactions. Blood pressure and anthropometric parameters were measured.

Results

The prevalence of HBP was 38.6% and was more frequently detected in boys than in girls (47.9% vs. 29.5%; p < 0.001). No significant differences in the frequencies of the AGT or AGTR1 genotypes or alleles between boys and girls were observed, except for ACE genotypes. The mean SBP value was higher in HBP subjects with ACE ID genotype compared to those with ACE II homozygotes (p = 0.04). No significant differences in BP between different AGT and AGTR1 genotype groups were found. Boys who carried the ACE ID + DD genotypes had higher odds of having HBP than carriers of the ACE II genotype did (controlling for the body mass index (BMI): ORMH = 1.83; 95% CI, 1.11–3.02, p = 0.024; and controlling for waist circumference (WC): ORMH = 1.76; 95% CI, 1.07–2.92, p = 0.035). These associations were not significant among girls. The same trend was observed in the multivariate analysis – after adjustment for BMI and WC, only boys with ACE ID genotype and ACE ID + DD genotypes had statistically significantly increased odds of HBP (aOR = 2.05; 95% CI, 1.19–3.53 (p = 0.01) and aOR = 1.82; 95% CI, 1.09–3.04 (p = 0.022), respectively).

Conclusions

The evaluated polymorphisms of the AGT and AGTR1 genes did not contribute to the presence of HBP in the present study and may be seen as predisposing factors, while ACE ID genotypes were associated with significantly increased odds for the development of HBP in the Lithuanian child and adolescent population - especially in boys.
Literature
4.
5.
go back to reference Reklaitiene R, Tamosiunas A, Virviciute D, Baceviciene M, Luksiene D. Trends in prevalence, awareness, treatment, and control of hypertension, and the risk of mortality among middle-aged Lithuanian urban population in 1983-2009. BMC Cardiovasc Disord. 2012 Aug 31;12:68. doi:10.1186/1471-2261-12-68.CrossRefPubMedPubMedCentral Reklaitiene R, Tamosiunas A, Virviciute D, Baceviciene M, Luksiene D. Trends in prevalence, awareness, treatment, and control of hypertension, and the risk of mortality among middle-aged Lithuanian urban population in 1983-2009. BMC Cardiovasc Disord. 2012 Aug 31;12:68. doi:10.​1186/​1471-2261-12-68.CrossRefPubMedPubMedCentral
6.
go back to reference Zaborskis A, Petrauskiene A, Gradeckiene S, Vaitkaitiene E, Bartasiūte V. Overweight and increased blood pressure in preschool-aged children. Medicina (Kaunas). 2003;39(12):1200–7. Zaborskis A, Petrauskiene A, Gradeckiene S, Vaitkaitiene E, Bartasiūte V. Overweight and increased blood pressure in preschool-aged children. Medicina (Kaunas). 2003;39(12):1200–7.
7.
go back to reference Grabauskas V, Klumbiene J, Petkeviciene J, Petrauskiene A, Tamosiūnas A, Kriaucioniene V, et al. Risk factors for noncommunicable diseases in Lithuanian rural population: CINDI survey 2007. Medicina (Kaunas). 2008;44(8):633–9. Grabauskas V, Klumbiene J, Petkeviciene J, Petrauskiene A, Tamosiūnas A, Kriaucioniene V, et al. Risk factors for noncommunicable diseases in Lithuanian rural population: CINDI survey 2007. Medicina (Kaunas). 2008;44(8):633–9.
10.
go back to reference Klumbiene J, Sileikiene L, Milasauskiene Z, Zaborskis A, Shatckute A. The relationship of childhood to adult blood pressure: longitudinal study of juvenile hypertension in Lithuania. J Hypertens. 2000;18:531–9.CrossRefPubMed Klumbiene J, Sileikiene L, Milasauskiene Z, Zaborskis A, Shatckute A. The relationship of childhood to adult blood pressure: longitudinal study of juvenile hypertension in Lithuania. J Hypertens. 2000;18:531–9.CrossRefPubMed
11.
go back to reference Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.CrossRefPubMed Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.CrossRefPubMed
12.
go back to reference Brady TM, Fivush B, Flynn JT, Parekh R. Ability of blood pressure to predict left ventricular hypertrophy in children with primary hypertension. J Pediatr. 2008;152(1):73–8. 78.e1CrossRefPubMed Brady TM, Fivush B, Flynn JT, Parekh R. Ability of blood pressure to predict left ventricular hypertrophy in children with primary hypertension. J Pediatr. 2008;152(1):73–8. 78.e1CrossRefPubMed
13.
go back to reference Sorof JM, Alexandrov AV, Garami Z, Turner JL, Grafe RE, Lai D, et al. Carotid ultrasonography for detection of vascular abnormalities in hypertensive children. Pediatr Nephrol. 2003;18(10):1020–4.CrossRefPubMed Sorof JM, Alexandrov AV, Garami Z, Turner JL, Grafe RE, Lai D, et al. Carotid ultrasonography for detection of vascular abnormalities in hypertensive children. Pediatr Nephrol. 2003;18(10):1020–4.CrossRefPubMed
15.
go back to reference Fava C, Philippe B, Almgren P, Groop L, Hulthén UL, Melander O. Heritability of ambulatory and office blood pressure phenotypes in Swedish families. J of Hyperten. 2004;9:1717–21.CrossRef Fava C, Philippe B, Almgren P, Groop L, Hulthén UL, Melander O. Heritability of ambulatory and office blood pressure phenotypes in Swedish families. J of Hyperten. 2004;9:1717–21.CrossRef
16.
go back to reference Kupper N, Willemsen G, Riese H, Posthuma D, Boomsma DI, de Geus EJ. Heritability of daytime ambulatory blood pressure in an extended twin design. Hypertension. 2005;45:80–5.CrossRefPubMed Kupper N, Willemsen G, Riese H, Posthuma D, Boomsma DI, de Geus EJ. Heritability of daytime ambulatory blood pressure in an extended twin design. Hypertension. 2005;45:80–5.CrossRefPubMed
17.
go back to reference Poch E1, González D, Giner V, Bragulat E, Coca A, de La Sierra A. Molecular Basis of Salt Sensitivity in Human Hypertension. Hyperten. 2001;38:1204–9.CrossRef Poch E1, González D, Giner V, Bragulat E, Coca A, de La Sierra A. Molecular Basis of Salt Sensitivity in Human Hypertension. Hyperten. 2001;38:1204–9.CrossRef
19.
go back to reference Yazdanpanah M, Aulchenko YS, Hofman A, Janssen JA, Sayed-Tabatabaei FA, van Schaik RH, et al. Effects of the renin-angiotensin system genes and salt sensitivity genes on blood pressure and atherosclerosis in the total population and patients with type 2 diabetes. Diabetes. 2007;56(7):1905–12.CrossRefPubMed Yazdanpanah M, Aulchenko YS, Hofman A, Janssen JA, Sayed-Tabatabaei FA, van Schaik RH, et al. Effects of the renin-angiotensin system genes and salt sensitivity genes on blood pressure and atherosclerosis in the total population and patients with type 2 diabetes. Diabetes. 2007;56(7):1905–12.CrossRefPubMed
20.
22.
go back to reference Xue H, Lu Z, Tang WL, Pang LW, Wang GM, Wong GW, et al. First-line drugs inhibiting the renin angiotensin system versus other first-line antihypertensive drug classes for hypertension. Cochrane Database Syst Rev. 2015;1:CD008170. doi:10.1002/14651858.CD008170.pub2.PubMed Xue H, Lu Z, Tang WL, Pang LW, Wang GM, Wong GW, et al. First-line drugs inhibiting the renin angiotensin system versus other first-line antihypertensive drug classes for hypertension. Cochrane Database Syst Rev. 2015;1:CD008170. doi:10.​1002/​14651858.​CD008170.​pub2.PubMed
23.
go back to reference Jeunemaitre X, Soubrier F, Kotelevtsev YV, Lifton RP, Williams CS, Charru A, et al. Molecular basis of human hypertension: role of angiotensinogen. Cell. 1992;71(1):169–80.CrossRefPubMed Jeunemaitre X, Soubrier F, Kotelevtsev YV, Lifton RP, Williams CS, Charru A, et al. Molecular basis of human hypertension: role of angiotensinogen. Cell. 1992;71(1):169–80.CrossRefPubMed
24.
go back to reference Lele RD. Hypertension: molecular approach. J Assoc Physicians India. 2004;52:53–62.PubMed Lele RD. Hypertension: molecular approach. J Assoc Physicians India. 2004;52:53–62.PubMed
25.
go back to reference Mondry A, Loh M, Liu P, Zhu AL, Nagel M. Polymorphisms of the insertion / deletion ACE and M235T AGT genes and hypertension: surprising new findings and meta-analysis of data. BMC Nephrol. 2005;6:1.CrossRefPubMedPubMedCentral Mondry A, Loh M, Liu P, Zhu AL, Nagel M. Polymorphisms of the insertion / deletion ACE and M235T AGT genes and hypertension: surprising new findings and meta-analysis of data. BMC Nephrol. 2005;6:1.CrossRefPubMedPubMedCentral
27.
go back to reference Chaves FJ, Pascual JM, Rovira E, Armengod ME, Redon J. Angiotensin II AT1 receptor gene polymorphism and microalbuminuria in essential hypertension. Am J Hypertens. 2001;14(4 Pt 1):364–70.CrossRefPubMed Chaves FJ, Pascual JM, Rovira E, Armengod ME, Redon J. Angiotensin II AT1 receptor gene polymorphism and microalbuminuria in essential hypertension. Am J Hypertens. 2001;14(4 Pt 1):364–70.CrossRefPubMed
28.
go back to reference Bonnardeaux A, Davies E, Jeunemaitre X, Féry I, Charru A, Clauser E, Tiret L, Cambien F, Corvol P, Soubrier F. Angiotensin II type 1 receptor gene polymorphisms in human essential hypertension. Hypertension. 1994;24(1):63–9.CrossRefPubMed Bonnardeaux A, Davies E, Jeunemaitre X, Féry I, Charru A, Clauser E, Tiret L, Cambien F, Corvol P, Soubrier F. Angiotensin II type 1 receptor gene polymorphisms in human essential hypertension. Hypertension. 1994;24(1):63–9.CrossRefPubMed
29.
go back to reference Wang WY, Zee RY, Morris BJ. Association of angiotensin II type 1 receptor gene polymorphism with essential hypertension. Clin Genet. 1997;51(1):31–4.CrossRefPubMed Wang WY, Zee RY, Morris BJ. Association of angiotensin II type 1 receptor gene polymorphism with essential hypertension. Clin Genet. 1997;51(1):31–4.CrossRefPubMed
30.
go back to reference National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl 4th Report):555–576. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl 4th Report):555–576.
31.
go back to reference Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320(7244):1240–3.CrossRefPubMedPubMedCentral Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320(7244):1240–3.CrossRefPubMedPubMedCentral
32.
go back to reference Fernández JR, Redden DT, Pietrobelli A, Allison DB. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr. 2004;145(4):439–44.CrossRefPubMed Fernández JR, Redden DT, Pietrobelli A, Allison DB. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr. 2004;145(4):439–44.CrossRefPubMed
33.
go back to reference Mayer NJ, Forsynth A, Kantachuvesiri S, Mullins JJ, Fleming S. Association of the D allele of the angiotensin I converting enzyme polymorphism with malignant vascular injury. J Clin Pathol Mol Pathol. 2002;55:29–33.CrossRef Mayer NJ, Forsynth A, Kantachuvesiri S, Mullins JJ, Fleming S. Association of the D allele of the angiotensin I converting enzyme polymorphism with malignant vascular injury. J Clin Pathol Mol Pathol. 2002;55:29–33.CrossRef
34.
go back to reference Ramos E, Barros H. Prevalence of hypertension in 13-year-old adolescents in Porto. Portugal Rev Port Cardiol. 2005;24(9):1075–87.PubMed Ramos E, Barros H. Prevalence of hypertension in 13-year-old adolescents in Porto. Portugal Rev Port Cardiol. 2005;24(9):1075–87.PubMed
35.
go back to reference McNiece KL, Poffenbarger TS, Turner JL, Franco KD, Sorof JM, Portman RJ. Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr. 2007;150(6):640–4.CrossRefPubMed McNiece KL, Poffenbarger TS, Turner JL, Franco KD, Sorof JM, Portman RJ. Prevalence of hypertension and pre-hypertension among adolescents. J Pediatr. 2007;150(6):640–4.CrossRefPubMed
38.
go back to reference Smetanina N, Albaviciute E, Babinska V, Karinauskiene L, Albertsson-Wikland K, Petrauskiene A, et al. Prevalence of overweight/obesity in relation to dietary habits and lifestyle among 7-17 years old children and adolescents in Lithuania. BMC Public Health. 2015;15:1001. doi:10.1186/s12889-015-2340-y.CrossRefPubMedPubMedCentral Smetanina N, Albaviciute E, Babinska V, Karinauskiene L, Albertsson-Wikland K, Petrauskiene A, et al. Prevalence of overweight/obesity in relation to dietary habits and lifestyle among 7-17 years old children and adolescents in Lithuania. BMC Public Health. 2015;15:1001. doi:10.​1186/​s12889-015-2340-y.CrossRefPubMedPubMedCentral
39.
go back to reference Kunešová M, Vignerová J, Pařízková J, Procházka B, Braunerová R, Riedlová J, et al. Long-term changes in prevalence of overweight and obesity in Czech 7-year-old children: evaluation of different cut-off criteria of childhood obesity. Obes Rev. 2011;12(7):483–91. doi:10.1111/j.1467-789X.2011.00870.x.CrossRefPubMed Kunešová M, Vignerová J, Pařízková J, Procházka B, Braunerová R, Riedlová J, et al. Long-term changes in prevalence of overweight and obesity in Czech 7-year-old children: evaluation of different cut-off criteria of childhood obesity. Obes Rev. 2011;12(7):483–91. doi:10.​1111/​j.​1467-789X.​2011.​00870.​x.CrossRefPubMed
41.
42.
go back to reference Wirix AJ, Verheul J, Groothoff JW, Nauta J, Chinapaw MJ, Kist-van Holthe JE. Screening, diagnosis and treatment of hypertension in obese children: an international policy comparison. J Nephrol. 2017;30(1):119–25. doi:10.1007/s40620-016-0277-6.CrossRefPubMed Wirix AJ, Verheul J, Groothoff JW, Nauta J, Chinapaw MJ, Kist-van Holthe JE. Screening, diagnosis and treatment of hypertension in obese children: an international policy comparison. J Nephrol. 2017;30(1):119–25. doi:10.​1007/​s40620-016-0277-6.CrossRefPubMed
43.
go back to reference Lu X, Shi P, Luo CY, Zhou YF, Yu HT, Guo CY, et al. Prevalence of hypertension in overweight and obese children from a large school-based population in shanghai. China BMC Public Health. 2013;13:24. doi:10.1186/1471-2458-13-24.CrossRefPubMed Lu X, Shi P, Luo CY, Zhou YF, Yu HT, Guo CY, et al. Prevalence of hypertension in overweight and obese children from a large school-based population in shanghai. China BMC Public Health. 2013;13:24. doi:10.​1186/​1471-2458-13-24.CrossRefPubMed
44.
go back to reference Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics. 2004;113(3 Pt 1):475–82.CrossRefPubMed Sorof JM, Lai D, Turner J, Poffenbarger T, Portman RJ. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics. 2004;113(3 Pt 1):475–82.CrossRefPubMed
45.
go back to reference Field AE, Cook NR, Gillman MW. Weight status in childhood as a predictor of becoming overweight or hypertensive in early adulthood. Obes Res. 2005;13(1):163–9.CrossRefPubMedPubMedCentral Field AE, Cook NR, Gillman MW. Weight status in childhood as a predictor of becoming overweight or hypertensive in early adulthood. Obes Res. 2005;13(1):163–9.CrossRefPubMedPubMedCentral
46.
47.
go back to reference Sethi AA, Nordestgaard BG, Agerholm-Larsen B, Frandsen E, Jensen G. Tybjaerg-Hansen. Angiotensinogen polymorphisms and elevated blood pressure in the general population: the Copenhagen City heart study. Hypertension. 2001 Mar;37(3):875–81.CrossRefPubMed Sethi AA, Nordestgaard BG, Agerholm-Larsen B, Frandsen E, Jensen G. Tybjaerg-Hansen. Angiotensinogen polymorphisms and elevated blood pressure in the general population: the Copenhagen City heart study. Hypertension. 2001 Mar;37(3):875–81.CrossRefPubMed
48.
go back to reference Inoue I, Nakajima T, Williams CS, Quackenbush J, Puryear R, Powers M, et al. A nucleotide substitution in the promoter of human angiotensinogen is associated with essential hypertension and effects basal transcription in vitro. J Clin Invest. 1997;99(7):1786–97.CrossRefPubMedPubMedCentral Inoue I, Nakajima T, Williams CS, Quackenbush J, Puryear R, Powers M, et al. A nucleotide substitution in the promoter of human angiotensinogen is associated with essential hypertension and effects basal transcription in vitro. J Clin Invest. 1997;99(7):1786–97.CrossRefPubMedPubMedCentral
49.
go back to reference Mattace-Raso FUS, Sie MPS, van der Cammen TJM, Safar ME, Hofman A, van Duijn CM, Witteman JCM. Insertion/deletion gene polymorphism of the angiotensin-converting enzyme and blood pressure changes in older adults. The Rotterdam study. J Human Hyperten. 2007;21:736–40.CrossRef Mattace-Raso FUS, Sie MPS, van der Cammen TJM, Safar ME, Hofman A, van Duijn CM, Witteman JCM. Insertion/deletion gene polymorphism of the angiotensin-converting enzyme and blood pressure changes in older adults. The Rotterdam study. J Human Hyperten. 2007;21:736–40.CrossRef
50.
go back to reference Papp F, Friedman AL, Bereczki C, Haszon I, Kiss E, Endreffy E, et al. Renin-angiotensin gene polymorphism in children with uremia and essential hypertension. Pediatr Nephrol. 2003;18(2):150–4.PubMed Papp F, Friedman AL, Bereczki C, Haszon I, Kiss E, Endreffy E, et al. Renin-angiotensin gene polymorphism in children with uremia and essential hypertension. Pediatr Nephrol. 2003;18(2):150–4.PubMed
51.
go back to reference Lemes VA, Neves AL, Guazzelli IC, Frazzatto E, Nicolau C, Corrêa-Giannella ML, et al. Angiotensin converting enzyme insertion/deletion polymorphism is associated with increased adiposity and blood pressure in obese children and adolescents. Gene. 2013;532(2):197–202. doi:10.1016/j.gene.2013.09.065.CrossRefPubMed Lemes VA, Neves AL, Guazzelli IC, Frazzatto E, Nicolau C, Corrêa-Giannella ML, et al. Angiotensin converting enzyme insertion/deletion polymorphism is associated with increased adiposity and blood pressure in obese children and adolescents. Gene. 2013;532(2):197–202. doi:10.​1016/​j.​gene.​2013.​09.​065.CrossRefPubMed
53.
go back to reference Fornage M, Amos CI, Kardia S, Sing CF, Turner ST, Boerwinkle E. Variation in the region of the angiotensin-converting enzyme gene influences interindividual differences in blood pressure levels in young white males. Circulation. 1998;97(18):1773–9.CrossRefPubMed Fornage M, Amos CI, Kardia S, Sing CF, Turner ST, Boerwinkle E. Variation in the region of the angiotensin-converting enzyme gene influences interindividual differences in blood pressure levels in young white males. Circulation. 1998;97(18):1773–9.CrossRefPubMed
54.
go back to reference O'Donnell CJ, Lindpaintner K, Larson MG, Rao VS, Ordovas JM, Schaefer EJ, et al. Evidence for association and genetic linkage of the angiotensin-converting enzyme locus with hypertension and blood pressure in men but not women in the Framingham heart study. Circulation. 1998;97(18):1766–72.CrossRefPubMed O'Donnell CJ, Lindpaintner K, Larson MG, Rao VS, Ordovas JM, Schaefer EJ, et al. Evidence for association and genetic linkage of the angiotensin-converting enzyme locus with hypertension and blood pressure in men but not women in the Framingham heart study. Circulation. 1998;97(18):1766–72.CrossRefPubMed
55.
go back to reference Di Pasquale P, Cannizzaro S, Paterna S. Does angiotensin-converting enzyme gene polymorphism affect blood pressure? Findings after 6 years of follow-up in healthy subjects. Eur J Heart Fail. 2004;6(1):11–6.CrossRefPubMed Di Pasquale P, Cannizzaro S, Paterna S. Does angiotensin-converting enzyme gene polymorphism affect blood pressure? Findings after 6 years of follow-up in healthy subjects. Eur J Heart Fail. 2004;6(1):11–6.CrossRefPubMed
57.
go back to reference Grady D, Rubin SM, Petitti DB, Fox CS, Black D, Ettinger B, et al. Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med. 1992;117(12):1016–37.CrossRefPubMed Grady D, Rubin SM, Petitti DB, Fox CS, Black D, Ettinger B, et al. Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med. 1992;117(12):1016–37.CrossRefPubMed
58.
go back to reference Bonnardeaux A, Davies E, Jeunemaitre X, Féry I, Charru A, Clauser E, et al. Angiotensin II type 1 receptor gene polymorphisms in human essential hypertension. Hypertension. 1994;24(1):63–9.CrossRefPubMed Bonnardeaux A, Davies E, Jeunemaitre X, Féry I, Charru A, Clauser E, et al. Angiotensin II type 1 receptor gene polymorphisms in human essential hypertension. Hypertension. 1994;24(1):63–9.CrossRefPubMed
59.
go back to reference Wang JL, Xue L, Hao PP, Xu F, Chen YG, Zhang Y. Angiotensin II type 1 receptor gene A1166C polymorphism and essential hypertension in Chinese: a meta-analysis. J Renin-Angiotensin-Aldosterone Syst. 2010;11(2):127–35. doi:10.1177/1470320310364181.CrossRefPubMed Wang JL, Xue L, Hao PP, Xu F, Chen YG, Zhang Y. Angiotensin II type 1 receptor gene A1166C polymorphism and essential hypertension in Chinese: a meta-analysis. J Renin-Angiotensin-Aldosterone Syst. 2010;11(2):127–35. doi:10.​1177/​1470320310364181​.CrossRefPubMed
60.
go back to reference Mehri S, Mahjoub S, Hammami S, Zaroui A, Frih A, Betbout F, et al. Renin-angiotensin system polymorphisms in relation to hypertension status and obesity in a Tunisian population. Mol Biol Rep. 2012;39(4):4059–65. doi:10.1007/s11033-011-1187-2.CrossRefPubMed Mehri S, Mahjoub S, Hammami S, Zaroui A, Frih A, Betbout F, et al. Renin-angiotensin system polymorphisms in relation to hypertension status and obesity in a Tunisian population. Mol Biol Rep. 2012;39(4):4059–65. doi:10.​1007/​s11033-011-1187-2.CrossRefPubMed
61.
go back to reference Sugimoto K, Katsuya T, Ohkubo T, Hozawa A, Yamamoto K, Matsuo A, et al. Association between angiotensin II type 1 receptor gene polymorphism and essential hypertension: the Ohasama study. Hypertens Res. 2004;27(8):551–6.CrossRefPubMed Sugimoto K, Katsuya T, Ohkubo T, Hozawa A, Yamamoto K, Matsuo A, et al. Association between angiotensin II type 1 receptor gene polymorphism and essential hypertension: the Ohasama study. Hypertens Res. 2004;27(8):551–6.CrossRefPubMed
62.
go back to reference Minority Rights Group International, World directory of minorities and indigenous peoples - Lithuania, 2007, available at: http://www.refworld.org/docid/4954ce4f23.html. [Accessed 10 Aug 2017]. Minority Rights Group International, World directory of minorities and indigenous peoples - Lithuania, 2007, available at: http://​www.​refworld.​org/​docid/​4954ce4f23.​html.​ [Accessed 10 Aug 2017].
64.
go back to reference Grimes DA, Schulz KF. Bias and causal associations in observational research. Lancet. 2002;359(9302):248–52.CrossRefPubMed Grimes DA, Schulz KF. Bias and causal associations in observational research. Lancet. 2002;359(9302):248–52.CrossRefPubMed
Metadata
Title
Renin-angiotensin system gene polymorphisms and high blood pressure in Lithuanian children and adolescents
Authors
Sandrita Simonyte
Renata Kuciene
Jurate Medzioniene
Virginija Dulskiene
Vaiva Lesauskaite
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Medical Genetics / Issue 1/2017
Electronic ISSN: 1471-2350
DOI
https://doi.org/10.1186/s12881-017-0462-z

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