Kostiukovskyi S. The clinical sense of angiotensin-converting enzyme gene polymorphism for different type of stroke in patients with arterial hyrertension

This thesis deals with a comprehensive assessment of the impact of ACE gene polymorphism on clinical and morphofunctional parameters in 131 patients with acute cerebral stroke. The prevalence of polymorphic variants of ACE gene was investigated in ischemic and hemorrhagic stroke in patients with arterial hypertension. It was shown that in patients with acute stroke the dominant genotype variant was homozygosity for allele D (DD). The patients with DD genotype had higher level of blood pressure at the onset of stroke and more severe neurological deficiency according to NIHSS scale. It was revealed that the patients with acute stroke carrying D-allele (with genotypes ID and DD) significantly more frequently demonstrated morphological changes in the extracranial arteries: thickening of the intima-media complex and stenosing atherosclerosis of the internal carotid artery. The patients with acute stroke ACE gene D-allele carriers were established to have higher levels of blood serum angiotensin II, which correlated with higher level of blood pressure and worse neurological outcome according to NIHSS and Glasgow scales. Albuminuria was found in 15,9% of patients with acute stroke; correlation between albuminuria and ACE gene polymorphism, that is higher rates of albuminuria were observed in patients with monozygotic variant of genotype DD.