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The aim of the study was to evaluated the role of ID ACE gene polymorphism in the development of acute myocardial ishemia in patients with arterial hypertension (HT). Patients with DD genotype were demonstrated a higher risk of myocardial infarction then patients with ID and II genotype. Conversely, the course of HT in II genotypic group is more favorable, but the efficacy of their treatment by traditional agents is minimal.