Schut Anna F C, Sayed-Tabatabaei Fakhredin A, Witteman Jacqueline C M, Avella Aida M Bertoli, Vergeer Jeannette M, Pols Huibert A P, Hofman Albert, Deinum Jaap, van Duijn Cornelia M
Departments of Epidemiology and Biostatistics, Erasmus Medical Center Rotterdam, The Netherlands.
J Hypertens. 2004 Feb;22(2):313-9. doi: 10.1097/00004872-200402000-00015.
Studies on the role of the angiotensin-converting enzyme (ACE) gene in the development of hypertension have yielded conflicting results. Recent studies suggested that this gene might have smoking-dependent effects on the development of cardiovascular disease.
To study the relationship between the ACE insertion/deletion (I/D) polymorphism, blood pressure and risk of hypertension in current, former and non-smokers in a population-based cohort.
We included 2412 non-smokers, 2794 former smokers and 1508 current smokers, all participants in the Rotterdam Study. In each group, we assessed the relationship between the ACE I/D polymorphism, systolic (SBP) and diastolic (DBP) blood pressures and risk of hypertension. Mean blood pressures and prevalence of hypertension were compared between carriers and non-carriers of the D allele. All analyses were adjusted for age, sex, body mass index, diabetes mellitus, high-density lipoprotein cholesterol, total cholesterol and use of antihypertensive medication.
In non-smokers and former smokers, blood pressure and the risk of hypertension did not differ significantly between genotypes. In smokers, we found a significant increase in SBP in DD carriers (139.6 +/- 22.8 mmHg) compared with II carriers (136.0 +/- 22.7 mmHg) (P = 0.04). No effect of ACE genotype was observed for DBP. The risk of hypertension was significantly increased in smokers who carried one [odds ratio (OR) 1.4, 95% confidence interval (CI) 1.0 to 1.9; P = 0.05] or two (OR 1.5, 95% CI 1.1 to 2.2; P = 0.02) copies of the D allele.
The D allele of the ACE polymorphism is associated with a significantly increased SBP and risk of hypertension in smokers. Our study underlines the importance of gene-environment interactions in the study of candidate genes for hypertension.
关于血管紧张素转换酶（ACE）基因在高血压发生中的作用的研究结果相互矛盾。近期研究表明，该基因可能对心血管疾病的发生具有吸烟依赖性影响。
在一个基于人群的队列中，研究目前吸烟者、既往吸烟者和从不吸烟者中ACE插入/缺失（I/D）多态性、血压与高血压风险之间的关系。
我们纳入了鹿特丹研究的2412名从不吸烟者、2794名既往吸烟者和1508名目前吸烟者。在每组中，我们评估了ACE I/D多态性、收缩压（SBP）和舒张压（DBP）与高血压风险之间的关系。比较了D等位基因携带者和非携带者的平均血压及高血压患病率。所有分析均根据年龄、性别、体重指数、糖尿病、高密度脂蛋白胆固醇、总胆固醇和抗高血压药物的使用情况进行了校正。
在从不吸烟者和既往吸烟者中，不同基因型之间的血压和高血压风险无显著差异。在吸烟者中，我们发现DD携带者的SBP（139.6±22.8 mmHg）显著高于II携带者（136.0±22.7 mmHg）（P = 0.04）。未观察到ACE基因型对DBP有影响。携带一个（比值比[OR] 1.4，95%置信区间[CI] 1.0至1.9；P = 0.05）或两个（OR 1.5，95% CI 1.1至2.2；P = 0.02）D等位基因拷贝的吸烟者患高血压的风险显著增加。
ACE多态性的D等位基因与吸烟者SBP显著升高及高血压风险增加相关。我们的研究强调了基因-环境相互作用在高血压候选基因研究中的重要性。
