Patel Sanjay R, Larkin Emma K, Mignot Emmanuel, Lin Ling, Redline Susan
Division of Pulmonary, Critical Care and Sleep Medicine, University Hospital and Case Western Reserve University, Cleveland, OH, USA.
Sleep. 2007 Apr;30(4):531-3. doi: 10.1093/sleep/30.4.531.
To identify the role of polymorphisms in the angiotensin-converting enzyme (ACE) gene in modulating susceptibility to hypertension in sleep apnea.
Observational cross-sectional study.
Nine hundred seventy-two participants of the Cleveland Family Study who underwent home sleep studies, blood pressure assessments, and genotyping.
After controlling for age, sex, race, and obesity, hypertension risk was reduced in participants who possess the ACE deletion (D) polymorphism with an odds ratio = 0.63 (95% confidence interval: 0.41-0.96) comparing those with 2 versus no D alleles. In analyses stratified by apnea severity, the protective effect of the D allele was most evident in those with severe apnea. Among subjects with severe apnea, the odds ratios for hypertension were 0.47 (0.22-1.00) for 1 D allele and 0.57 (0.26-1.24) for 2 D alleles.
The ACE deletion allele may protect against hypertension in the setting of obstructive sleep apnea. Further research into the potential role of angiotensin in modulating the hypertensive effect of sleep apnea is needed.
确定血管紧张素转换酶（ACE）基因多态性在调节睡眠呼吸暂停患者高血压易感性中的作用。
观察性横断面研究。
972名克利夫兰家庭研究的参与者，他们接受了家庭睡眠研究、血压评估和基因分型。
在控制年龄、性别、种族和肥胖因素后，携带ACE缺失（D）多态性的参与者患高血压的风险降低，与无D等位基因者相比，有2个D等位基因者的优势比为0.63（95%置信区间：0.41 - 0.96）。在按呼吸暂停严重程度分层的分析中，D等位基因的保护作用在重度呼吸暂停患者中最为明显。在重度呼吸暂停患者中，有1个D等位基因者患高血压的优势比为0.47（0.22 - 1.00），有2个D等位基因者为0.57（0.26 - 1.24）。
ACE缺失等位基因可能在阻塞性睡眠呼吸暂停情况下预防高血压。需要进一步研究血管紧张素在调节睡眠呼吸暂停高血压效应中的潜在作用。
