Polymorphism of the Apolipoprotein E and Angiotensin-Converting Enzyme Genes in Japanese Subjects With Silent Myocardial Ischemia

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 1996-06, Vol.27 (6), p.1205-1209
• Main Authors: Nakata, Yukiko, Katsuya, Tomohiro, Rakugi, Hiromi, Takami, Seiju, Ohishi, Mitsuru, Kamino, Kouzin, Higaki, Jitsuo, Tabuchi, Yoshikatsu, Kumahara, Yuichi, Miki, Tetsuro, Ogihara, Toshio
• Format: Article
• Language: English
• Subjects: Adult; Aged; Alleles; Apolipoproteins E - genetics; Biological and medical sciences; Cardiology. Vascular system; Cholesterol - blood; Coronary heart disease; Exercise Test; Female; Genotype; Heart; Humans; Japan; Male; Medical sciences; Middle Aged; Myocardial Ischemia - ethnology; Myocardial Ischemia - genetics; Peptidyl-Dipeptidase A - genetics; Polymerase Chain Reaction; Polymorphism, Genetic; Risk Factors
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/01.HYP.27.6.1205

The apolipoprotein epsilon 4 allele and homozygous deletion allele (DD) of the angiotensin-converting enzyme gene are reported to be associated with an increase in the incidence of ischemic heart disease. In this study, we examined whether the apolipoprotein epsilon 4 genotype and angiotensin-converting enzyme/DD allele are associated with silent myocardial ischemia. We screened 3920 subjects undergoing general checkups who had no symptoms of ischemic heart disease. Seventy subjects (2%) showed ischemic ST-segment depression during the double two-step exercise test. One hundred and twenty control subjects without ischemic ST-segment depression were recruited from the same population and matched for sex, age, and blood pressure. We performed genotyping of the apolipoprotein E gene (epsilon 2, epsilon 3, and epsilon 4) and angiotensin-converting enzyme gene (I and D) using polymerase chain reaction-restriction fragment length polymorphism and polymerase chain reaction, respectively. Allele frequency of epsilon 4 of the apolipoprotein E gene was higher in the ischemic group (11%) than the nonischemic group (5%) (chi = 5.35, P < .05), but there was no significant association between the allele or the genotype frequency of the angiotensin-converting enzyme gene and the incidence of ischemic ST-segment depression. Furthermore, stepwise multiple regression analysis also revealed that total cholesterol level and epsilon 4 genotype were predictors of ischemic change in the exercise tolerance test (chi = 12.8, P < .005, R = .051). These results suggest that the apolipoprotein epsilon 4 allele is an independent genetic risk factor for silent myocardial ischemia in Japanese subjects. (Hypertension. 1996;27:1205-1209.)