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(Hypertension. 1996;27:1205-1209.)
© 1996 American Heart Association, Inc.

Articles

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

Yukiko Nakata; Tomohiro Katsuya; Hiromi Rakugi; Seiju Takami; Mitsuru Ohishi; Kouzin Kamino; Jitsuo Higaki; Yoshikatsu Tabuchi; Yuichi Kumahara; Tetsuro Miki; Toshio Ogihara

From the Department of Geriatric Medicine, Osaka (Japan) University Medical School (Y.N., T.K., H.R., S.T., M.O., K.K., J.H., T.M., T.O.), and the Japan Research Foundation for Chronic Diseases and Rehabilitation Affiliated Hospital, Sakuragaoka Hospitel (Y.T., Y.K.), Hyogo, Japan.

Abstract The apolipoprotein 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 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 (2, 3, and 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 4 of the apolipoprotein E gene was higher in the ischemic group (11%) than the nonischemic group (5%) (²=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 4 genotype were predictors of ischemic change in the exercise tolerance test (²=12.8, P<.005, R²=.051). These results suggest that the apolipoprotein 4 allele is an independent genetic risk factor for silent myocardial ischemia in Japanese subjects.

Key Words: polymorphism • genetics • apolipoprotein E • angiotensin-converting enzyme • myocardial ischemia

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