[Angiotensin converting enzyme gene polymorphisms and coronary risk in a Portuguese population].
BACKGROUND
A family history of coronary heart disease (CHD) is a strong risk marker for the disease, independently of classical risk factors. It could be decoded by recognizing the polymorphisms associated with increased risk. Renin-angiotensin system genes are candidate genes in CHD and the deletion allele of the angiotensin converting enzyme (ACE) has been reported as deleterious. However, there is disagreement as to the role of the insertion/deletion polymorphism of the ACE gene in coronary risk.


OBJECTIVE
To evaluate whether ACE gene polymorphisms constitute a CHD risk factor.


METHODS
We conducted a population-based case-control study of 301 subjects with a history of myocardial infarction or angiographic evidence of coronary heart disease and 510 age- and gender-matched controls, without CHD, living in a region with high CHD mortality rates. Blood samples were taken, DNA extracted and genotypes determined by the polymerase chain reaction (PCR). Amplification products were identified by agarose gel electrophoresis.


METHODS
The Data were evaluated by SPSS for Windows, using the Student's t test, the chi-square test, odds ratios and 95% confidence intervals.


RESULTS
The prevalence of the DD, ID and II genotype was 41.2%, 46.3%, 12.5% in the cases and 28.1%, 55.2% and 16.7% in the control group. The frequency of the DD genotype was significantly higher in the cases than in the controls (41.2% vs. 28.1%, odds ratio 1.79, 95% CI 1.31 to 2.4, p < 0.0001). By contrast, the ID and II genotypes' prevalence was higher in the control group (55.2% vs. 46.3%, p = 0.002 and 16.7 vs. 12.5%, p = NS, respectively) compared to the case group.


CONCLUSIONS
This study clearly shows that the ACE DD polymorphism is strongly linked to CHD, and if our data are confirmed in a larger population sample, more aggressive vascular prevention could be justified in patients carrying the DD genotype.
Mendonça
Isabel
I
Departamento de Cardiologia Médico-Cirúrgica do Hospital Central do Funchal, Madeira, Portugal. dep.card@srs.pt
Freitas
Isabel A
IA
Sousa
Célia A
CA
Gomes
Susana
S
Faria
Paula
P
Drumond
António
A
Silva
Graça
G
Araújo
Jorge J
JJ
Freitas
Sónia
S
Ornelas
Ilídio
I
Andrade
Graça
G
Coelho
Ana P
AP
Silva
P Marques
PM
Cardoso
Almada
A
Brehm
António A
AA
dos Reis
R Palma
RP
D016022:Case-Control Studies; D003327:Coronary Disease / Q000235:genetics*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011110:Polymorphism, Genetic; D011174:Portugal; D012307:Risk Factors
D007703:Peptidyl-Dipeptidase A