The association of angiotensin converting enzyme (ACE) polymorphisms with sleep apnea and hypertension.
OBJECTIVE
To identify the role of polymorphisms in the angiotensin-converting enzyme (ACE) gene in modulating susceptibility to hypertension in sleep apnea.


METHODS
Observational cross-sectional study.


METHODS
Nine hundred seventy-two participants of the Cleveland Family Study who underwent home sleep studies, blood pressure assessments, and genotyping.


RESULTS
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.


CONCLUSIONS
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.
Patel
Sanjay R
SR
Division of Pulmonary, Critical Care and Sleep Medicine, University Hospital and Case Western Reserve University, Cleveland, OH, USA. srp20@case.edu
Larkin
Emma K
EK
Mignot
Emmanuel
E
Lin
Ling
L
Redline
Susan
S
D000328:Adult; D000368:Aged; D000483:Alleles; D002872:Chromosome Deletion; D015897:Comorbidity; D045422:Continuous Positive Airway Pressure; D003430:Cross-Sectional Studies; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005838:Genotype; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000235:genetics* / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016254:Mutagenesis, Insertional / Q000235:genetics; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D010641:Phenotype; D011110:Polymorphism, Genetic / Q000235:genetics*; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000235:genetics* / Q000628:therapy
D007703:Peptidyl-Dipeptidase A