title: Effects of interactions between ApoE polymorphisms, alcohol consumption and obesity on age-related trends of blood pressure levels in postmenopausal women: the Bambuì cohort study of aging (1997-2008).
abstract: OBJECTIVE
  To evaluate the effects of interactions between ApoE genotypes, alcohol consumption and obesity on the age-related trends of blood pressure (BP) levels in postmenopausal women.
  
  
  METHODS
  A population-based prospective cohort study of all residents in Bambuì, south-eastern Brazil, aged 60 years or older. Repeated BP measurements were obtained in four waves from 851 women who underwent ApoE genotyping at baseline (88.3% of those enrolled), and multi-level random-effects pattern-mixture models were used to evaluate the age-related BP trajectories, while accounting for non-ignorable dropouts/deaths and handling heterogeneities as random parameter variations. The few measurements (2.1%) made during hormone replacement therapy were excluded from the analysis.
  
  
  RESULTS
  Alcohol consumption was associated with high levels of systolic and diastolic BP in an age×genotype-dependent manner only in the non-obese women (BMI<27 kg/m(2)). Among those with the ɛ3/3 genotype, the differences in systolic and diastolic levels between drinkers and non-drinkers estimated at the age of 60 years were respectively 13.7 mmHg (p=0.022) and 10.7 mmHg (p=0.002), and disappeared in the older age groups, in which drinking was associated with systolic/diastolic hypertension if the non-obese women were ɛ4 carriers.
  
  
  CONCLUSIONS
  In non-obese postmenopausal women, alcohol consumption is associated with systolic and diastolic hypertension early in those with the ɛ3/3 ApoE genotype, and late in ɛ4 carriers. We hypothesize the mediation of androgen hormones and the influence of ApoE genotypes on age at natural menopause. A better understanding of these mechanisms may guide better preventive choices.
authors.affiliation: Institute of Biomedical Technologies, National Research Council, Milan, Italy. lea.correa@itb.cnr.it
authors.forename: Maria Léa
authors.initials: ML
authors.lastname: Correa Leite
authors.forename: Emilio H
authors.initials: EH
authors.lastname: Moriguchi
authors.forename: Maria Fernanda
authors.initials: MF
authors.lastname: Lima-Costa
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging / Q000235:genetics*; D000428:Alcohol Drinking / Q000235:genetics* / Q000503:physiopathology; D001057:Apolipoproteins E / Q000235:genetics*; D001794:Blood Pressure / Q000235:genetics*; D015992:Body Mass Index; D001938:Brazil; D005260:Female; D005838:Genotype; D006801:Humans; D006973:Hypertension / Q000235:genetics* / Q000503:physiopathology; D008875:Middle Aged; D009765:Obesity / Q000235:genetics* / Q000503:physiopathology; D011110:Polymorphism, Genetic; D017698:Postmenopause; D011446:Prospective Studies; D012016:Reference Values
chemical_list: D001057:Apolipoproteins E
keywords: Alcohol consumption; Apolipoprotein E; Blood pressure; Menopause; Obesity