Reciprocal interactions of obstructive sleep apnea and hypertension associated with ACE I/D polymorphism in males.

Abstract

BACKGROUND:

The angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism gene contributes to the genesis of hypertension (HTN) and may help explain the relationship between obstructive sleep apnea (OSA) and HTN. However, ACE is a pleiotropic gene that has several influences, including skeletal muscle and control of ventilation. We therefore tested the hypothesis that ACE polymorphism influences OSA severity.

METHODS:

Male OSA patients (apnea-hypopnea index [AHI]>5 events/h) from 2 university sleep centers were evaluated by polysomnography and ACE I/D polymorphism genotyping.

RESULTS:

We studied 266 males with OSA (age=48+/-13 y, body mass index=29+/-5 kg/m(2), AHI=34+/-25 events/h). HTN was present in 114 patients (43%) who were older (p<0.01), heavier (p<0.05) and had more severe OSA (p<0.01). The I allele was associated with HTN in patients with mild to moderate OSA (p<0.01), but not in those with severe OSA. ACE I/D polymorphism was not associated with apnea severity among normotensive patients. In contrast, the only variables independently associated with OSA severity among patients with hypertension in multivariate analysis were BMI (OR=1.12) and II genotype (OR=0.27).

CONCLUSIONS:

Our results indicate reciprocal interactions between OSA and HTN with ACE I/D polymorphism, suggesting that among hypertensive OSA males, the homozygous ACE I allele protects from severe OSA.

• Authors: Renata G Koyama, Luciano F Drager, Geraldo Lorenzi-Filho, Fátima D Cintra, Alexandre C Pereira, Dalva Poyares, José Eduardo Krieger, Rosa M R P S Castro, Sérgio Tufik, Marco Túlio de Mello, Mario Pedrazzoli
• Journal: Sleep medicine (Sleep Med) Vol. 10 Issue 10 Pg. 1107-11 (Dec 2009) ISSN: 1878-5506 [Electronic] Netherlands
• PMID: 19482546 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Peptidyl-Dipeptidase A

Topics

• Adult
• Aged
• Alleles
• Body Mass Index
• Gene Frequency (genetics)
• Genotype
• Homozygote
• Humans
• Hypertension (diagnosis, genetics)
• INDEL Mutation
• Male
• Middle Aged
• Multivariate Analysis
• Peptidyl-Dipeptidase A (genetics)
• Phenotype
• Polymorphism, Genetic (genetics)
• Polysomnography
• Sleep Apnea, Obstructive (diagnosis, genetics)