APOLIPOPROTEIN-E PHENOTYPE DETERMINES THE EFFECT OF ALCOHOL ON BLOOD-PRESSURE IN MIDDLE-AGED MEN

Apolipoprotein E (apoE) has an essential role in lipoprotein metabolis m, but recent studies have also revealed other functions associated wi th it,eg, neurologic and malignant diseases. We studied the associatio n between apoE phenotypes E2/3,E3/3,and E4/3 and blood pressure after adjustment for covariates, as well as the association between phenotyp es and adjusted plasma glucose and insulin levels in the standard oral glucose tolerance test in a random middle-aged population-based cohor t of 259 men and 267 women. Systolic blood pressure was associated wit h apoE phenotype in the men with moderate or heavy alcohol consumption (>115 g/week), the mean systolic blood pressure value being 16 mm Hg higher in the E2/3 and 11 mm Hg higher in the E3/3 phenotypes than in the E4/3 phenotype, P = .04. No association was seen in occasional dri nkers or teetotalers (lowest tertile <24 g/week), whereas in the middl e tertile the association was intermediate. The same association was s een with diastolic blood pressure. In men, there was a significant cor relation between systolic blood pressure and alcohol consumption in th e E2/3 phenotype (r(s) = 0.71, P < .01) and in the E3/3 phenotype (r(s ) = 0.25, P < .01) but not in the E4/3 phenotype (r(s) = 0.03, NS). No association between apoE phenotypes and insulin resistance was observ ed. In conclusion, in middle-aged men, apoE phenotype significantly in fluences the blood-pressure-increasing effect of alcohol consumption. This gene-environment interaction may have marked implications for the prevention and treatment of hypertension. (C) 1998 American Journal o f Hypertension, Ltd.