Angiotensin II type-I receptor and ACE polymorphisms and risk of myocardial infarction in men and women

Background Findings relating an association between an insertion/deletion p olymorphism of the angiotensin converting enzyme (ACE) gene and myocardial infarction (MI) have been mixed. While other loci, such as the angiotensin II type-I receptor (AT(1)R), may modulate risk, few studies have adequately documented the risk in women. We aimed to study whether the findings in re spect of ACE and AT(1)R in UK men were borne out in women. Methods Cases of MI (305 women, 391 men) in Belfast and Glasgow have been c ompared to controls (291 women, 356 men). These new samples augment the ori ginal men (200 cases, 181 controls) included from Belfast in the ECTIM stud y. Results Among men, the odds ratio for MI for ACE (DD vs. ID + II) was 1.03 (0.79, 1.34) and among women, 0.69 (0.47, 1.01). This heterogeneity between the risks in men and women was significant in Glasgow (P = 0.02). Among me n and women the odds ratio for MI for AT(1)R (CC vs. AC + AA) was 1.02 (0.7 1, 1.47). There was a small gradient in risk, such that the odds ratio for DD genotype was 0.86 (0.63, 1.17) among subjects homozygous for the common AT(1)R alelle (AA): 0.94 (0.67, 1.30) among heterozygotes and 1.21 (0.53, 2 .77) among CC subjects; but this interaction was not statistically signific ant. Conclusions Some of the contradictory findings concerning the ACE polymorph ism and the risk of MI may be due to heterogeneity in the risk between men and women. The AT(1)R(1196) polymorphism is not an independent risk factor for MI in either sex.