ACE GENE POLYMORPHISM AS A RISK FACTOR FOR ISCHEMIC CEREBROVASCULAR-DISEASE

Background: Researchers have suggested that the deletional allele of t he ACE (angiotensin-converting enzyme) gene insertion-deletion polymor phism is a potent risk factor for myocardial infarction. This associat ion could not be confirmed in the Copenhagen City Heart Study, in whic h 10 150 persons were studied. The ACE gene polymorphism has also rece ntly been suggested as a potent risk factor for ischemic cerebrovascul ar disease. Objective: To investigate the association between ACE gene polymorphism and ischemic cerebrovascular disease. Design: Two case-r eferent studies and a cross-sectional study. Setting: University hospi tal in Copenhagen, Denmark. Participants: Case-referent study 1: 35 wo men and 38 men who developed ischemic cerebrovascular disease before 5 0 years of age compared with 1454 women and 1737 men from a general po pulation sample. Case-referent study 2: 82 women and 137 men with isch emic cerebrovascular disease and carotid stenosis greater than 40% com pared with 4273 women and 3091 men from the general population sample. Cross-sectional study of the general population sample: 67 women and 93 men with ischemic cerebrovascular disease compared with 4077 women and 3156 men without such disease. Measurements: Genotype; age; body m ass index; smoking habits; levels of lipids, lipoproteins, apolipoprot eins, and fibrinogen; and diagnosis of hypertension, diabetes mellitus , and ischemic cerebrovascular disease. Results: Odds ratios for ische mic cerebrovascular disease by ACE genotype classes were not significa ntly different from 1.0 in women or men in any of the three studies, s eparately or combined. In a logistic regression analysis that controll ed for age and conventional cardiovascular risk factors, odds ratios i n either sex still did not significantly differ from 1.0 in any study, separately or combined. Conclusion: In two case-referent studies, a c ross-sectional study, and the three studies combined, no statistically significant difference was found in the development of ischemic cereb rovascular disease between genotype classes of the ACE gene polymorphi sm in women or men.