The association between apolipoprotein E gene polymorphisms and essential hypertension: a meta-analysis of 45 studies including 13 940 cases and 16 364 controls

Abstract

The apolipoprotein E single-nucleotide polymorphisms are among the potential candidate genes that may serve as modulators in susceptibility to essential hypertension. In an effort to clarify earlier inconclusive results, we performed a meta-analysis of population-based case-control genetic association studies. Random-effects methods were applied on summary data in order to combine the results of the individual studies. We identified in total 45 studies, including 13 940 hypertensive cases and 16 364 controls. The contrast of E4 carriers versus non-carriers yielded an overall odds ratio (OR) of 1.16 (95% confidence interval (CI): 1.02, 1.31), whereas the contrast of E4 allele versus the others in a subtotal of 6617 cases and 7330 controls, yielded an OR of 1.39 (95% CI: 1.12, 1.72). There was moderate evidence of publication bias in both contrasts, which was eliminated after excluding studies not in Hardy-Weinberg equilibrium. Subgroup analyses revealed that significant estimates arose from studies on Asian populations, as opposed to the Caucasian ones. Furthermore, no evidence of publication bias was demonstrated in the comparisons within this subgroup. Our results are consistent with recent meta-analyses but show that the association is weaker than that has been previously demonstrated. Further studies are needed in order to fully address questions about the etiological mechanism of the particular association, as well as to study the effect in populations of African descent.

Association of APOE gene polymorphism with lipid profile and coronary artery disease in Afro-Caribbeans

“…A meta-analysis of 45 studies including 13 940 cases and 16 364 controls by Stoumpos et al indicated an increased risk of hypertension associated with the ε4 allele compared with the ε2 and ε3 alleles [33]. This association was stronger in populations of Asian descent, with an odds ratio (OR) of 1.49 (95% confidence interval (CI): 1.05–2.13) vs an OR of 1.39 (95% CI: 1.12–1.72) for the overall population (mostly of European descent).…”

Apolipoprotein E polymorphism is associated with lower extremity deep venous thrombosis: color-flow Doppler ultrasound evaluation

“…A meta-analysis included 29 studies involving 2,737 CI cases and 2,689 controls suggested that APOE E4 allele was associated with an increased risk of developing cerebral infarction in Chinese population [36]. A meta-analysis of 45 studies including 13,940 cases and 16,364 controls found that APOE gene polymorphisms were associated with essential hypertension [37]. A meta-analysis of 28 case–control studies provided evidence for an association between the APOE E4 allele and frontotemporal lobar degeneration [38].…”

Apolipoprotein E, Carbon Dioxide Vasoreactivity, and Cognition in Older Adults: Effect of Hypertension

“…The ε 4 allele of the gene that codes apolipoprotein E (APOE) has been consistently found to be a risk factor for Alzheimer's disease (AD) and other cognitive disorders . APOE‐ ε 4 may also be associated with poor cognitive performance in older adults without dementia and is associated with hypertension, which in turn may increase the risk of cognitive impairment . Prior studies suggest that hypertension and APOE have a cumulative effect on the risk of AD, but fewer studies have explored the combined effect on cognition in older adults without dementia.…”

“…1 APOE-e4 may also be associated with poor cognitive performance in older adults without dementia 2,3 and is associated with hypertension, which in turn may increase the risk of cognitive impairment. 4,5 Prior studies suggest that hypertension and APOE have a cumulative effect on the risk of AD, 6 but fewer studies have explored the combined effect on cognition in older adults without dementia. For example in the Honolulu-Asia Aging Study, midlife high systolic blood pressure had a stronger negative effect on global measures of cognition in participants with APOE-e4.…”