The Interaction of Apolipoprotein E and Angiotensin I-Converting Enzyme Dna Polymorphisms with Hypertension on Early Ischemic Stroke Risk

Combinations of multiple predisposing polymorphisms and their interactions with modifiable factors may result in synergistic effects on early ischemic stroke risk. We evaluated the potential interaction of apolipoprotein (apo) E and angiotensin I-converting enzyme (ACE) gene polymorphisms and hypertension on early ischemic stroke risk in Serbian population. We analyzed 65 stroke patients (mean age 35 yrs) and age- and body mass index matched 330 controls. ACE genotypes were determined by polymerase chain method (PCR) and apoE genotypes by PCR appended by HhaI restriction fragment-length polymorphism/MADGE analysis. Odds ratios (ORs) for stroke were 1.35 (95% confidence interval (CI) 0.50-3.62) in subjects with one studied polymorphism and 3.78 (95% CI, 1.28-11.18) in those with two. Compared with nonhypertensive subjects bearing no polymorphisms, ORs were 2.73 (95% CI 0.32-17.55) and 4.80 (95% CI 0.50-28.12) for nonhypertensive subjects with one and two polymorphisms, 8.53 (95% CI 1.04-62.47) and 30.00 (95% CI 3.21-186.45) for hypertensive. These data suggest a gene-dose effect of the examined gene variants and a synergistic effect of these polymorphisms and hypertension in the pathogenesis of early ischemic stroke.