摘要

The role of apolipoprotein E (apoE) polymorphisms in regulating blood pressure (BP) is still not clear. The aim of this study was to examine longitudinal changes in BP levels by apoE genotypes in a population-based prospective cohort of elderly subjects, and explore interactions with plasma lipids and uric acid. Subjects whose apoE genes had been genotyped at baseline (1408, representing 80.8% of all the elderly residents in Bambui city, south-eastern Brazil; age range 60-95 years) were included in the analysis. Repeated BP measurements were obtained in four waves. Multi-level random-effects pattern-mixture models were used to evaluate the age-related BP trajectories, accounting for non-ignorable dropouts/deaths and handling heterogeneities as random parameter variations. Subjects with the epsilon 4/4 genotype and high levels of low-density lipoprotein cholesterol had higher systolic BP levels at 60 years of age than those with the other genotypes (154.5 vs. 133.2 mm Hg, P = 0.020), but this was not the case among the older subjects. Systolic BP increased more rapidly with age in the epsilon 2 carriers, leading to significantly higher levels among the oldest. This relationship seemed to be modulated by uric acid levels, as it was present in the subjects with the epsilon 2/3 genotype and high uric acid levels, and in those with the epsilon 2/4 genotype and low or normal uric acid levels. The differences in systolic BP between the genotypes were age dependent, and the shift between the epsilon 4 and epsilon 2 alleles suggest that these alleles are involved in the different mechanisms leading to increased BP in middle-aged and elderly subjects. Hypertension Research (2013) 36, 270-276; doi: 10.1038/hr.2012.175; published online 18 October 2012

  • 出版日期2013-3