Published Online
on June 12, 2003

A more recent version of this article appeared on July 1, 2003

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Submitted on January 30, 2003
Accepted on February 18, 2003

Angiotensin-Converting Enzyme Gene Polymorphism and Carotid Artery Wall Thickness. A Meta-Analysis

Fakhredin A. Sayed-Tabatabaei MSc, MD; Jeanine J. Houwing-Duistermaat PhD; Cornelia M. van Duijn PhD; and Jacqueline C.M. Witteman PhD^*

From the Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands.

^* To whom correspondence should be addressed. E-mail: witteman{at}epib.fgg.eur.nl.

Background and Purpose--Many studies have investigated the association between the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and carotid artery intima-media thickness (IMT); however, most studies were small and conducted in selective samples. The aim of this study was to evaluate this association by performing a meta-analysis on published articles.

Methods--We searched Medline for articles studying the association between the ACE I/D polymorphism and carotid IMT. Twenty-six studies were found; 23 articles containing 9833 subjects were qualified to enter the meta-analysis. We classified those articles on the basis of their samples into high-risk and low-risk populations and white and Asian ethnic groups. IMT was used as a continuous variable, and data were analyzed with the Cochrane Review Manager.

Results--A significant positive association was present between the D allele and common carotid IMT (weighted mean difference between DD and II genotypes, 0.23 mmx10^-1; P<0.01). The association was stronger among high-risk populations. The point estimates of DD versus II were higher than those of ID versus II.

Conclusions--Our meta-analysis showed evidence of a positive association between the D allele of the ACE gene and common carotid IMT. The overall results were concordant in both ethnic groups.

Key words: angiotensins • carotid arteries • genetics • meta-analysis

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