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(Stroke. 2003;34:1634.)
© 2003 American Heart Association, Inc.

Original Contributions

Angiotensin-Converting Enzyme Gene Polymorphism and Carotid Artery Wall Thickness

A Meta-Analysis

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

Reprint requests to Dr J.C.M. Witteman, Department of Epidemiology and Biostatistics, Erasmus Medical Center, PO Box 1738, 3000 DR Rotterdam, Netherlands. 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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