Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Meta-based evidence for apolipoprotein E ɛ2/ɛ3/ɛ4 polymorphism in association with hypertension among Chinese

Journal of Human Hypertension volume 25, pages 725–731 (2011)Cite this article

Subjects

Abstract

Mounting evidence suggests that hypertension is strongly linked to a variety of lipoprotein metabolism abnormalities. Apolipoprotein E gene (ApoE) is one such candidate with its common ɛ2/ɛ3/ɛ4 polymorphism ranking high in hypertension association. To derive more specific information, we pinpoint our research scope in Chinese to test whether this polymorphism is associated with hypertension via a meta-analysis. Random-effects model was performed irrespective of the between study heterogeneity. Data and study quality were assessed in duplicate. Publication bias was evaluated using the fail-safe number. Overall, 12 studies with 14 study groups totalling 1532 hypertensive patients and 2172 controls were identified. Carriers of ApoE ɛ2 allele had no significant increased risk for hypertension (pooled odds ratio (OR)=1.04; 95% confidence interval (CI): 0.80–1.35; P=0.78), compared with those carrying ɛ3 allele, whereas those with ɛ4 allele had a significant increased risk for hypertension (pooled OR=2.03; 95% CI: 1.61–2.55; P<0.00001). After excluding those with other small nationalities, we observed comparison of ApoE ɛ2 with ɛ3 allele yielded a pooled OR of 0.99 (95% CI: 0.82–1.19; P=0.89) among Han Chinese, and that of ɛ4 with ɛ3 yielded a pooled OR of 1.99 (95% CI: 1.48–2.67; P<0.00001). The fail-safe number at the level of 0.05 supported these significant associations. Taken together, our results expand previous findings and show that ApoE ɛ4 allele is associated with a twofold increased risk of developing hypertension in Chinese.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Wu Y, Huxley R, Li L, Ogaoawara AK, Dybdal N, Bunting S et al. Prevalence, awareness, treatment, and control of hypertension in China: data from the China National Nutrition and Health Survey 2002. Circulation 2008; 118: 2679–2686.

    Article  Google Scholar 

  2. Yang J, Lu F, Zhang C, Liu Z, Zhao Y, Gao F et al. Prevalence of prehypertension and hypertension in a Chinese rural area from 1991 to 2007. Hypertens Res 2010; 33: 331–337.

    Article  Google Scholar 

  3. Izawa H, Yamada Y, Okada T, Tanaka M, Hirayama H, Yokota M . Prediction of genetic risk for hypertension. Hypertension 2003; 41: 1035–1040.

    Article  CAS  Google Scholar 

  4. Niu W, Guo X, Su Y, Qiu C . Apolipoprotein E and low-density lipoprotein receptor gene polymorphisms in dyslipidemias-associated essential hypertension. J Hum Hypertens 2007; 21: 337–339.

    Article  CAS  Google Scholar 

  5. Brewer Jr HB, Zech LA, Gregg RE, Schwartz D, Schaefer EJ . NIH conference. Type III hyperlipoproteinemia: diagnosis, molecular defects, pathology, and treatment. Ann Intern Med 1983; 98: 623–640.

    Article  Google Scholar 

  6. Yang R, Powell-Braxton L, Ogaoawara AK, Dybdal N, Bunting S, Ohneda O et al. Hypertension and endothelial dysfunction in apolipoprotein E knockout mice. Arterioscler Thromb Vasc Biol 1999; 19: 2762–2768.

    Article  CAS  Google Scholar 

  7. Niu W, Qi Y, Qian Y, Gao P, Zhu D . The relationship between apolipoprotein E epsilon2/epsilon3/epsilon4 polymorphisms and hypertension: a meta-analysis of six studies comprising 1812 cases and 1762 controls. Hypertens Res 2009; 32: 1060–1066.

    Article  CAS  Google Scholar 

  8. Higgins JP, Thompson SG, Deeks JJ, Altman DG . Measuring inconsistency in meta-analyses. BMJ 2003; 327: 557–560.

    Article  Google Scholar 

  9. Cohn LD, Becker BJ . How meta-analysis increases statistical power. Psychol Methods 2003; 8: 243–253.

    Article  Google Scholar 

  10. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR . Introduction to Meta-Analysis 2009. John Wiley & Sons, Ltd: Chichester, UK.

    Book  Google Scholar 

  11. Hamulati W, Aisikaer Y, Yilihamujiang S . Relationship between ApoE gene polymorphism and patients of hypertension in Uighur. Chin J Immunol 2003; 19: 108–110.

    CAS  Google Scholar 

  12. Zhimian Z, Haiqing G, Qing S, Lihua F . Clinical study of relationship between ApoE gene polymorphism and hypertension in aged. Acta Academiae Medicinae Shandong 2000; 38: 173–176.

    Google Scholar 

  13. Caiyou H, Chenguang Z, Zeping L, Ze Y, Jiying L, Yong W et al. The study of relation between blood pressure and apolipoprotein E genotypes in long-lived elderly in Bama area of Guangxi. Chin J Geriatr Heart Brain Vessel Dis 2007; 9: 11–13.

    Google Scholar 

  14. Weize Z, Xinghui L, Yongqing C, Ling M, Mingxu Z, Mian Q et al. Relationship between apolipoprotein E gene polymorphism and essential hypertension in Han, Tibetan and Hui population in high altitude area. Chin Circ J 2007; 22: 263–266.

    Google Scholar 

  15. Chunli R, Yingxin P, Meixia L, Ruyi L, Xue G . Analysis of apolipoprotein E gene polymorphism in hypertensive patients. Shandong Med J 2007; 47: 29–30.

    Google Scholar 

  16. Yingwang L, Shuiping Z, An Z, Sai N . Effect of apolipoprotein E gene polymorphism on lipid and essential hypertension. Chin J Arterioscler 2002; 10: 517–520.

    Google Scholar 

  17. Wen P, Siming G, Wei L, Xiaohong Z . Apolipoprotein E gene polymorphism and hypertension. J Chin Gen Pract 2003; 2: 14–15.

    Google Scholar 

  18. Guofang C, Zhu M, Bingxian H . Relationships between polymorphism of apoE gene and hypertension in the Han ethnics of China. Chin J Clin Rehab 2003; 7: 2545–2546.

    Google Scholar 

  19. Min P, Jianhua Z, Li L, Haiyan P, Huimin W, Shu L et al. Association of Apolipoprotein E with essential hypertension, NIDDM and coronary heart disease in Chinese population. Chin Synth Med 2002; 3: 1–3.

    Google Scholar 

  20. Li X, Du Y, Du Y, Huang X . Association of apolipoprotein E gene polymorphism with essential hypertension and its complications. Clin Exp Med 2003; 2: 175–179.

    Article  CAS  Google Scholar 

  21. Ruixing Y, Jinzhen W, Weixiong L, Yuming C, Dezhai Y, Shangling P . The environmental and genetic evidence for the association of hyperlipidemia and hypertension. J Hypertens 2009; 27: 251–258.

    Article  Google Scholar 

  22. Kesäniemi YA, Ehnholm C, Miettinen TA . Intestinal cholesterol absorption efficiency in man is related to apoprotein E phenotype. J Clin Invest 1987; 80: 578–581.

    Article  Google Scholar 

  23. Cardon LR, Bell JI . Association study designs for complex diseases. Nat Rev Genet 2001; 2: 91–99.

    Article  CAS  Google Scholar 

  24. Munafò MR, Flint J . Meta-analysis of genetic association studies. Trends Genet 2004; 20: 439–444.

    Article  Google Scholar 

  25. Utermann G, Hees M, Steinmetz A . Polymorphism of apolipoprotein E and occurrence of dysbetalipoproteinaemia in man. Nature 1977; 269: 604–607.

    Article  CAS  Google Scholar 

  26. Peacock ML, Fink JK . ApoE epsilon 4 allelic association with Alzheimer's disease: independent confirmation using denaturing gradient gel electrophoresis. Neurology 1994; 44: 339–341.

    Article  CAS  Google Scholar 

  27. Pang CP, Baum L, Chan WM, Lau TC, Poon PM, Lam DS . The apolipoprotein E epsilon4 allele is unlikely to be a major risk factor of age-related macular degeneration in Chinese. Ophthalmologica 2000; 214: 289–291.

    Article  CAS  Google Scholar 

  28. Woo D, Kaushal R, Chakraborty R, Woo J, Haverbusch M, Sekar P et al. Association of apolipoprotein E4 and haplotypes of the apolipoprotein E gene with lobar intracerebral hemorrhage. Stroke 2005; 36: 1874–1879.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This work was supported by the Shanghai ‘Chen Guang’ Project (09CG12), the Natural Science Foundation of Shanghai (09ZR1426200) and the National Science Foundation for Young Scientists of China (Grant Number: 30900808).

Author information

Authors and Affiliations

  1. Shanghai Key Laboratory of Vascular Biology and Department of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

    W-Q Niu

  2. Laboratory of Vascular Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China

    W-Q Niu

  3. Shanghai Institute of Hypertension, Shanghai, China

    W-Q Niu

  4. Department of Epidemiology, Capital Medical University Affiliated Beijing Anzhen Hospital, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China

    Y Qi

Authors
  1. W-Q Niu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Y Qi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W-Q Niu.

Ethics declarations

Competing interests

The authors declared no conflict of interest.

Additional information

Supplementary Information accompanies the paper on the Journal of Human Hypertension website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

Niu, WQ., Qi, Y. Meta-based evidence for apolipoprotein E ɛ2/ɛ3/ɛ4 polymorphism in association with hypertension among Chinese. J Hum Hypertens 25, 725–731 (2011). https://doi.org/10.1038/jhh.2010.116

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2010.116

Keywords

This article is cited by

Search

Advanced search

Quick links