Abstract :
We examined the contribution of ACE I/D polymorphism in a large Chinese population to
four year change in ankle-brachial index (ABI), development of cardiovascular diseases and mortality in a
prospective study adjusting for many confounding factors. Method: Data are drawn from a longitudinal study of
4000 community-living men and women aged 65 years and over, for which detailed information regarding
lifestyle, chronic diseases, body mass index (BMI), ABI measurements and ACE polymorphisms were
documented at baseline. During the fifth year of follow up, incident cardiovascular diseases, ABI, and mortality
were documented, and related to ACE genotype adjusting for age, smoking, alcohol, dietary intake, physical
activity, body mass index, and use of ACE inhibitors. Results: Women with the D/D genotype had the greatest
reduction in mean ABI after adjusting for confounding factors. D/D genotype was also more common among
women who developed hypertension or myocardial infarction. However D/D genotype was associated with
mortality only in men. Conclusion: In a Chinese elderly population, ACE polymorphism may be considered
‘deleterious’ to longevity, the D/D genotype being associated with mortality, the atherosclerotic process,
hypertension and myocardial infarction. There are gender differences in the relationship between D/D genotype
and cardiovascular diseases and mortality may not be mediated by the atherosclerotic process alone.
