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Gene variant increases heart disease risk, even when cholesterol is normal

ATLANTA, Nov. 7 -- A gene already implicated in high cholesterol may pose yet another risk for heart disease, according to a study presented today at the American Heart Association's Scientific Sessions.

Apolipoprotein E is a key protein involved in the transport and disposal of cholesterol in the body. Sitting on the surface of circulating blood-fat particles, apo E normally binds to liver cells, to help rid the body of cholesterol. There are three variants of apo E.

Lead investigator of the study, Angelo Scuteri, M.D., Ph.D., of the National Institute of Aging in Baltimore, Md., says research suggests that one of the variants, apoE-4, raises levels of total cholesterol and "bad" low-density lipoprotein, or LDL. Too much cholesterol in the blood can block blood vessels, setting the stage for a heart attack or stroke.

To determine if the apoE-4 variant was associated with heart disease, Scuteri and his colleagues studied 731 healthy men and women in the Baltimore Longitudinal Study of Aging, a study that began in 1958 and involved individuals ranging in age from 21 to 96. The study participants underwent physical, physiological and psychological exams every two years for 17 years. The study included men and women age 50 or older who had no apparent signs of heart disease. More than half (57 percent) of the participants were men.

Gene testing revealed that 200 of the 731 individuals had the apoE-4 gene, and they also were more likely to have a "coronary event" later in life than those without the variant--roughly 20 percent versus 13 percent in the non-mutation group. Coronary events were defined as angina (chest pain), heart attacks or dying from heart attack or another form of coronary heart disease.

A surprising finding was that individuals with apoE-4 still had an increased risk of heart disease, even if their cholesterol levels and blood pressure were normal.

Overall, there were 104 coronary events among the study group. Because m
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Contact: Carole Bullock
caroleb@heart.org
214-706-1279
American Heart Association
6-Nov-1999


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