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24 August 2001 News Update


A common gene variant, when carried by cigarette smokers, can significantly increase the risk of coronary heart disease (CHD).

While smokers have an increased risk of CHD, new research funded by the British Heart Foundation (BHF) shows that the Apo-E gene - carried by 26% of the UK male population - makes them much more vulnerable to heart problems if they are smokers.

An eight-year study by BHF in collaboration with University College London (UCL), the Wolfson Institute and St Bartholomew's Hospital, London, focused on the Apo-E gene that is known to be important in controlling the levels of fat in the blood.

The gene comes in three common forms - E2, E3 and E4. The researchers studied a group of 3,052 healthy middle-aged men (50 to 61 years) drawn from family practices throughout the UK.

Participants in the study had their cholesterol and other heart-disease risk factors measured as well as completing a smoking questionnaire.

Genetic-based techniques were used to determine if the men carried one or more copies of the E2 or E4 variant or held the common E3 version.

CHD events included all fatal or non-fatal heart attacks as well as coronary artery surgery and silent heart attacks occurring over the study period.

The researchers looked at the different versions of Apo-E in the men and found that in those with the E4 version, the risk in smokers was over three times greater than those who had never smoked. The risk was still 2.8 times higher for this group even after taking account of all other risk factors.

The risk of CHD in E4 former smokers was similar to those who had never smoked, strongly suggesting that the high risk in smokers was reversible by quitting.

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