Key result
The alpha-adducin Gly460Trp variant was associated with a 2.8-fold higher risk of stroke (HR 2.8; 95% CI 1.3-5.8), with risk particularly elevated in the presence of systolic hypertension.
Why the study?
Does the alpha-adducin Gly460Trp variant increase the risk of stroke, CHD, and MI in initially healthy women?
Cohort (n=15,236)
Does the alpha-adducin Gly460Trp variant increase the risk of stroke, CHD, and MI in initially healthy women?
The alpha-adducin Gly460Trp polymorphism significantly increases the risk of stroke, particularly ischemic stroke in the presence of systolic hypertension, among Dutch women.
Hypothesis-generating for stroke risk stratification in hypertensive women; leaves open validation in diverse cohorts before clinical use.
The Gly460Trp variant of the alpha-adducin gene has been associated with renal sodium retention and salt-sensitive hypertension. Independent of blood pressure, salt sensitivity has been related to cerebrovascular events. We studied the risk of stroke, coronary heart disease (CHD), and myocardial infarction (MI) associated with the alpha-adducin variant and examined the extent to which this risk is modified by the presence of hypertension. We performed a case-cohort study in a prospective cohort of 15,236 initially healthy Dutch women. We applied a Cox proportional hazards model with an estimation procedure adapted for case-cohort designs to study the relation of the polymorphism and CHD (n=210), MI (n=71), any stroke (n=74), and ischemic stroke (n=49). Subjects with the Gly460Trp variant had a 2.8 times higher risk of stroke (95% confidence intervals [CI] 1.3 to 5.8) under the dominant genetic model, which did not attenuate after adjustment. The same pattern was found under per-allele comparison. Risk of ischemic stroke in the variant allele carriers was 3.9 times higher than in subjects with the common genotype (95% CI 1.7 to 8.6) using dominant inheritance model. The same patterns were found under per-allele comparison. CHD and MI were not related to the variant. The risk of ischemic stroke was more pronounced among women with systolic hypertension (10.9; 95% CI 3.6 to 31.5). The findings in this prospective study in a population based cohort of Dutch women strongly suggest that presence of the alpha-adducin Gly460Trp polymorphism increases the risk of stroke. This risk is particularly elevated in the presence of systolic hypertension.
No takes yet. Share an insight, caveat, or question.
Zafarmand et al. (2008) conducted a cohort in Initially healthy (n=15,236). alpha-adducin Gly460Trp variant vs. common genotype was evaluated on any stroke (HR 2.8, 95% CI 1.3 to 5.8). The alpha-adducin Gly460Trp variant was associated with a 2.8-fold higher risk of stroke (HR 2.8; 95% CI 1.3-5.8), with risk particularly elevated in the presence of systolic hypertension.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: