Severe α 1 -antitrypsin deficiency associated with lower blood pressure and reduced risk of ischemic heart disease: a cohort study of 91,540 individuals and a meta-analysis.

Autor: Winther SV; Department of Clinical Biochemistry, Zealand University Hospital, Køge, Denmark.; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark., Ahmed D; Department of Clinical Biochemistry, Zealand University Hospital, Køge, Denmark., Al-Shuweli S; Department of Clinical Biochemistry, Zealand University Hospital, Køge, Denmark., Landt EM; Department of Clinical Biochemistry, Zealand University Hospital, Køge, Denmark., Nordestgaard BG; Department of Clinical Biochemistry, Herlev-Gentofte University Hospital, Herlev, Denmark.; The Copenhagen General Population Study, Herlev-Gentofte University Hospital, Herlev, Denmark.; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark., Seersholm N; Department of Pulmonary Medicine, Herlev-Gentofte University Hospital, Gentofte, Denmark., Dahl M; Department of Clinical Biochemistry, Zealand University Hospital, Køge, Denmark. modah@regionsjaelland.dk.; The Copenhagen General Population Study, Herlev-Gentofte University Hospital, Herlev, Denmark. modah@regionsjaelland.dk.; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark. modah@regionsjaelland.dk.
Jazyk: angličtina
Zdroj: Respiratory research [Respir Res] 2022 Mar 09; Vol. 23 (1), pp. 55. Date of Electronic Publication: 2022 Mar 09.
DOI: 10.1186/s12931-022-01973-3
Abstrakt: Background: Increased elastase activity in α 1 -antitrypsin deficiency may affect elasticity of the arterial walls, and thereby blood pressure and susceptibility to cardiovascular disease. We hypothesized that severe α 1 -antitrypsin deficiency is associated with reduced blood pressure and susceptibility to cardiovascular disease.
Methods: We genotyped 91,353 adults randomly selected from the Danish general population and 187 patients from the Danish α 1 -Antitrypsin Deficiency Registry and recorded baseline blood pressure, baseline plasma lipids and cardiovascular events during follow-up. 185 participants carried the ZZ genotype, 207 carried the SZ genotype and 91,148 carried the MM genotype.
Results: α 1 -Antitrypsin deficiency was associated with decreases in blood pressure of up to 5 mmHg for systolic blood pressure and up to 2 mmHg for diastolic blood pressure, in ZZ vs SZ vs MM individuals (trend test, P's ≤ 0.01). Plasma triglycerides and remnant cholesterol were reduced in ZZ individuals compared with MM individuals (t-test, P's < 0.001). α 1 -Antitrypsin deficiency was associated with lower risk of myocardial infarction (trend test P = 0.03), but not with ischemic heart disease, ischemic cerebrovascular disease or hypertension (trend test, P's ≥ 0.59). However, when results for ischemic heart disease were summarized in meta-analysis with results from four previous studies, individuals with versus without α 1 -antitrypsin deficiency had an odds ratio for ischemic heart disease of 0.66 (95% CI:0.53-0.84).
Conclusions: Individuals with severe α 1 -antitrypsin deficiency have lower systolic and diastolic blood pressure, lower plasma triglycerides and remnant cholesterol, reduced risk of myocardial infarction, and a 34% reduced risk of ischemic heart disease.
(© 2022. The Author(s).)
Databáze: MEDLINE
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