Affiliation:
1. From the Department of Internal Medicine, Division of Endocrinology and Nephrology, Universitätsklinikum Benjamin Franklin, Free University of Berlin. Dr Kunz is currently affiliated with the Department of Internal Medicine, Division of Nephrology and Transplantation Universitätsklinikum Virchow-Charité, Humboldt-University Berlin, Germany.
Abstract
Abstract
Recently, an allelic variant of the angiotensinogen gene (
AGT
235T) has been associated with increased risk of hypertension. However, this finding has not been confirmed by all investigators. A meta-analysis was performed to examine the association between the
AGT
235T-allele and hypertension in whites and to identify potential reasons for the controversial results. All relevant articles published between 1992 and 1996 were identified through multiple sources. The studies were methodologically appraised, and the frequency of the
AGT
235T-allele was extracted. The 235T-allele frequency was pooled using the common odds ratio (OR) estimator by Mantel-Haenszel. Homogeneity was assessed using the Breslow-Day test. Together these studies present data on 5493 patients. The
AGT
235T-allele was significantly associated with hypertension (OR: 1.20; 95% [CI]: 1.11 to 1.29;
P
<.0001). This association increased in studies with positive family history (OR: 1.42; 95% CI: 1.25 to 1.61,
P
<.0001), recruitment of cases from referral centers (OR: 1.39; 95% CI: 1.20 to 1.62,
P
<.0001), and more severe hypertension (OR: 1.34; 95% CI: 1.22 to 1.47,
P
<.0001). However, the presence of methodological problems in all studies gives rise to serious concerns regarding bias and confounding. Despite a statistically significant, albeit weak, association between the
AGT
235T variant and hypertension that has been confirmed through sensitivity analysis, this finding has to be interpreted with caution, as the methodological weaknesses of the individual studies are likely to have biased the outcome of the meta-analysis. Clearly, more rigorous methods need to be applied in association studies on the genetics of human hypertension.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Cited by
167 articles.
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