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. 2002 Feb 1;112(2):89-94.
doi: 10.1016/s0002-9343(01)01071-3.

Deletion allele of the angiotensin-converting enzyme gene as a risk factor for pneumonia in elderly patients

Shigeto Morimoto  1 , Kohya Okaishi, Miyuki Onishi, Tomohiro Katsuya, Jin Yang, Masashi Okuro, Shoroku Sakurai, Toshio Onishi, Toshio Ogihara
Affiliations

Deletion allele of the angiotensin-converting enzyme gene as a risk factor for pneumonia in elderly patients

Shigeto Morimoto et al. Am J Med. .

Abstract

Purpose: Aspiration due to an age-related reduction in cough is a major cause of pneumonia in elderly persons. Because the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene (ACE) has been associated with the cough reflex, we studied whether this genetic polymorphism was also associated with the risk of pneumonia.

Subjects and methods: We studied 1011 elderly inpatients (221 men and 790 women, mean [+/- SD] age of 82 +/- 7 years) in a long-term care hospital. The association between the ACE I/D polymorphism and the incidence of pneumonia (defined using specific criteria that included radiographic abnormalities) was assessed during an 8-month period that excluded the winter. Data were analyzed using proportional hazards models, with adjustment for age, sex, and other potential confounders.

Results: During follow-up, 87 cases (9%) of pneumonia occurred, 38 of which were fatal. The ACE DD allele (vs. ID + II) was associated with an increased risk of pneumonia (relative risk [RR] = 2.9; 95% confidence interval [CI]: 1.7 to 4.8, P < 0.001) and fatal pneumonia [RR = 4.4; 95% CI: 2.1 to 9.0; P < 0.0001).

Conclusions: The ACE D allele is an independent risk factor for pneumonia in elderly persons.

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