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(Circulation. 1999;100:2231.)
© 1999 American Heart Association, Inc.

Clinical Investigation and Reports

Human Prostacyclin Synthase Gene and Hypertension

The Suita Study

Naoharu Iwai, MD; Tomohiro Katsuya, MD; Kazuhiko Ishikawa, MD; Toshifumi Mannami, MD; Jun Ogata, MD; Jitsuo Higaki, MD; Toshio Ogihara, MD; Tadashi Tanabe, PhD; Shunroku Baba, MD

From the Departments of Biochemistry (N.I.) and Pharmacology (T.T.), Research Institute, National Cardiovascular Center; the Departments of Preventive Cardiology (T.M., J.O., S.B.) and Hypertension and Nephrology (N.I.), National Cardiovascular Center; and the Department of Geriatric Medicine (T.K., K.I., J.H., T.O.), Osaka University Medical School, Suita, Osaka, Japan.

Correspondence to Naoharu Iwai, MD, Department of Biochemistry, Research Institute, National Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan. E-mail niwai{at}res.ncvc.go.jp

Background—Prostacyclin (prostaglandin I₂) is a strong vasodilator that inhibits the growth of vascular smooth muscle cells and is also the most potent endogenous inhibitor of platelet aggregation. Therefore, it has been considered to play an important roles in cardiovascular disease. On the basis of the hypothesis that variations of the prostacyclin synthase gene may also play an important role in human cardiovascular disease, we performed a screening for variations in the human prostacyclin synthase gene.

Methods and Results—We have detected a repeat polymorphism in the promoter region of the human prostacyclin synthase gene. The number of 9-bp (CCGCCAGCC) repeats in the promoter region, which encodes a tandem repeat of Sp1 transcriptional binding sites, varied between 3 and 7 in Japanese subjects. Luciferase reporter analysis indicated that the alleles of 3 and 4 repeats (R3 and R4, respectively) had less promoter activity in cultured human umbilical vein endothelial cells. We then investigated the possible association of this repeat polymorphism with blood pressure in a large population-based sample (the Suita Study), which consisted of 4971 Japanese participants. Multivariate models indicated that participants with the R3R3, R3R4, or R4R4 genotype (SS genotype, n=80) had significantly higher systolic pressure (P=0.0133) and pulse pressure (P=0.0005). The odds ratio of hypertension (140/90 mm Hg) for the SS genotype was 1.942 (95% confidence interval 3.20 to 1.19, P=0.0084).

Conclusions—Repeat polymorphism of the human prostacyclin synthase gene seems to be a risk factor for higher pulse pressure and is consequently a risk factor for systolic hypertension in the Japanese population.

Key Words: genetics • hypertension • prostaglandins • blood pressure

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