Apolipoprotein E (APOE) and risk of cardiovascular diseases

     Apolipoprotein E (APOE) is a protein that is best known for its role in lipid metabolism, helping to remove cholesterol from the bloodstream.

    It can exist in three main forms known as e2, e3 and e4. Variations in the APOE gene determine which forms of the APOE protein are present. Different forms of APOE work in different ways.

    The e4 (epsilon 4) form of the APOE gene has been associated with disorders of lipid metabolism (increased plasma levels of cholesterol and triglycerides) and susceptibility to cardiovascular disease (heart attacks or strokes due to atherosclerosis).

    APOE É›3 is the most common allele found in about 60% of people. The presence of É›2 or É›4 alleles may be a risk factor for several conditions including cardiovascular diseases.

    APOE É›2 carriers may be more likely to develop familial dysbetalipoproteinemia or type III hyperlipoproteinemia. Having these variants does not mean you will have any disease associated with them.

    If you have a higher-risk version of apoe, you can reduce your risk of developing cardiovascular disease by making changes to your diet and lifestyle. For example, tangerine or bergamot has two flavones: melitidine and brutieridine, with properties similar to statins, whose intake of the fruit or supplementation with tangerine or bergamot oil can benefit those who are carriers of APOE É›2, which are associated with an increased cardiovascular risk due to increased clot formation.

    The APOE4 isoform is the most atherogenic, and e4 carriers have LDL cholesterol concentrations 31% higher than e2 carriers. An average greater risk of 40% and 50% for coronary heart disease is seen in men carrying E4 because they have significantly higher cholesterol levels and in women with the E4 allele a greater risk of premature coronary heart disease and increased risk of heart attack. Individuals with the APOE4 genotype have significantly higher systolic blood pressure and diastolic blood pressure. Several studies have shown that individuals with the APOE4 genotype have a significantly greater reduction in triglycerides after consuming eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).


APOE type

rs429358 Cys130Arg

rs7412 Arg158Cys

Risk of

cardiovascular diseases


E2/E2

TT

TT

no risk

E2/E3

TT

TC

no risk

E3/E3

TT

CC

most common, risk neutral

E2/E4

TC

TC

above average risk

E3/E4

TC

CC

high risk

E4/E4

CC

CC

higher risk


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