In regard to lipid profile, the results obtained in this study showed an association between higher levels of LDL-c and the E3E4 genotype, both in the analyses of the means and in the analysis of the percentiles of the LDL-c levels. The other components did not vary significantly between the groups of different genotypes. The serum lipid levels observed in the different most frequent ApoE geno- types obtained in this study were compared with those re- cently published in the literature (tab. VIII). It is worth no- ting that the LDL-c level observed in the elderly of Veranó- polis with the E3E4 genotype (155.6±47.3) was very similar to that reported by Bader 33 for the elderly living in Italy (151.4±45.5). This suggests that those of the same ethnicity may have similar mean serum lipid levels despite living in different and geographically isolated environmental condi- tions, ie, a genetic pattern with a reduced environmental in- fluence or maintenance of similar life habits and styles in the 2 populations, or both, despite the migratory event. This statement can be confirmed if we consider the results obtai- ned in the multiethnic study carried out by Pablos-Mendez et al 36, which analyzed 1,068 noninstitutionalized indivi- duals living in the United States. The study showed that the association between serum LDL-c levels and those of other lipid components varied according to the ethnic group.

association between the E3E4 genotype and acute myocar- dial infarction at an early age 31. An association between the E4 allele and myocardial ischemia was also observed 34.

Among the studies in which no consistent associa- tion between the ApoE genotypes and cardiovascular diseases was found, we can cite longitudinal studies on the relation between the genotypes and coronary lesions las- ting 4 to 6 years 37. In 1 study carried out in Italy with 15,000 individuals, no association between cardiovascular disea- ses and differential ApoE genotypes was found 33. It is still early to confirm or deny the association between the ApoE gene and cardiovascular diseases, because the relation between ApoE and cardiovascular diseases is still contro- versial. We can infer that if this relation exists, it is not cau- sal (direct) and may be associated with other factors, both genetic and environmental 1-4.

Unlike LDL-c, no correlation was observed between the ApoE genotypes and HDL-c, mainly in regard to the presence of the E4 allele. This finding was also reported in other population studies, such as that by Pablos-Mendez et al 36.

Population studies have suggested the association between an increase in the frequency of hypertriglyceride- mia (type IV HLP) in individuals with the E2 allele and indivi- duals with the E4E4 genotype; a lower frequency of the E2 allele associated with dyslipidemia IIa; and an increase in the frequency of type IIb dyslipidemia in individuals with at least 1 E4 allele in their genotype 32. However, the associa- tion of the effect of hypocholesterolemia and the E2 allele was stronger than the association of hypercholesterolemia and the E4 allele 32.

Other findings of our study that were not reported in studies published about the subject were the relation between high fibrinogen levels and the E3E4 genotype and the relation between more elevated levels of uric acid and the E3E3 genotype. In regard to the former, it is worth no- ting that elevated fibrinogen levels are associated with car- diovascular diseases 22. However, despite the differences observed between the 2 genotypes, the fibrinogen levels observed are within the reference levels (< 400 mg/dL) for both groups. Only 1 individual in the entire sample had fibri- nogen levels higher than 400 mg/dL. In regard to the second finding, considering that high uric acid levels may increase the risk of cardiovascular diseases 38, this association could reduce the benefits related to the E3E3 genotype in regard to atherogenesis.

In the third phase of the analysis of the results, the association between the ApoE genotypes with morbidity and other plasma factors of cardiovascular diseases were investigated.

The general analysis of the results showed no asso- ciation between individuals with the E4 allele and the morbi- dity and comorbidity associated with cardiovascular disea- ses, except the occurrence of a significantly higher number of obese individuals with the E3E3 genotype.

The lack of association with cardiovascular morbidity is not surprising, because data in the literature are contro- versial. The studies in which a relation between cardiovas- cular diseases and ApoE genotypes was found report an

Our results suggest the hypothesis that we need to in- crease knowledge about the elderly with longevity, because data in the literature show that the elderly have a biology and a set of risk factors for cardiovascular diseases diffe-

gher than those in E3E3 individuals, suggesting the influ- ence of additional environmental factors that were not ana- lyzed in the study (such as nutritional condition) or the inte- raction with other genetic factors that could reduce or neu- tralize the negative effects caused by the E4 allele or reduce the beneficial effects of the E3E3 genotype (such as high uric acid levels). Complementary studies on the relation to other genetic polymorphisms in this population may help to elucidate this hypothesis.