BACKGROUND AND OBJECTIVES: Cardiovascular disease (CVD) is a complex multigenic disorder, with significant inheritable elements having important roles relating to environmental factors. Recently, the alpha 2 adrenoceptor (alpha(2)-AR) gene has been reported to be involved in the development of coronary artery disease (CAD). The aim of this study was to investigate the relationships between an insertion/deletion (I/D) in alpha(2B)-AR and CAD in Korean subjects. SUBJECTS AND METHODS: The alpha(2B)-AR I/D polymorphism, which was located in the third intracellular loop of the receptor polypeptide, was examined in 292 patients (M:F=219:73) with CAD and 151 healthy control subjects (M:F=70:81) who visited the Cardiovascular Genome Center in Yonsei Cardiovascular Hospital. RESULTS: In the patient group, 77 men (35.1%) and 26 women (35.6%) had the I/I genotype; 105 men (47.9%) and 39 women (53.4%) a heterozygous genotype and 37 (17.0%) and 8 (11.0%) the D/D genotype. In the controls, 23 men (32.8%) and 29 women (35.8%) had the I/I genotype; 38 (54.3%) and 39 (48.1%) the I/D genotype and 9 (12.9%) and 13 (16.1%) the D/D genotype. There were no differences in the genotype frequencies between the patient and control groups, either in men or women. From a logistical regression analysis, the alpha(2B)-AR genotype was not significantly associated with CAD in our study group. CONCLUSION: The alpha(2B)-AR I/D polymorphism is not a risk factor for CAD in the Korean population.