Genetic predisposition to higher blood pressure increases risk of incident hypertension and cardiovascular diseases in Chinese

Xiangfeng Lu; Jianfeng Huang; Laiyuan Wang; Shufeng Chen; Xueli Yang; Jianxin Li; Jie Cao; Jichun Chen; Ying Li; Liancheng Zhao; Hongfan Li; Fangcao Liu; Chen Huang; Chong Shen; Jinjin Shen; Ling Yu; Lihua Xu; Jianjun Mu; Xianping Wu; Xu Ji; Dongshuang Guo; Zhengyuan Zhou; Zili Yang; Renping Wang; Jun Yang; Weili Yan; Dongfeng Gu

doi:10.1161/HYPERTENSIONAHA.115.05961

Genetic predisposition to higher blood pressure increases risk of incident hypertension and cardiovascular diseases in Chinese

Hypertension. 2015 Oct;66(4):786-92. doi: 10.1161/HYPERTENSIONAHA.115.05961. Epub 2015 Aug 17.

Authors

Xiangfeng Lu¹, Jianfeng Huang¹, Laiyuan Wang¹, Shufeng Chen¹, Xueli Yang¹, Jianxin Li¹, Jie Cao¹, Jichun Chen¹, Ying Li¹, Liancheng Zhao¹, Hongfan Li¹, Fangcao Liu¹, Chen Huang¹, Chong Shen¹, Jinjin Shen¹, Ling Yu¹, Lihua Xu¹, Jianjun Mu¹, Xianping Wu¹, Xu Ji¹, Dongshuang Guo¹, Zhengyuan Zhou¹, Zili Yang¹, Renping Wang¹, Jun Yang¹, Weili Yan¹, Dongfeng Gu²

Affiliations

¹ From the State Key Laboratory of Cardiovascular Disease (X.L., L.W., S.C., X.Y., J.L., J. Cao, J. Chen, Y.L., L.Z., F.L., C.H., D. Gu) and Hypertension Division (J.H.), Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Human Genome Center at Beijing, Beijing, China (L.W., H.L.); Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China (C.S.); Yancheng Municipal Center for Disease Control and Prevention, Yancheng, Jiangsu, China (J.S.); Department of Cardiology, Fujian Provincial People's Hospital, Fuzhou, Fujian, China (L.Y.); Department of Cardiology, the Affiliated Hospital of Beihua University, Beihua University, Jilin, China (L.X.); Department of Cardiology, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shannxi, China (J.M.); Center for Chronic and Noncommunicable Disease Control and Prevention, Sichuan Center of Disease Control and Prevention, Chengdu, Sichuan, China (X.W.); Department of Internal Medicine, Xinle Red Cross Hospital, Xinle, Hebei, China (X.J.); Department of Internal Medicine, Yuxian Renmin Hospital, Yuxian, Shanxi, China (D. Guo); Changshu Center of Disease Control and Prevention, Changshu, Jiangsu, China (Z.Z.); Nantong Center of Disease Control and Prevention, Nantong, Jiangsu, China (Z.Y.); Department of Internal Medicine, Shijiazhuang Greatwall Hospital, Shijiazhuang, Hebei, China (R.W.); Department of Cardiology, Hanzhong People's Hospital, Hanzhong, Shannxi, China (J.Y.); and Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China (W.Y.).
² From the State Key Laboratory of Cardiovascular Disease (X.L., L.W., S.C., X.Y., J.L., J. Cao, J. Chen, Y.L., L.Z., F.L., C.H., D. Gu) and Hypertension Division (J.H.), Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Human Genome Center at Beijing, Beijing, China (L.W., H.L.); Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China (C.S.); Yancheng Municipal Center for Disease Control and Prevention, Yancheng, Jiangsu, China (J.S.); Department of Cardiology, Fujian Provincial People's Hospital, Fuzhou, Fujian, China (L.Y.); Department of Cardiology, the Affiliated Hospital of Beihua University, Beihua University, Jilin, China (L.X.); Department of Cardiology, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shannxi, China (J.M.); Center for Chronic and Noncommunicable Disease Control and Prevention, Sichuan Center of Disease Control and Prevention, Chengdu, Sichuan, China (X.W.); Department of Internal Medicine, Xinle Red Cross Hospital, Xinle, Hebei, China (X.J.); Department of Internal Medicine, Yuxian Renmin Hospital, Yuxian, Shanxi, China (D. Guo); Changshu Center of Disease Control and Prevention, Changshu, Jiangsu, China (Z.Z.); Nantong Center of Disease Control and Prevention, Nantong, Jiangsu, China (Z.Y.); Department of Internal Medicine, Shijiazhuang Greatwall Hospital, Shijiazhuang, Hebei, China (R.W.); Department of Cardiology, Hanzhong People's Hospital, Hanzhong, Shannxi, China (J.Y.); and Department of Clinical Epidemiology, Children's Hospital of Fudan University, Shanghai, China (W.Y.). gudongfeng@vip.sina.com.

PMID: 26283040
DOI: 10.1161/HYPERTENSIONAHA.115.05961

Abstract

Although multiple genetic markers associated with blood pressure have been identified by genome-wide association studies, their aggregate effect on risk of incident hypertension and cardiovascular disease is uncertain, particularly among East Asian who may have different genetic and environmental exposures from Europeans. We aimed to examine the association between genetic predisposition to higher blood pressure and risk of incident hypertension and cardiovascular disease in 26 262 individuals in 2 Chinese population-based prospective cohorts. A genetic risk score was calculated based on 22 established variants for blood pressure in East Asian. We found the genetic risk score was significantly and independently associated with linear increases in blood pressure and risk of incident hypertension and cardiovascular disease (P range from 4.57×10(-3) to 3.10×10(-6)). In analyses adjusted for traditional risk factors including blood pressure, individuals carrying most blood pressure-related risk alleles (top quintile of genetic score distribution) had 40% (95% confidence interval, 18-66) and 26% (6-45) increased risk for incident hypertension and cardiovascular disease, respectively, when compared with individuals in the bottom quintile. The genetic risk score also significantly improved discrimination for incident hypertension and cardiovascular disease and led to modest improvements in risk reclassification for cardiovascular disease (all the P<0.05). Our data indicate that genetic predisposition to higher blood pressure is an independent risk factor for blood pressure increase and incident hypertension and cardiovascular disease and provides modest incremental information to cardiovascular disease risk prediction. The potential clinical use of this panel of blood pressure-associated polymorphisms remains to be determined.

Keywords: blood pressure; cardiovascular diseases; genetic markers; hypertension; incidence.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Blood Pressure / physiology*
Blood Pressure Determination
Cardiovascular Diseases / epidemiology
Cardiovascular Diseases / genetics
Cardiovascular Diseases / physiopathology
China / epidemiology
Female
Follow-Up Studies
Genetic Predisposition to Disease*
Genome-Wide Association Study
Humans
Hypertension / epidemiology
Hypertension / genetics*
Hypertension / physiopathology
Male
Middle Aged
Morbidity / trends
Polymorphism, Genetic*
Prospective Studies
Risk Assessment / methods*
Risk Factors