Raha Pazoki1, Abbas Dehghan1,2, Evangelos Evangelou1,3, Helen Warren4,5, He Gao1,2, Mark Caulfield4,5, Paul Elliott6,2, Ioanna Tzoulaki1,2,3. 1. Department of Biostatistics and Epidemiology, School of Public Health, Imperial College London, United Kingdom (R.P., A.D., E.E., H.G., P.E., I.T.). 2. MRC-PHE Centre for Environment, School of Public Health, Imperial College London, United Kingdom (A.D., H.G., P.E., I.T.). 3. Department of Hygiene and Epidemiology, University of Ioannina Medical School, Greece (E.E., I.T.). 4. William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom (H.W., M.C.). 5. National Institute for Health Research, Barts Cardiovascular Biomedical Research Center, Queen Mary University of London, United Kingdom (H.W., M.C.). 6. Department of Biostatistics and Epidemiology, School of Public Health, Imperial College London, United Kingdom (R.P., A.D., E.E., H.G., P.E., I.T.) p.elliott@imperial.ac.uk itzoulak@cc.uoi.gr.
Abstract
BACKGROUND: High blood pressure (BP) is a major risk factor for cardiovascular diseases (CVDs), the leading cause of mortality worldwide. Both heritable and lifestyle risk factors contribute to elevated BP levels. We aimed to investigate the extent to which lifestyle factors could offset the effect of an adverse BP genetic profile and its effect on CVD risk. METHODS: We constructed a genetic risk score for high BP by using 314 published BP loci in 277 005 individuals without previous CVD from the UK Biobank study, a prospective cohort of individuals aged 40 to 69 years, with a median of 6.11 years of follow-up. We scored participants according to their lifestyle factors including body mass index, healthy diet, sedentary lifestyle, alcohol consumption, smoking, and urinary sodium excretion levels measured at recruitment. We examined the association between tertiles of genetic risk and tertiles of lifestyle score with BP levels and incident CVD by using linear regression and Cox regression models, respectively. RESULTS: Healthy lifestyle score was strongly associated with BP (P<10-320) for systolic and diastolic BP and CVD events regardless of the underlying BP genetic risk. Participants with a favorable in comparison with an unfavorable lifestyle (bottom versus top tertile lifestyle score) had 3.6, 3.5, and 3.6 mm Hg lower systolic BP in low, middle, and high genetic risk groups, respectively (P for interaction=0.0006). Similarly, favorable in comparison with unfavorable lifestyle showed 30%, 33%, and 31% lower risk of CVD among participants in low, middle, and high genetic risk groups, respectively (P for interaction=0.99). CONCLUSIONS: Our data further support population-wide efforts to lower BP in the population via lifestyle modification. The advantages and disadvantages of disclosing genetic predisposition to high BP for risk stratification needs careful evaluation.
BACKGROUND: High blood pressure (BP) is a major risk factor for cardiovascular diseases (CVDs), the leading cause of mortality worldwide. Both heritable and lifestyle risk factors contribute to elevated BP levels. We aimed to investigate the extent to which lifestyle factors could offset the effect of an adverse BP genetic profile and its effect on CVD risk. METHODS: We constructed a genetic risk score for high BP by using 314 published BP loci in 277 005 individuals without previous CVD from the UK Biobank study, a prospective cohort of individuals aged 40 to 69 years, with a median of 6.11 years of follow-up. We scored participants according to their lifestyle factors including body mass index, healthy diet, sedentary lifestyle, alcohol consumption, smoking, and urinary sodium excretion levels measured at recruitment. We examined the association between tertiles of genetic risk and tertiles of lifestyle score with BP levels and incident CVD by using linear regression and Cox regression models, respectively. RESULTS: Healthy lifestyle score was strongly associated with BP (P<10-320) for systolic and diastolic BP and CVD events regardless of the underlying BP genetic risk. Participants with a favorable in comparison with an unfavorable lifestyle (bottom versus top tertile lifestyle score) had 3.6, 3.5, and 3.6 mm Hg lower systolic BP in low, middle, and high genetic risk groups, respectively (P for interaction=0.0006). Similarly, favorable in comparison with unfavorable lifestyle showed 30%, 33%, and 31% lower risk of CVD among participants in low, middle, and high genetic risk groups, respectively (P for interaction=0.99). CONCLUSIONS: Our data further support population-wide efforts to lower BP in the population via lifestyle modification. The advantages and disadvantages of disclosing genetic predisposition to high BP for risk stratification needs careful evaluation.
Authors: Pedro L Valenzuela; Pedro Carrera-Bastos; Beatriz G Gálvez; Gema Ruiz-Hurtado; José M Ordovas; Luis M Ruilope; Alejandro Lucia Journal: Nat Rev Cardiol Date: 2020-10-09 Impact factor: 32.419
Authors: Oyomoare L Osazuwa-Peters; R J Waken; Karen L Schwander; Yun Ju Sung; Paul S de Vries; Sarah M Hartz; Daniel I Chasman; Alanna C Morrison; Laura J Bierut; Chengjie Xiong; Lisa de Las Fuentes; D C Rao Journal: Genet Epidemiol Date: 2020-03-29 Impact factor: 2.135