Genetic predisposition to high blood pressure and lifestyle factors. Associations with midlife blood pressure levels and cardiovascular events
File(s)
Author(s)
Type
Journal Article
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 4.9, 4.3, and 4.1 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.
Date Issued
2018-02-13
Date Acceptance
2017-10-16
ISSN
0009-7322
Publisher
American Heart Association
Start Page
653
End Page
661
Journal / Book Title
Circulation
Volume
137
Issue
7
Replaces
10044/1/68472
Copyright Statement
© 2017 American Heart Association, Inc.
Sponsor
Imperial College Healthcare NHS Trust- BRC Funding
Medical Research Council (MRC)
Medical Research Council (MRC)
British Heart Foundation
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000459428700002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
RDF03
MR/L01632X/1
MR/L01632X/1
SP/13/2/30111
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Peripheral Vascular Disease
Cardiovascular System & Cardiology
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Peripheral Vascular Disease
Cardiovascular System & Cardiology
blood pressure
cardiovascular diseases
genetic predisposition to disease
genetics
healthy lifestyle
risk
REGRESSION DILUTION BIAS
RISK-FACTORS
PHYSICAL-ACTIVITY
INTERSALT
COHORT
HYPERTENSION
INDIVIDUALS
EXCRETION
PATTERN
blood pressure
cardiovascular diseases
genetic predisposition to disease
genetics
healthy lifestyle
risk
Blood Pressure
Body Mass Index
Diet, Healthy
Female
Follow-Up Studies
Genetic Loci
Genetic Predisposition to Disease
Humans
Hypertension
Life Style
Male
Middle Aged
Risk Factors
Humans
Hypertension
Genetic Predisposition to Disease
Body Mass Index
Risk Factors
Follow-Up Studies
Life Style
Blood Pressure
Middle Aged
Female
Male
Genetic Loci
Diet, Healthy
Cardiovascular System & Hematology
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
1117 Public Health and Health Services
Publication Status
Published
Date Publish Online
2017-12-18