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Abstract
Hypertension is a frequent finding in elderly patients. Hypertension in older age can be both associated with frailty and represent a risk factor for frailty. Hypertension is recognized as a main risk factor for cardiovascular diseases such as heart failure, atrial fibrillation, and stroke and the occurrence of these diseases may provoke a decline in health status and/or worsen the degree of frailty. Blood pressure targets in hypertensive older and frail patients are not completely defined. However, specific evaluations of individual patients and their co-morbidities and assessment of domains and components of frailty, together with weighted consideration of drug use, may help in finding the appropriate therapy.
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Belyaeva II, Subbotina AG, Eremenko II, Tarasov VV, Chubarev VN, Schiöth HB, Mwinyi J. Pharmacogenetics in Primary Headache Disorders. Front Pharmacol 2022; 12:820214. [PMID: 35222013 PMCID: PMC8866828 DOI: 10.3389/fphar.2021.820214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/23/2021] [Indexed: 11/09/2022] Open
Abstract
Primary headache disorders, such as migraine, tension-type headache (TTH), and cluster headache, belong to the most common neurological disorders affecting a high percentage of people worldwide. Headache induces a high burden for the affected individuals on the personal level, with a strong impact on life quality, daily life management, and causes immense costs for the healthcare systems. Although a relatively broad spectrum of different pharmacological classes for the treatment of headache disorders are available, treatment effectiveness is often limited by high variances in therapy responses. Genetic variants can influence the individual treatment success by influencing pharmacokinetics or pharmacodynamics of the therapeutic as investigated in the research field of pharmacogenetics. This review summarizes the current knowledge on important primary headache disorders, including migraine, TTH, and cluster headache. We also summarize current acute and preventive treatment options for the three headache disorders based on drug classes and compounds taking important therapy guidelines into consideration. Importantly, the work summarizes and discusses the role of genetic polymorphisms regarding their impact on metabolism safety and the effect of therapeutics that are used to treat migraine, cluster headache, and TTH exploring drug classes such as nonsteroidal anti-inflammatory drugs, triptans, antidepressants, anticonvulsants, calcium channel blockers, drugs with effect on the renin-angiotensin system, and novel headache therapeutics such as ditans, anti-calcitonin-gene-related peptide antibodies, and gepants. Genetic variants in important phase I-, II-, and III-associated genes such as cytochrome P450 genes, UGT genes, and different transporter genes are scrutinized as well as variants in genes important for pharmacodynamics and several functions outside the pharmacokinetic and pharmacodynamic spectrum. Finally, the article evaluates the potential and limitations of pharmacogenetic approaches for individual therapy adjustments in headache disorders.
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Affiliation(s)
- Irina I. Belyaeva
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, University of Uppsala, Uppsala, Sweden,Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Anna G. Subbotina
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, University of Uppsala, Uppsala, Sweden,Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ivan I. Eremenko
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, University of Uppsala, Uppsala, Sweden,Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Vadim V. Tarasov
- Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia,Institute of Translational Medicine and Biotechnology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Vladimir N. Chubarev
- Department of Pharmacology, Institute of Pharmacy, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Helgi B. Schiöth
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, University of Uppsala, Uppsala, Sweden,Institute of Translational Medicine and Biotechnology, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Jessica Mwinyi
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, University of Uppsala, Uppsala, Sweden,*Correspondence: Jessica Mwinyi,
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3
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Babayeva M, Azzi B, Loewy ZG. Pharmacogenomics Informs Cardiovascular Pharmacotherapy. Methods Mol Biol 2022; 2547:201-240. [PMID: 36068466 DOI: 10.1007/978-1-0716-2573-6_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Precision medicine exemplifies the emergence of personalized treatment options which may benefit specific patient populations based upon their genetic makeup. Application of pharmacogenomics requires an understanding of how genetic variations impact pharmacokinetic and pharmacodynamic properties. This particular approach in pharmacotherapy is helpful because it can assist in and improve clinical decisions. Application of pharmacogenomics to cardiovascular pharmacotherapy provides for the ability of the medical provider to gain critical knowledge on a patient's response to various treatment options and risk of side effects.
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Affiliation(s)
| | | | - Zvi G Loewy
- Touro College of Pharmacy, New York, NY, USA.
- School of Medicine, New York Medical College, Valhalla, NY, USA.
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4
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Rahman F, Muthaiah N, Kumaramanickavel G. Current concepts and molecular mechanisms in pharmacogenetics of essential hypertension. Indian J Pharmacol 2021; 53:301-309. [PMID: 34414909 PMCID: PMC8411967 DOI: 10.4103/ijp.ijp_593_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Hypertension is a leading age-related disease in our society and if left untreated, leads to fatal cardiovascular complications. The prevalence of hypertension has increased and becomes a significant global health economic burden, particularly in lower-income societies. Many loci associated with blood pressure and hypertension have been reported by genome-wide association studies that provided potential targets for pharmacotherapy. Pharmacogenetic research had shown interindividual variations in drug efficacy, safety, and tolerability. This could be due to genetic polymorphisms in the pharmacokinetics (genes involved in a transporter, plasma protein binding, and metabolism) or pharmacodynamic pathway (receptors, ion channels, enzymes). Pharmacogenetics promises great hope toward targeted therapy, but challenges remain in implementing pharmacogenetic aided antihypertensive therapy in clinical practice. Using various databases, we analyzed the underlying mechanisms between the candidate gene polymorphisms and antihypertensive drug interactions and the challenges of implementing precision medicine. We review the emergence of pharmacogenetics and its relevance to clinical pharmacological practice.
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Affiliation(s)
- Farhana Rahman
- Department of Pharmacology, Sree Balaji Medical College and Hospital, Bharat University, Chennai, Tamil Nadu, India
| | - Nagasundaram Muthaiah
- Department of Pharmacology, Sree Balaji Medical College and Hospital, Bharat University, Chennai, Tamil Nadu, India
| | - Govindasamy Kumaramanickavel
- Genomic Research Centre, Sree Balaji Medical College and Hospital, Bharat University, Chennai, Tamil Nadu, India
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5
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Rysz J, Franczyk B, Rysz-Górzyńska M, Gluba-Brzózka A. Pharmacogenomics of Hypertension Treatment. Int J Mol Sci 2020; 21:ijms21134709. [PMID: 32630286 PMCID: PMC7369859 DOI: 10.3390/ijms21134709] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/21/2020] [Accepted: 06/26/2020] [Indexed: 12/12/2022] Open
Abstract
Hypertension is one of the strongest modifiable cardiovascular risk factors, affecting an increasing number of people worldwide. Apart from poor medication adherence, the low efficacy of some therapies could also be related to inter-individual genetic variability. Genetic studies of families revealed that heritability accounts for 30% to 50% of inter-individual variation in blood pressure (BP). Genetic factors not only affect blood pressure (BP) elevation but also contribute to inter-individual variability in response to antihypertensive treatment. This article reviews the recent pharmacogenomics literature concerning the key classes of antihypertensive drugs currently in use (i.e., diuretics, β-blockers, ACE inhibitors, ARB, and CCB). Due to the numerous studies on this topic and the sometimes-contradictory results within them, the presented data are limited to several selected SNPs that alter drug response. Genetic polymorphisms can influence drug responses through genes engaged in the pathogenesis of hypertension that are able to modify the effects of drugs, modifications in drug–gene mechanistic interactions, polymorphisms within drug-metabolizing enzymes, genes related to drug transporters, and genes participating in complex cascades and metabolic reactions. The results of numerous studies confirm that genotype-based antihypertension therapies are the most effective and may help to avoid the occurrence of major adverse events, as well as decrease the costs of treatment. However, the genetic heritability of drug response phenotypes seems to remain hidden in multigenic and multifactorial complex traits. Therefore, further studies are required to analyze all associations and formulate final genome-based treatment recommendations.
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Affiliation(s)
- Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 90-549 Lodz, Poland; (J.R.); (B.F.)
| | - Beata Franczyk
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 90-549 Lodz, Poland; (J.R.); (B.F.)
| | - Magdalena Rysz-Górzyńska
- Department of Ophthalmology and Visual Rehabilitation, Medical University of Lodz, 90-549 Lodz, Poland;
| | - Anna Gluba-Brzózka
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 90-549 Lodz, Poland; (J.R.); (B.F.)
- Correspondence:
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Oliveira-Paula GH, Pereira SC, Tanus-Santos JE, Lacchini R. Pharmacogenomics And Hypertension: Current Insights. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2019; 12:341-359. [PMID: 31819590 PMCID: PMC6878918 DOI: 10.2147/pgpm.s230201] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 11/05/2019] [Indexed: 11/23/2022]
Abstract
Hypertension is a multifactorial disease that affects approximately one billion subjects worldwide and is a major risk factor associated with cardiovascular events, including coronary heart disease and cerebrovascular accidents. Therefore, adequate blood pressure control is important to prevent these events, reducing premature mortality and disability. However, only one third of patients have the effective control of blood pressure, despite several classes of antihypertensive drugs available. These disappointing outcomes may be at least in part explained by interpatient variability in drug response due to genetic polymorphisms. To address the effects of genetic polymorphisms on blood pressure responses to the antihypertensive drug classes, studies have applied candidate genes and genome wide approaches. More recently, a third approach that considers gene-gene interactions has also been applied in hypertension pharmacogenomics. In this article, we carried out a comprehensive review of recent findings on the pharmacogenomics of antihypertensive drugs, including diuretics, β-blockers, angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, and calcium channel blockers. We also discuss the limitations and inconsistences that have been found in hypertension pharmacogenomics and the challenges to implement this valuable approach in clinical practice.
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Affiliation(s)
- Gustavo H Oliveira-Paula
- Department of Medicine, Division of Cardiology, Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, New York, NY, USA.,Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Sherliane C Pereira
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Jose E Tanus-Santos
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Riccardo Lacchini
- Department of Psychiatric Nursing and Human Sciences, Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirao Preto, SP, Brazil
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Cunningham PN, Wang Z, Grove ML, Cooper-DeHoff RM, Beitelshees AL, Gong Y, Gums JG, Johnson JA, Turner ST, Boerwinkle E, Chapman AB. Hypertensive APOL1 risk allele carriers demonstrate greater blood pressure reduction with angiotensin receptor blockade compared to low risk carriers. PLoS One 2019; 14:e0221957. [PMID: 31532792 PMCID: PMC6750571 DOI: 10.1371/journal.pone.0221957] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 08/19/2019] [Indexed: 12/12/2022] Open
Abstract
Background Hypertension (HTN) disproportionately affects African Americans (AAs), who respond better to thiazide diuretics than other antihypertensives. Variants of the APOL1 gene found in AAs are associated with a higher rate of kidney disease and play a complex role in cardiovascular disease. Methods AA subjects from four HTN trials (n = 961) (GERA1, GERA2, PEAR1, and PEAR2) were evaluated for blood pressure (BP) response based on APOL1 genotype after 4–9 weeks of monotherapy with thiazides, beta blockers, or candesartan. APOL1 G1 and G2 variants were determined by direct sequencing or imputation. Results Baseline systolic BP (SBP) and diastolic BP (DBP) levels did not differ based on APOL1 genotype. Subjects with 1–2 APOL1 risk alleles had a greater SBP response to candesartan (-12.2 +/- 1.2 vs -7.5 +/- 1.8 mmHg, p = 0.03; GERA2), and a greater decline in albuminuria with candesartan (-8.3 +/- 3.1 vs +3.7 +/- 4.3 mg/day, p = 0.02). APOL1 genotype did not associate with BP response to thiazides or beta blockers. GWAS was performed to determine associations with BP response to candesartan depending on APOL1 genotype. While no SNPs reached genome wide significance, SNP rs10113352, intronic in CSMD1, predicted greater office SBP response to candesartan (p = 3.7 x 10−7) in those with 1–2 risk alleles, while SNP rs286856, intronic in DPP6, predicted greater office SBP response (p = 3.2 x 10−7) in those with 0 risk alleles. Conclusions Hypertensive AAs without overt kidney disease who carry 1 or more APOL1 risk variants have a greater BP and albuminuria reduction in response to candesartan therapy. BP response to thiazides or beta blockers did not differ by APOL1 genotype. Future studies confirming this initial finding in an independent cohort are required.
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Affiliation(s)
- Patrick N. Cunningham
- Section of Nephrology, University of Chicago, Chicago, Illinois, United States of America
- * E-mail:
| | - Zhiying Wang
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Megan L. Grove
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
| | - Rhonda M. Cooper-DeHoff
- Department of Pharmacotherapy and Translational Research, College of Pharmacy and Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Amber L. Beitelshees
- Endocrinology, Diabetes, and Nutrition Division, Department of Medicine, University of Maryland, Baltimore, Maryland, United States of America
| | - Yan Gong
- Department of Pharmacotherapy and Translational Research, College of Pharmacy and Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - John G. Gums
- Department of Pharmacotherapy and Translational Research, College of Pharmacy and Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Julie A. Johnson
- Department of Pharmacotherapy and Translational Research, College of Pharmacy and Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Stephen T. Turner
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Eric Boerwinkle
- Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, United States of America
- Baylor College of Medicine, Human Genome Sequencing Center, Houston, Texas, United States of America
| | - Arlene B. Chapman
- Section of Nephrology, University of Chicago, Chicago, Illinois, United States of America
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8
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Abstract
AIM Protein kinase Cα (PKCα) is a critical regulator of multiple cell signaling pathways including gene transcription, posttranslation modifications and activation/inhibition of many signaling kinases. In regards to the control of blood pressure, PKCα causes increased vascular smooth muscle contractility, while reducing cardiac contractility. In addition, PKCα has been shown to modulate nephron ion transport. However, the role of PKCα in modulating mean arterial pressure (MAP) has not been investigated. In this study, we used a whole animal PKCα knock out (PKC KO) to test the hypothesis that global PKCα deficiency would reduce MAP, by a reduction in vascular contractility. METHODS Radiotelemetry measurements of ambulatory blood pressure (day/night) were obtained for 18 h/day during both normal chow and high-salt (4%) diet feedings. PKCα mice had a reduced MAP, as compared with control, which was not normalized with high-salt diet (14 days). Metabolic cage studies were performed to determine urinary sodium excretion. RESULTS PKC KO mice had a significantly lower diastolic, systolic and MAP as compared with control. No significant differences in urinary sodium excretion were observed between the PKC KO and control mice, whether fed normal chow or high-salt diet. Western blot analysis showed a compensatory increase in renal sodium chloride cotransporter expression. Both aorta and mesenteric vessels were removed for vascular reactivity studies. Aorta and mesenteric arteries from PKC KO mice had a reduced receptor-independent relaxation response, as compared with vessels from control. Vessels from PKC KO mice exhibited a decrease in maximal contraction, compared with controls. CONCLUSION Together, these data suggest that global deletion of PKCα results in reduced MAP due to decreased vascular contractility.
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9
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Ng FL, Warren HR, Caulfield MJ. Hypertension genomics and cardiovascular prevention. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:291. [PMID: 30211179 DOI: 10.21037/atm.2018.06.34] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Hypertension continues to be a major risk factor for global mortality, and recent genome-wide association studies (GWAS) have expanded in size, leading to the identification of further genetic loci influencing blood pressure. In light of the new knowledge from the largest cardiovascular GWAS to date, we review the potential impact of genomics on discovering potential drug targets, risk stratification with genetic risk scores, drug selection with pharmacogenetics, and exploring insights provided by gene-environment interactions.
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Affiliation(s)
- Fu Liang Ng
- William Harvey Research Institute, The NIHR Biomedical Research Centre at Barts, Queen Mary University London, London, UK.,Barts BP Centre of Excellence, Barts Heart Centre, The NIHR Biomedical Research Centre at Barts, St Bartholomew's Hospital, W Smithfield, London, UK
| | - Helen R Warren
- William Harvey Research Institute, The NIHR Biomedical Research Centre at Barts, Queen Mary University London, London, UK
| | - Mark J Caulfield
- William Harvey Research Institute, The NIHR Biomedical Research Centre at Barts, Queen Mary University London, London, UK.,Barts BP Centre of Excellence, Barts Heart Centre, The NIHR Biomedical Research Centre at Barts, St Bartholomew's Hospital, W Smithfield, London, UK
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10
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Rausch JC, Lavine JE, Chalasani N, Guo X, Kwon S, Schwimmer JB, Molleston JP, Loomba R, Brunt EM, da Chen YDI, Goodarzi MO, Taylor KD, Yates KP, Rotter JI. Genetic Variants Associated With Obesity and Insulin Resistance in Hispanic Boys With Nonalcoholic Fatty Liver Disease. J Pediatr Gastroenterol Nutr 2018; 66:789-796. [PMID: 29470286 PMCID: PMC5916321 DOI: 10.1097/mpg.0000000000001926] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Nonalcoholic fatty liver disease (NAFLD) disproportionately affects Hispanic boys. Further, obesity and insulin resistance are major risk factors for NAFLD. No gene localization studies had been performed on children with biopsy-proven NAFLD. This study aims to identify genomic variants associated with increased adiposity and insulin resistance in a population of children with varying histologic severity of NAFLD. METHODS We conducted a genome-wide association scan (GWAS) including 624,297 single-nucleotide polymorphisms (SNPs) distributed among all 22 autosomal chromosomes in 234 Hispanic boys (up to 18 years of age) who were consecutively recruited in a prospective cohort study in the Nonalcoholic Steatohepatitis Clinical Research Network Studies. Traits were examined quantitatively using linear regression. SNPs with P value <10 and a minor allele frequency >5% were considered potentially significant. RESULTS Evaluated subjects had a median age of 12.0 years, body mass index (BMI) of 31.4, and hemoglobin A1C (Hgb A1C) of 5.3. The prevalence of NAFL, borderline NASH, and definite NASH were 23%, 53%, and 22%, respectively. The GWAS identified 10 SNPs that were associated with BMI z score, 6 within chromosome 2, and 1 within CAMK1D, which has a potential role in liver gluconeogenesis. In addition, the GWAS identified 9 novel variants associated with insulin resistance: HOMA-IR (6) and HbA1c (3). CONCLUSIONS This study of Hispanic boys with biopsy-proven NAFLD with increased risk for the metabolic syndrome revealed novel genetic variants that are associated with obesity and insulin resistance.
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Affiliation(s)
| | | | | | - Xiuqing Guo
- Institute for Translational Genomics and Population Science and Pediatrics, LA BioMed at Harbor-UCLA Medical Center, Los Angeles, CA
| | - Soonil Kwon
- Institute for Translational Genomics and Population Science and Pediatrics, LA BioMed at Harbor-UCLA Medical Center, Los Angeles, CA
| | | | | | - Rohit Loomba
- Medicine, University of California, San Diego, San Diego, CA
| | | | - Yii-Der I da Chen
- Institute for Translational Genomics and Population Science and Pediatrics, LA BioMed at Harbor-UCLA Medical Center, Los Angeles, CA
| | - Mark O Goodarzi
- Division of Endocrinology, Diabetes and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Kent D Taylor
- Institute for Translational Genomics and Population Science and Pediatrics, LA BioMed at Harbor-UCLA Medical Center, Los Angeles, CA
| | - Katherine P Yates
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Science and Pediatrics, LA BioMed at Harbor-UCLA Medical Center, Los Angeles, CA
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Halladay JR, Lenhart KC, Robasky K, Jones W, Homan WF, Cummings DM, Cené CW, Hinderliter AL, Miller CL, Donahue KE, Garcia BA, Keyserling TC, Ammerman AS, Patterson C, DeWalt DA, Johnston LF, Willis MS, Schisler JC. Applicability of Precision Medicine Approaches to Managing Hypertension in Rural Populations. J Pers Med 2018; 8:E16. [PMID: 29710874 PMCID: PMC6023309 DOI: 10.3390/jpm8020016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/23/2018] [Accepted: 04/23/2018] [Indexed: 12/28/2022] Open
Abstract
As part of the Heart Healthy Lenoir Project, we developed a practice level intervention to improve blood pressure control. The goal of this study was: (i) to determine if single nucleotide polymorphisms (SNPs) that associate with blood pressure variation, identified in large studies, are applicable to blood pressure control in subjects from a rural population; (ii) to measure the association of these SNPs with subjects' responsiveness to the hypertension intervention; and (iii) to identify other SNPs that may help understand patient-specific responses to an intervention. We used a combination of candidate SNPs and genome-wide analyses to test associations with either baseline systolic blood pressure (SBP) or change in systolic blood pressure one year after the intervention in two genetically defined ancestral groups: African Americans (AA) and Caucasian Americans (CAU). Of the 48 candidate SNPs, 13 SNPs associated with baseline SBP in our study; however, one candidate SNP, rs592582, also associated with a change in SBP after one year. Using our study data, we identified 4 and 15 additional loci that associated with a change in SBP in the AA and CAU groups, respectively. Our analysis of gene-age interactions identified genotypes associated with SBP improvement within different age groups of our populations. Moreover, our integrative analysis identified AQP4-AS1 and PADI2 as genes whose expression levels may contribute to the pleiotropy of complex traits involved in cardiovascular health and blood pressure regulation in response to an intervention targeting hypertension. In conclusion, the identification of SNPs associated with the success of a hypertension treatment intervention suggests that genetic factors in combination with age may contribute to an individual's success in lowering SBP. If these findings prove to be applicable to other populations, the use of this genetic variation in making patient-specific interventions may help providers with making decisions to improve patient outcomes. Further investigation is required to determine the role of this genetic variance with respect to the management of hypertension such that more precise treatment recommendations may be made in the future as part of personalized medicine.
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Affiliation(s)
- Jacqueline R Halladay
- Department of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Kaitlin C Lenhart
- McAllister Heart Institute at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Kimberly Robasky
- Q2 Solutions|EA Genomics, Morrisville, North Carolina. 27560, USA.
| | - Wendell Jones
- Q2 Solutions|EA Genomics, Morrisville, North Carolina. 27560, USA.
| | - Wayne F Homan
- Department of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Doyle M Cummings
- Department of Family Medicine, East Carolina University, Greenville, NC 27834, USA.
| | - Crystal W Cené
- Cecil R. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Alan L Hinderliter
- Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Cassandra L Miller
- Center for Health Promotion and Disease Prevention at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Katrina E Donahue
- Department of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Cecil R. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Beverly A Garcia
- Center for Health Promotion and Disease Prevention at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Thomas C Keyserling
- Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Nutrition, Gillings School of Global Public Health at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Alice S Ammerman
- Center for Health Promotion and Disease Prevention at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Nutrition, Gillings School of Global Public Health at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Cam Patterson
- Presbyterian Hospital/Weill-Cornell Medical Center, New York, NY 10065, USA.
| | - Darren A DeWalt
- Cecil R. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Larry F Johnston
- Center for Health Promotion and Disease Prevention at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Monte S Willis
- McAllister Heart Institute at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Pharmacology and Department of Pathology and Lab Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
| | - Jonathan C Schisler
- McAllister Heart Institute at The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
- Department of Pharmacology and Department of Pathology and Lab Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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12
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Eadon MT, Kanuri SH, Chapman AB. Pharmacogenomic studies of hypertension: paving the way for personalized antihypertensive treatment. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2018; 3:33-47. [PMID: 29888336 DOI: 10.1080/23808993.2018.1420419] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Introduction Increasing clinical evidence supports the implementation of genotyping for anti-hypertensive drug dosing and selection. Despite robust evidence gleaned from clinical trials, the translation of genotype guided therapy into clinical practice faces significant challenges. Challenges to implementation include the small effect size of individual variants and the polygenetic nature of antihypertensive drug response, a lack of expert consensus on dosing guidelines even without genetic information, and proper definition of major antihypertensive drug toxicities. Balancing clinical benefit with cost, while overcoming these challenges, remains crucial. Areas covered This review presents the most impactful clinical trials and cohorts which continue to inform and guide future investigation. Variants were selected from among those identified in the Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR), the Genetic Epidemiology of Responses to Antihypertensives study (GERA), the Genetics of Drug Responsiveness in Essential Hypertension (GENRES) study, the SOPHIA study, the Milan Hypertension Pharmacogenomics of hydro-chlorothiazide (MIHYPHCTZ), the Campania Salute Network, the International Verapamil SR Trandolapril Study (INVEST), the Nordic Diltiazem (NORDIL) Study, GenHAT, and others. Expert Commentary The polygenic nature of antihypertensive drug response is a major barrier to clinical implementation. Further studies examining clinical effectiveness are required to support broad-based implementation of genotype-based prescribing in medical practice.
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Affiliation(s)
- Michael T Eadon
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sri H Kanuri
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Hiltunen TP, Rimpelä JM, Mohney RP, Stirdivant SM, Kontula KK. Effects of four different antihypertensive drugs on plasma metabolomic profiles in patients with essential hypertension. PLoS One 2017; 12:e0187729. [PMID: 29121091 PMCID: PMC5679533 DOI: 10.1371/journal.pone.0187729] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 10/25/2017] [Indexed: 12/24/2022] Open
Abstract
Objective In order to search for metabolic biomarkers of antihypertensive drug responsiveness, we measured >600 biochemicals in plasma samples of subjects participating in the GENRES Study. Hypertensive men received in a double-blind rotational fashion amlodipine, bisoprolol, hydrochlorothiazide and losartan, each as a monotherapy for one month, with intervening one-month placebo cycles. Methods Metabolomic analysis was carried out using ultra high performance liquid chromatography-tandem mass spectrometry. Full metabolomic signatures (the drug cycles and the mean of the 3 placebo cycles) became available in 38 to 42 patients for each drug. Blood pressure was monitored by 24-h recordings. Results Amlodipine (P values down to 0.002), bisoprolol (P values down to 2 x 10−5) and losartan (P values down to 2 x 10−4) consistently decreased the circulating levels of long-chain acylcarnitines. Bisoprolol tended to decrease (P values down to 0.002) the levels of several medium- and long-chain fatty acids. Hydrochlorothiazide administration was associated with an increase of plasma uric acid level (P = 5 x 10-4) and urea cycle metabolites. Decreases of both systolic (P = 0.06) and diastolic (P = 0.04) blood pressure after amlodipine administration tended to associate with a decrease of plasma hexadecanedioate, a dicarboxylic fatty acid recently linked to blood pressure regulation. Conclusions Although this systematic metabolomics study failed to identify circulating metabolites convincingly predicting favorable antihypertensive response to four different drug classes, it provided accumulating evidence linking fatty acid metabolism to human hypertension.
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Affiliation(s)
- Timo P. Hiltunen
- Department of Medicine, University of Helsinki, Helsinki, Finland
- Helsinki University Hospital, Helsinki, Finland
- * E-mail:
| | - Jenni M. Rimpelä
- Department of Medicine, University of Helsinki, Helsinki, Finland
- Helsinki University Hospital, Helsinki, Finland
| | | | | | - Kimmo K. Kontula
- Department of Medicine, University of Helsinki, Helsinki, Finland
- Helsinki University Hospital, Helsinki, Finland
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Abstract
Pharmacogenomics (PGx), a substantial component of "personalized medicine", seeks to understand each individual's genetic composition to optimize drug therapy -- maximizing beneficial drug response, while minimizing adverse drug reactions (ADRs). Drug responses are highly variable because innumerable factors contribute to ultimate phenotypic outcomes. Recent genome-wide PGx studies have provided some insight into genetic basis of variability in drug response. These can be grouped into three categories. [a] Monogenic (Mendelian) traits include early examples mostly of inherited disorders, and some severe (idiosyncratic) ADRs typically influenced by single rare coding variants. [b] Predominantly oligogenic traits represent variation largely influenced by a small number of major pharmacokinetic or pharmacodynamic genes. [c] Complex PGx traits resemble most multifactorial quantitative traits -- influenced by numerous small-effect variants, together with epigenetic effects and environmental factors. Prediction of monogenic drug responses is relatively simple, involving detection of underlying mutations; due to rarity of these events and incomplete penetrance, however, prospective tests based on genotype will have high false-positive rates, plus pharmacoeconomics will require justification. Prediction of predominantly oligogenic traits is slowly improving. Although a substantial fraction of variation can be explained by limited numbers of large-effect genetic variants, uncertainty in successful predictions and overall cost-benefit ratios will make such tests elusive for everyday clinical use. Prediction of complex PGx traits is almost impossible in the foreseeable future. Genome-wide association studies of large cohorts will continue to discover relevant genetic variants; however, these small-effect variants, combined, explain only a small fraction of phenotypic variance -- thus having limited predictive power and clinical utility.
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Affiliation(s)
- Ge Zhang
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, United States.
| | - Daniel W Nebert
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, United States; Department of Environmental Health and Center for Environmental Genetics, University of Cincinnati School of Medicine, Cincinnati, OH 45267-0056, United States.
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15
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Lu Q, Powles RL, Abdallah S, Ou D, Wang Q, Hu Y, Lu Y, Liu W, Li B, Mukherjee S, Crane PK, Zhao H. Systematic tissue-specific functional annotation of the human genome highlights immune-related DNA elements for late-onset Alzheimer's disease. PLoS Genet 2017; 13:e1006933. [PMID: 28742084 PMCID: PMC5546707 DOI: 10.1371/journal.pgen.1006933] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 08/07/2017] [Accepted: 07/18/2017] [Indexed: 12/31/2022] Open
Abstract
Continuing efforts from large international consortia have made genome-wide epigenomic and transcriptomic annotation data publicly available for a variety of cell and tissue types. However, synthesis of these datasets into effective summary metrics to characterize the functional non-coding genome remains a challenge. Here, we present GenoSkyline-Plus, an extension of our previous work through integration of an expanded set of epigenomic and transcriptomic annotations to produce high-resolution, single tissue annotations. After validating our annotations with a catalog of tissue-specific non-coding elements previously identified in the literature, we apply our method using data from 127 different cell and tissue types to present an atlas of heritability enrichment across 45 different GWAS traits. We show that broader organ system categories (e.g. immune system) increase statistical power in identifying biologically relevant tissue types for complex diseases while annotations of individual cell types (e.g. monocytes or B-cells) provide deeper insights into disease etiology. Additionally, we use our GenoSkyline-Plus annotations in an in-depth case study of late-onset Alzheimer's disease (LOAD). Our analyses suggest a strong connection between LOAD heritability and genetic variants contained in regions of the genome functional in monocytes. Furthermore, we show that LOAD shares a similar localization of SNPs to monocyte-functional regions with Parkinson's disease. Overall, we demonstrate that integrated genome annotations at the single tissue level provide a valuable tool for understanding the etiology of complex human diseases. Our GenoSkyline-Plus annotations are freely available at http://genocanyon.med.yale.edu/GenoSkyline.
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Affiliation(s)
- Qiongshi Lu
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Ryan L. Powles
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, United States of America
| | - Sarah Abdallah
- Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Derek Ou
- Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Qian Wang
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, United States of America
| | - Yiming Hu
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Yisi Lu
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Wei Liu
- School of Life Sciences, Peking University, Beijing, China
| | - Boyang Li
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Shubhabrata Mukherjee
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Paul K. Crane
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Hongyu Zhao
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, United States of America
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, United States of America
- VA Cooperative Studies Program Coordinating Center, West Haven, Connecticut, United States of America
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Pescatello LS, Schifano ED, Ash GI, Panza GA, Lamberti L, Chen MH, Deshpande V, Zaleski A, Farinatti P, Taylor BA, Thompson PD. Deep-targeted exon sequencing reveals renal polymorphisms associate with postexercise hypotension among African Americans. Physiol Rep 2016; 4:e12992. [PMID: 27940662 PMCID: PMC5064144 DOI: 10.14814/phy2.12992] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 09/14/2016] [Accepted: 09/15/2016] [Indexed: 12/23/2022] Open
Abstract
We found variants from the Angiotensinogen-Converting Enzyme (ACE), Angiotensin Type 1 Receptor (AGTR1), Aldosterone Synthase (CYP11B2), and Adducin (ADD1) genes exhibited intensity-dependent associations with the ambulatory blood pressure (BP) response following acute exercise, or postexercise hypotension (PEH). In a validation cohort, we sequenced exons from these genes for their associations with PEH Obese (30.9 ± 3.6 kg m-2) adults (n = 23; 61% African Americans [AF], 39% Caucasian) 42.0 ± 9.8 years with hypertension (139.8 ± 10.4/84.6 ± 6.2 mmHg) completed three random experiments: bouts of vigorous and moderate intensity cycling and control. Subjects wore an ambulatory BP monitor for 19 h. We performed deep-targeted exon sequencing using the Illumina TruSeq Custom Amplicon kit. Variant genotypes were coded as number of minor alleles (#MA) and selected for further statistical analysis based upon Bonferonni or Benjamini-Yekutieli multiple testing corrected p-values under time adjusted linear models for 19 hourly BP measurements per subject. After vigorous intensity over 19 h among ACE, AGTR1, CYP11B2, and ADD1 variants passing multiple testing thresholds, as the #MA increased, systolic (SBP) and/or diastolic BP decreased 12 mmHg (P = 4.5E-05) to 30 mmHg (P = 6.4E-04) among AF only. In contrast, after moderate intensity over 19 h among ACE and CYP11B2 variants passing multiple testing thresholds, as the #MA increased, SBP increased 21 mmHg (P = 8.0E-04) to 22 mmHg (P = 8.2E-04) among AF only. In this replication study, ACE, AGTR1, CYP11B2, and ADD1 variants exhibited associations with PEH after vigorous, but not moderate intensity exercise among AF only. Renal variants should be explored further with a multi-level "omics" approach for associations with PEH among a large, ethnically diverse sample of adults with hypertension.
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Affiliation(s)
- Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
- Institute for Systems Genomics, University of Connecticut, Storrs, Connecticut
| | | | - Garrett I Ash
- School of Nursing, Yale University, New Haven, Connecticut
| | - Gregory A Panza
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
| | - Lauren Lamberti
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, Connecticut
| | - Ved Deshpande
- Department of Statistics, University of Connecticut, Storrs, Connecticut
| | - Amanda Zaleski
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
| | - Paulo Farinatti
- Department of Physical Activity Sciences, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Beth A Taylor
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
| | - Paul D Thompson
- Department of Preventive Cardiology, Hartford Hospital, Hartford, Connecticut
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17
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Whelton PK, Einhorn PT, Muntner P, Appel LJ, Cushman WC, Diez Roux AV, Ferdinand KC, Rahman M, Taylor HA, Ard J, Arnett DK, Carter BL, Davis BR, Freedman BI, Cooper LA, Cooper R, Desvigne-Nickens P, Gavini N, Go AS, Hyman DJ, Kimmel PL, Margolis KL, Miller ER, Mills KT, Mensah GA, Navar AM, Ogedegbe G, Rakotz MK, Thomas G, Tobin JN, Wright JT, Yoon SSS, Cutler JA. Research Needs to Improve Hypertension Treatment and Control in African Americans. Hypertension 2016; 68:1066-1072. [PMID: 27620388 DOI: 10.1161/hypertensionaha.116.07905] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Paul K Whelton
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.).
| | - Paula T Einhorn
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Paul Muntner
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Lawrence J Appel
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - William C Cushman
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Ana V Diez Roux
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Keith C Ferdinand
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Mahboob Rahman
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Herman A Taylor
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Jamy Ard
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Donna K Arnett
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Barry L Carter
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Barry R Davis
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Barry I Freedman
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Lisa A Cooper
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Richard Cooper
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Patrice Desvigne-Nickens
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Nara Gavini
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Alan S Go
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - David J Hyman
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Paul L Kimmel
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Karen L Margolis
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Edgar R Miller
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Katherine T Mills
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - George A Mensah
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Ann M Navar
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Gbenga Ogedegbe
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Michael K Rakotz
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - George Thomas
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Jonathan N Tobin
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Jackson T Wright
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Sung Sug Sarah Yoon
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
| | - Jeffrey A Cutler
- From the Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine (P.K.W., K.C.F.), and Department of Medicine, Tulane University School of Medicine (P.K.W., K.C.F.), New Orleans, LA; Division of Cardiovascular Sciences (P.T.E., P.D.-N., G.A.M., J.A.C.), and Center for Translation Research and Implementation Science (N.G., G.A.M.), National Heart, Lung, and Blood Institute, Bethesda, MD; Department of Epidemiology, School of Public Health, University of Alabama at Birmingham (P.M.); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, MD (L.J.A., L.A.C., E.R.M.); Preventive Medicine Section, Veterans Affairs Medical Center, Memphis, TN (W.C.C.); Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA (A.V.D.R.); Department of Medicine, Case Western Reserve University, University Hospitals Case Medical Center, Louis Stokes Cleveland VA Medical Center, OH (M.R., J.T.W.); Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (H.A.T.); Department of Epidemiology and Prevention (J.A.) and Department of Medicine (B.I.F., J.A.), Wake Forest School of Medicine, Wake Forest University, Winston Salem, NC; Dean's Office, University of Kentucky College of Public Health, Lexington (D.K.A.); Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, Iowa City (B.L.C.); Department of Biostatistics, University of Texas School of Public Health, Houston (B.R.D.); Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Maywood, IL (R.C.); Division of Research, Kaiser Permanente Northern California, Oakland (A.S.G.); Department of Internal Medicine, Baylor College of Medicine, Houston, TX (D.J.H.); National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD (P.L.K.); HealthPartners Institute, Minneapolis, MN (K.L.M.); Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (A.M.N.); Department of Population Health, NYU School of Medicine, New York (G.O.); American Medical Association, Chicago, IL (M.K.R.); Department of Nephrology and Hypertension, Cleveland Clinic, OH (G.T.); Clinical Directors Network (CND) and The Rockefeller University Center for Clinical and Translational Science, New York (J.N.T.); and National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD (S.S.(S.)Y.)
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TET2 and CSMD1 genes affect SBP response to hydrochlorothiazide in never-treated essential hypertensives. J Hypertens 2016; 33:1301-9. [PMID: 25695618 DOI: 10.1097/hjh.0000000000000541] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Thiazide diuretics have been recommended as a first-line antihypertensive treatment, although the choice of 'the right drug in the individual essential hypertensive patient' remains still empirical. Essential hypertension is a complex, polygenic disease derived from the interaction of patient's genetic background with the environment. Pharmacogenomics could be a useful tool to pinpoint gene variants involved in antihypertensive drug response, thus optimizing therapeutic advantages and minimizing side effects. METHODS AND RESULTS We looked for variants associated with blood pressure response to hydrochlorothiazide over an 8-week follow-up by means of a genome-wide association analysis in two Italian cohorts of never-treated essential hypertensive patients: 343 samples from Sardinia and 142 from Milan. TET2 and CSMD1 as plausible candidate genes to affect SBP response to hydrochlorothiazide were identified. The specificity of our findings for hydrochlorothiazide was confirmed in an independent cohort of essential hypertensive patients treated with losartan. Our best findings were also tested for replication in four independent hypertensive samples of European Ancestry, such as GENetics of drug RESponsiveness in essential hypertension, Genetic Epidemiology of Responses to Antihypertensives, NORdic DILtiazem intervention, Pharmacogenomics Evaluation of Antihypertensive Responses, and Campania Salute Network-StayOnDiur. We validated a polymorphism in CSMD1 and UGGT2. CONCLUSION This exploratory study reports two plausible loci associated with SBP response to hydrochlorothiazide: TET2, an aldosterone-responsive mediator of αENaC gene transcription; and CSMD1, previously described as associated with hypertension in a case-control study.
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The effects of genes implicated in cardiovascular disease on blood pressure response to treatment among treatment-naive hypertensive African Americans in the GenHAT study. J Hum Hypertens 2016; 30:549-54. [PMID: 26791477 PMCID: PMC4956602 DOI: 10.1038/jhh.2015.121] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 09/29/2015] [Accepted: 10/19/2015] [Indexed: 12/24/2022]
Abstract
African Americans have the highest prevalence of hypertension in the United States. Blood-pressure control is important to reduce cardiovascular disease (CVD)-related morbidity and mortality in this ethnic group. Genetic variants have been found to be associated with BP response to treatment. Previous pharmacogenetic studies of blood-pressure response to treatment in African Americans suffer limitations of small sample size as well as a limited number of candidate genes, and often focused on one antihypertensive treatment. Using 1,131 African-American treatment naïve participants from the Genetics of Hypertension Associated Treatment (GenHAT) Study, we examined whether variants in 35 candidate genes might modulate blood-pressure response to four different antihypertensive medications, including an angiotensin converting enzyme (ACE) inhibitor (lisinopril), a calcium channel blocker (amlodipine), and an α-adrenergic blocker (doxazosin) as compared to a thiazide diuretic (chlorthalidone) after 6 months of follow-up. Several suggestive gene by treatment interactions were identified. For example, among participants with two minor alleles of REN rs6681776, diastolic blood-pressure response was much improved on doxazosin compared to chlorthalidone (on average −9.49 mmHg vs. −1.70 mmHg) (P=0.007). Although several suggestive loci were identified, none of the findings passed significance criteria after correction for multiple testing. Given the impact of hypertension and its sequelae in this population, this research highlights the potential for genetic factors to contribute to blood-pressure response to treatment. Continued concerted research efforts focused on genetics are needed to improve treatment response in this high risk group.
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Biel NM, Santostefano KE, DiVita BB, El Rouby N, Carrasquilla SD, Simmons C, Nakanishi M, Cooper-DeHoff RM, Johnson JA, Terada N. Vascular Smooth Muscle Cells From Hypertensive Patient-Derived Induced Pluripotent Stem Cells to Advance Hypertension Pharmacogenomics. Stem Cells Transl Med 2015; 4:1380-90. [PMID: 26494780 PMCID: PMC4675511 DOI: 10.5966/sctm.2015-0126] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 08/31/2015] [Indexed: 12/12/2022] Open
Abstract
UNLABELLED Studies in hypertension (HTN) pharmacogenomics seek to identify genetic sources of variable antihypertensive drug response. Genetic association studies have detected single-nucleotide polymorphisms (SNPs) that link to drug responses; however, to understand mechanisms underlying how genetic traits alter drug responses, a biological interface is needed. Patient-derived induced pluripotent stem cells (iPSCs) provide a potential source for studying otherwise inaccessible tissues that may be important to antihypertensive drug response. The present study established multiple iPSC lines from an HTN pharmacogenomics cohort. We demonstrated that established HTN iPSCs can robustly and reproducibly differentiate into functional vascular smooth muscle cells (VSMCs), a cell type most relevant to vasculature tone control. Moreover, a sensitive traction force microscopy assay demonstrated that iPSC-derived VSMCs show a quantitative contractile response on physiological stimulus of endothelin-1. Furthermore, the inflammatory chemokine tumor necrosis factor α induced a typical VSMC response in iPSC-derived VSMCs. These studies pave the way for a large research initiative to decode biological significance of identified SNPs in hypertension pharmacogenomics. SIGNIFICANCE Treatment of hypertension remains suboptimal, and a pharmacogenomics approach seeks to identify genetic biomarkers that could be used to guide treatment decisions; however, it is important to understand the biological underpinnings of genetic associations. Mouse models do not accurately recapitulate individual patient responses based on their genetics, and hypertension-relevant cells are difficult to obtain from patients. Induced pluripotent stem cell (iPSC) technology provides a great interface to bring patient cells with their genomic data into the laboratory and to study hypertensive responses. As an initial step, the present study established an iPSC bank from patients with primary hypertension and demonstrated an effective and reproducible method of generating functional vascular smooth muscle cells.
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Affiliation(s)
- Nikolett M. Biel
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
- Center for Cellular Reprogramming, University of Florida, Gainesville, Florida, USA
| | - Katherine E. Santostefano
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
- Center for Cellular Reprogramming, University of Florida, Gainesville, Florida, USA
| | - Bayli B. DiVita
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
- Center for Cellular Reprogramming, University of Florida, Gainesville, Florida, USA
| | - Nihal El Rouby
- Department of Pharmacotherapy and Translational Research, College of Pharmacy and Center for Pharmacogenomics, University of Florida, Gainesville, Florida, USA
| | - Santiago D. Carrasquilla
- J. Crayton Pruitt Family Department of Biomedical Engineering, College of Engineering, University of Florida, Gainesville, Florida, USA
| | - Chelsey Simmons
- Mechanical and Aerospace Engineering, College of Engineering, University of Florida, Gainesville, Florida, USA
- Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Mahito Nakanishi
- Biotechnology Research Institute for Drug Discovery, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Rhonda M. Cooper-DeHoff
- Department of Pharmacotherapy and Translational Research, College of Pharmacy and Center for Pharmacogenomics, University of Florida, Gainesville, Florida, USA
- Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Julie A. Johnson
- Department of Pharmacotherapy and Translational Research, College of Pharmacy and Center for Pharmacogenomics, University of Florida, Gainesville, Florida, USA
- Division of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Naohiro Terada
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
- Center for Cellular Reprogramming, University of Florida, Gainesville, Florida, USA
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Lupoli S, Salvi E, Barcella M, Barlassina C. Pharmacogenomics considerations in the control of hypertension. Pharmacogenomics 2015; 16:1951-64. [PMID: 26555875 DOI: 10.2217/pgs.15.131] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The response to antihypertensive therapy is very heterogeneous and the need by the physicians to account for it has driven much interest in pharmacogenomics of antihypertensive drugs. The Human Genome Project and the initiatives in genomics that followed, generated a huge number of genetic data that furnished the tools to explore the genotype-phenotype association in candidate genes and at genome-wide level. In spite of the efforts and the great number of publications, pharmacogenomics of antihypertensive drugs is far from being used in clinical practice. In this review, we analyze the main findings available in PubMed from 2010 to 2015, in relation to the major classes of antihypertensive drugs. We also describe a new Phase II drug that targets two specific hypertension predisposing mechanisms.
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Affiliation(s)
- Sara Lupoli
- Department of Health Sciences, Milan University, Via Rudinì 8, 20142 Milan & Filarete Foundation, Viale Ortles 22/4, 20139 Milan, Italy
| | - Erika Salvi
- Department of Health Sciences, Milan University, Via Rudinì 8, 20142 Milan & Filarete Foundation, Viale Ortles 22/4, 20139 Milan, Italy
| | - Matteo Barcella
- Department of Health Sciences, Milan University, Via Rudinì 8, 20142 Milan & Filarete Foundation, Viale Ortles 22/4, 20139 Milan, Italy
| | - Cristina Barlassina
- Department of Health Sciences, Milan University, Via Rudinì 8, 20142 Milan & Filarete Foundation, Viale Ortles 22/4, 20139 Milan, Italy
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Bis JC, Sitlani C, Irvin R, Avery CL, Smith AV, Sun F, Evans DS, Musani SK, Li X, Trompet S, Krijthe BP, Harris TB, Quibrera PM, Brody JA, Demissie S, Davis BR, Wiggins KL, Tranah GJ, Lange LA, Sotoodehnia N, Stott DJ, Franco OH, Launer LJ, Stürmer T, Taylor KD, Cupples LA, Eckfeldt JH, Smith NL, Liu Y, Wilson JG, Heckbert SR, Buckley BM, Ikram MA, Boerwinkle E, Chen YDI, de Craen AJM, Uitterlinden AG, Rotter JI, Ford I, Hofman A, Sattar N, Slagboom PE, Westendorp RGJ, Gudnason V, Vasan RS, Lumley T, Cummings SR, Taylor HA, Post W, Jukema JW, Stricker BH, Whitsel EA, Psaty BM, Arnett D. Drug-Gene Interactions of Antihypertensive Medications and Risk of Incident Cardiovascular Disease: A Pharmacogenomics Study from the CHARGE Consortium. PLoS One 2015; 10:e0140496. [PMID: 26516778 PMCID: PMC4627813 DOI: 10.1371/journal.pone.0140496] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 09/25/2015] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Hypertension is a major risk factor for a spectrum of cardiovascular diseases (CVD), including myocardial infarction, sudden death, and stroke. In the US, over 65 million people have high blood pressure and a large proportion of these individuals are prescribed antihypertensive medications. Although large long-term clinical trials conducted in the last several decades have identified a number of effective antihypertensive treatments that reduce the risk of future clinical complications, responses to therapy and protection from cardiovascular events vary among individuals. METHODS Using a genome-wide association study among 21,267 participants with pharmaceutically treated hypertension, we explored the hypothesis that genetic variants might influence or modify the effectiveness of common antihypertensive therapies on the risk of major cardiovascular outcomes. The classes of drug treatments included angiotensin-converting enzyme inhibitors, beta-blockers, calcium channel blockers, and diuretics. In the setting of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, each study performed array-based genome-wide genotyping, imputed to HapMap Phase II reference panels, and used additive genetic models in proportional hazards or logistic regression models to evaluate drug-gene interactions for each of four therapeutic drug classes. We used meta-analysis to combine study-specific interaction estimates for approximately 2 million single nucleotide polymorphisms (SNPs) in a discovery analysis among 15,375 European Ancestry participants (3,527 CVD cases) with targeted follow-up in a case-only study of 1,751 European Ancestry GenHAT participants as well as among 4,141 African-Americans (1,267 CVD cases). RESULTS Although drug-SNP interactions were biologically plausible, exposures and outcomes were well measured, and power was sufficient to detect modest interactions, we did not identify any statistically significant interactions from the four antihypertensive therapy meta-analyses (Pinteraction > 5.0×10-8). Similarly, findings were null for meta-analyses restricted to 66 SNPs with significant main effects on coronary artery disease or blood pressure from large published genome-wide association studies (Pinteraction ≥ 0.01). Our results suggest that there are no major pharmacogenetic influences of common SNPs on the relationship between blood pressure medications and the risk of incident CVD.
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Affiliation(s)
- Joshua C. Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Colleen Sitlani
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Ryan Irvin
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Christy L. Avery
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
| | - Albert Vernon Smith
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Fangui Sun
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Daniel S. Evans
- California Pacific Medical Center Research Institute, San Francisco, California, United States of America
| | - Solomon K. Musani
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Xiaohui Li
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States of America
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Stella Trompet
- Department of Cardiology, Leiden University Medical Center, The Netherlands
- Department of Gerontology and Geriatrics, Leiden University Medical Center, The Netherlands
| | - Bouwe P. Krijthe
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Tamara B. Harris
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America
| | - P. Miguel Quibrera
- Collaborative Studies Coordinating Center, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
| | - Jennifer A. Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Serkalem Demissie
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Barry R. Davis
- Department of Biostatistics, University of Texas School of Public Health, Houston, Texas, United States of America
| | - Kerri L. Wiggins
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Gregory J. Tranah
- California Pacific Medical Center Research Institute, San Francisco, California, United States of America
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Leslie A. Lange
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina, 27599, United States of America
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Cardiology Division, University of Washington, Seattle, Washington, United States of America
| | - David J. Stott
- Institute of Cardiovascular and Medical Sciences, Faculty of Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Oscar H. Franco
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Lenore J. Launer
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Til Stürmer
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
- University of North Carolina—GSK Center of Excellence in Pharmacoepidemiology, Chapel Hill, North Carolina, United States of America
| | - Kent D. Taylor
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States of America
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - L. Adrienne Cupples
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
- The Framingham Heart Study, Framingham, Massachusetts, United States of America
| | - John H. Eckfeldt
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Nicholas L. Smith
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Seattle Epidemiologic Research and Information Center of the Department of Veterans Affairs Office of Research and Development, Seattle, Washington, United States of America
- Group Health Research Institute, Group Health, Seattle, Washington, United States of America
| | - Yongmei Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina, United States of America
| | - James G. Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Susan R. Heckbert
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Group Health Research Institute, Group Health, Seattle, Washington, United States of America
| | - Brendan M. Buckley
- Department of Pharmacology and Therapeutics, University College Cork, Cork, Ireland
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Eric Boerwinkle
- Institute for Molecular Medicine, University of Texas Health Science Center, Houston, Texas, United States of America
| | - Yii-Der Ida Chen
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States of America
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Anton J. M. de Craen
- Department of Gerontology and Geriatrics, Leiden University Medical Center, The Netherlands
| | - Andre G. Uitterlinden
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California, United States of America
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, California, United States of America
| | - Ian Ford
- Robertson Center for Biostatistics, University of Glasgow, Glasgow, United Kingdom
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, Faculty of Medicine, Glasgow, United Kingdom
| | - P. Eline Slagboom
- Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Rudi G. J. Westendorp
- Faculty of Health and Medical Sciences, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ramachandran S. Vasan
- The Framingham Heart Study, Framingham, Massachusetts, United States of America
- Boston University School of Medicine, Boston, Massachusetts, United States of America
- Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Thomas Lumley
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - Steven R. Cummings
- California Pacific Medical Center Research Institute, San Francisco, California, United States of America
| | - Herman A. Taylor
- Department of Medicine, Morehouse School of Medicine, Atlanta, Georgia, United States of America
| | - Wendy Post
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - J. Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, The Netherlands
| | - Bruno H. Stricker
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Inspectorate for Health Care, the Hague, The Netherlands
| | - Eric A. Whitsel
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, United States of America
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina United States of America
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Department of Health Services, University of Washington, Seattle, Washington, United States of America
- Group Health Research Institute, Group Health, Seattle, Washington, United States of America
| | - Donna Arnett
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
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Mascarenhas R, Pietrzak M, Smith RM, Webb A, Wang D, Papp AC, Pinsonneault JK, Seweryn M, Rempala G, Sadee W. Allele-Selective Transcriptome Recruitment to Polysomes Primed for Translation: Protein-Coding and Noncoding RNAs, and RNA Isoforms. PLoS One 2015; 10:e0136798. [PMID: 26331722 PMCID: PMC4558023 DOI: 10.1371/journal.pone.0136798] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 08/07/2015] [Indexed: 11/19/2022] Open
Abstract
mRNA translation into proteins is highly regulated, but the role of mRNA isoforms, noncoding RNAs (ncRNAs), and genetic variants remains poorly understood. mRNA levels on polysomes have been shown to correlate well with expressed protein levels, pointing to polysomal loading as a critical factor. To study regulation and genetic factors of protein translation we measured levels and allelic ratios of mRNAs and ncRNAs (including microRNAs) in lymphoblast cell lines (LCL) and in polysomal fractions. We first used targeted assays to measure polysomal loading of mRNA alleles, confirming reported genetic effects on translation of OPRM1 and NAT1, and detecting no effect of rs1045642 (3435C>T) in ABCB1 (MDR1) on polysomal loading while supporting previous results showing increased mRNA turnover of the 3435T allele. Use of high-throughput sequencing of complete transcript profiles (RNA-Seq) in three LCLs revealed significant differences in polysomal loading of individual RNA classes and isoforms. Correlated polysomal distribution between protein-coding and non-coding RNAs suggests interactions between them. Allele-selective polysome recruitment revealed strong genetic influence for multiple RNAs, attributable either to differential expression of RNA isoforms or to differential loading onto polysomes, the latter defining a direct genetic effect on translation. Genes identified by different allelic RNA ratios between cytosol and polysomes were enriched with published expression quantitative trait loci (eQTLs) affecting RNA functions, and associations with clinical phenotypes. Polysomal RNA-Seq combined with allelic ratio analysis provides a powerful approach to study polysomal RNA recruitment and regulatory variants affecting protein translation.
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Affiliation(s)
- Roshan Mascarenhas
- Center for Pharmacogenomics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
| | - Maciej Pietrzak
- Center for Pharmacogenomics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
| | - Ryan M. Smith
- Center for Pharmacogenomics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
| | - Amy Webb
- Department of Biomedical Informatics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
| | - Danxin Wang
- Center for Pharmacogenomics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
| | - Audrey C. Papp
- Center for Pharmacogenomics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
| | - Julia K. Pinsonneault
- Center for Pharmacogenomics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
| | - Michal Seweryn
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
- Department of Mathematics and Computer Science, University of Lodz, Lodz, Poland
- Mathematical Biosciences Institute, The Ohio State University, Columbus, Ohio, United States of America
| | - Grzegorz Rempala
- Center for Pharmacogenomics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, United States of America
- Mathematical Biosciences Institute, The Ohio State University, Columbus, Ohio, United States of America
| | - Wolfgang Sadee
- Center for Pharmacogenomics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- Department of Medical Genetics, College of Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States of America
- * E-mail:
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Abstract
Resistant hypertension (RHTN), defined as an uncontrolled blood pressure despite the use of multiple antihypertensive medications, is an increasing clinical problem associated with increased cardiovascular (CV) risk, including stroke and target organ damage. Genetic variability in blood pressure (BP)-regulating genes and pathways may, in part, account for the variability in BP response to antihypertensive agents, when taken alone or in combination, and may contribute to the RHTN phenotype. Pharmacogenomics focuses on the identification of genetic factors responsible for inter-individual variability in drug response. Expanding pharmacogenomics research to include patients with RHTN taking multiple BP-lowering medications may identify genetic markers associated with RHTN. To date, the available evidence surrounding pharmacogenomics in RHTN is limited and primarily focused on candidate genes. In this review, we summarize the most current data in RHTN pharmacogenomics and offer some recommendations on how to advance the field.
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Affiliation(s)
- Nihal El Rouby
- Department of Pharmacotherapy and Translational Research, University of Florida, PO Box 100486, 1600 SW Archer Road, Gainesville, FL 32610-0486, USA
| | - Rhonda M. Cooper-DeHoff
- Department of Pharmacotherapy and Translational Research, University of Florida, PO Box 100486, 1600 SW Archer Road, Gainesville, FL 32610-0486, USA
- Division of Cardiovascular Medicine, Colleges of Pharmacy and Medicine, University of Florida, PO Box 100486, 1600 SW Archer Road, Gainesville, FL 32610-0486, USA
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25
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Hamrefors V. Common genetic risk factors for coronary artery disease: new opportunities for prevention? Clin Physiol Funct Imaging 2015; 37:243-254. [DOI: 10.1111/cpf.12289] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 07/03/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Viktor Hamrefors
- Department of Clinical Sciences; Faculty of Medicine; Lund University; Malmö Sweden
- Department of Medical Imaging and Physiology; Skåne University Hospital; Malmö Sweden
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26
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Abstract
By continuous assessment of dynamic changes in systemic and regional perfusion during transition to extrauterine life and beyond, comprehensive neonatal hemodynamic monitoring creates numerous opportunities for both clinical and research applications. In particular, it has the potential of providing additional details about physiologic interactions among the key hemodynamic factors regulating systemic blood flow and blood flow distribution along with the subtle changes that are frequently transient in nature and would not be detected without such systems in place. The data can then be applied for predictive mathematical modeling and validation of physiologically realistic computer models aiming to identify patient subgroups at higher risk for adverse outcomes and/or predicting the response to a particular perturbation or therapeutic intervention. Another emerging application that opens an entirely new era in hemodynamic research is the use of the physiometric data obtained by the monitoring and data acquisition systems in conjunction with genomic information.
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28
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Wang Y, Cao Y, Yamada S, Thirunavukkarasu M, Nin V, Joshi M, Rishi MT, Bhattacharya S, Camacho-Pereira J, Sharma AK, Shameer K, Kocher JPA, Sanchez JA, Wang E, Hoeppner LH, Dutta SK, Leof EB, Shah V, Claffey KP, Chini EN, Simons M, Terzic A, Maulik N, Mukhopadhyay D. Cardiomyopathy and Worsened Ischemic Heart Failure in SM22-α Cre-Mediated Neuropilin-1 Null Mice: Dysregulation of PGC1α and Mitochondrial Homeostasis. Arterioscler Thromb Vasc Biol 2015; 35:1401-12. [PMID: 25882068 DOI: 10.1161/atvbaha.115.305566] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 03/30/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Neuropilin-1 (NRP-1) is a multidomain membrane receptor involved in angiogenesis and development of neuronal circuits, however, the role of NRP-1 in cardiovascular pathophysiology remains elusive. APPROACH AND RESULTS In this study, we first observed that deletion of NRP-1 induced peroxisome proliferator-activated receptor γ coactivator 1α in cardiomyocytes and vascular smooth muscle cells, which was accompanied by dysregulated cardiac mitochondrial accumulation and induction of cardiac hypertrophy- and stress-related markers. To investigate the role of NRP-1 in vivo, we generated mice lacking Nrp-1 in cardiomyocytes and vascular smooth muscle cells (SM22-α-Nrp-1 KO), which exhibited decreased survival rates, developed cardiomyopathy, and aggravated ischemia-induced heart failure. Mechanistically, we found that NRP-1 specifically controls peroxisome proliferator-activated receptor γ coactivator 1 α and peroxisome proliferator-activated receptor γ in cardiomyocytes through crosstalk with Notch1 and Smad2 signaling pathways, respectively. Moreover, SM22-α-Nrp-1 KO mice exhibited impaired physical activities and altered metabolite levels in serum, liver, and adipose tissues, as demonstrated by global metabolic profiling analysis. CONCLUSIONS Our findings provide new insights into the cardioprotective role of NRP-1 and its influence on global metabolism.
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Affiliation(s)
- Ying Wang
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Ying Cao
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Satsuki Yamada
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Mahesh Thirunavukkarasu
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Veronica Nin
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Mandip Joshi
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Muhammed T Rishi
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Santanu Bhattacharya
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Juliana Camacho-Pereira
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Anil K Sharma
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Khader Shameer
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Jean-Pierre A Kocher
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Juan A Sanchez
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Enfeng Wang
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Luke H Hoeppner
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Shamit K Dutta
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Edward B Leof
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Vijay Shah
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Kevin P Claffey
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Eduardo N Chini
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Michael Simons
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Andre Terzic
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Nilanjana Maulik
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.)
| | - Debabrata Mukhopadhyay
- From the Department of Biochemistry and Molecular Biology (Y.W., Y.C., S.B., A.K.S., E.W., L.H.H., S.K.D., E.B.L., D.M.), Center for Regenerative Medicine, Marriott Heart Disease Research Program, Division of Cardiovascular Diseases, Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics (S.Y., A.T.), Department of Anesthesiology (V.N., J.C.-P., E.N.C.), Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Health Science Program (K.S., J.-P.A.K.), Department of Gastroenterology (V.S.), and Thoracic Diseases Research Unit, Department of Biochemistry and Molecular Biology (E.B.L.), Mayo Clinic, Rochester, MN; Molecular Cardiology and Angiogenesis Laboratory, Department of Surgery (M.T., M.J., M.T.R., J.A.S., N.M.) and Department of Cell Biology, Center for Vascular Biology (K.P.C.), University of Connecticut Health Center, Farmington; Department of Surgery, Saint Mary's Hospital, Waterbury, CT (M.J., M.T.R., J.A.S.); and Yale Cardiovascular Research Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT (M.S.).
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29
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Shahabi P, Dubé MP. Cardiovascular pharmacogenomics; state of current knowledge and implementation in practice. Int J Cardiol 2015; 184:772-795. [DOI: 10.1016/j.ijcard.2015.02.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 02/17/2015] [Accepted: 02/21/2015] [Indexed: 02/07/2023]
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Cabrera CP, Ng FL, Warren HR, Barnes MR, Munroe PB, Caulfield MJ. Exploring hypertension genome-wide association studies findings and impact on pathophysiology, pathways, and pharmacogenetics. WILEY INTERDISCIPLINARY REVIEWS-SYSTEMS BIOLOGY AND MEDICINE 2015; 7:73-90. [DOI: 10.1002/wsbm.1290] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 11/25/2014] [Accepted: 01/05/2015] [Indexed: 01/11/2023]
Affiliation(s)
- Claudia P Cabrera
- Department of Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry; Queen Mary University of London; London UK
- NIHR Barts Cardiovascular Biomedical Research Unit; Queen Mary University of London; London UK
| | - Fu Liang Ng
- Department of Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry; Queen Mary University of London; London UK
| | - Helen R Warren
- Department of Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry; Queen Mary University of London; London UK
- NIHR Barts Cardiovascular Biomedical Research Unit; Queen Mary University of London; London UK
| | - Michael R Barnes
- Department of Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry; Queen Mary University of London; London UK
- NIHR Barts Cardiovascular Biomedical Research Unit; Queen Mary University of London; London UK
| | - Patricia B Munroe
- Department of Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry; Queen Mary University of London; London UK
- NIHR Barts Cardiovascular Biomedical Research Unit; Queen Mary University of London; London UK
| | - Mark J Caulfield
- Department of Clinical Pharmacology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry; Queen Mary University of London; London UK
- NIHR Barts Cardiovascular Biomedical Research Unit; Queen Mary University of London; London UK
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31
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Hiltunen TP, Donner KM, Sarin A, Saarela J, Ripatti S, Chapman AB, Gums JG, Gong Y, Cooper‐DeHoff RM, Frau F, Glorioso V, Zaninello R, Salvi E, Glorioso N, Boerwinkle E, Turner ST, Johnson JA, Kontula KK. Pharmacogenomics of hypertension: a genome‐wide, placebo‐controlled cross‐over study, using four classes of antihypertensive drugs. J Am Heart Assoc 2015. [PMID: 25622599 PMCID: PMC4330076 DOI: 10.1161/jaha.114.001521] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Identification of genetic markers of antihypertensive drug responses could assist in individualization of hypertension treatment. METHODS AND RESULTS We conducted a genome-wide association study to identify gene loci influencing the responsiveness of 228 male patients to 4 classes of antihypertensive drugs. The Genetics of Drug Responsiveness in Essential Hypertension (GENRES) study is a double-blind, placebo-controlled cross-over study where each subject received amlodipine, bisoprolol,hydrochlorothiazide, and losartan, each as a monotherapy, in a randomized order. Replication analyses were performed in 4 studies with patients of European ancestry (PEAR Study, N=386; GERA I and II Studies, N=196 and N=198; SOPHIA Study, N=372). We identified 3 single-nucleotide polymorphisms within the ACY3 gene that showed associations with bisoprolol response reaching genome-wide significance (P<5x10(-8))however, this could not be replicated in the PEAR Study using atenolol. In addition, 39 single-nucleotide polymorphisms showed P values of 10(-5) to 10(-7). The 20 top-associated single-nucleotide polymorphisms were different for each antihypertensive drug. None of these top single-nucleotide polymorphisms co-localized with the panel of >40 genes identified in genome-wide association studies of hypertension. Replication analyses of GENRES results provided suggestive evidence for a missense variant (rs3814995) in the NPHS1 (nephrin) gene influencing losartan response, and for 2 variants influencing hydrochlorothiazide response, located within or close to the ALDH1A3 (rs3825926) and CLIC5 (rs321329) genes. CONCLUSIONS These data provide some evidence for a link between biology of the glomerular protein nephrin and antihypertensive action of angiotensin receptor antagonists and encourage additional studies on aldehyde dehydrogenase–mediated reactions in antihypertensive drug action.
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Affiliation(s)
- Timo P. Hiltunen
- Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland (T.P.H., K.K.K.)
| | - Kati M. Donner
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland (K.M.D., A.P.S., J.S., S.R.)
| | - Antti‐Pekka Sarin
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland (K.M.D., A.P.S., J.S., S.R.)
- Public Health Genomics Unit, National Institute for Health and Welfare, University of Helsinki, Helsinki, Finland (A.P.S.)
| | - Janna Saarela
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland (K.M.D., A.P.S., J.S., S.R.)
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland (K.M.D., A.P.S., J.S., S.R.)
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland (S.R.)
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom (S.R.)
| | - Arlene B. Chapman
- Mayo Clinic, Rochester, MN (A.B.C.)
- Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, GA (A.B.C.)
| | - John G. Gums
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida, Gainesville, FL (J.G.G., Y.G., R.M.C.D.H., J.A.J.)
- Department of Community Health and Family Medicine, Gainesville, FL (J.G.G.)
| | - Yan Gong
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida, Gainesville, FL (J.G.G., Y.G., R.M.C.D.H., J.A.J.)
| | - Rhonda M. Cooper‐DeHoff
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida, Gainesville, FL (J.G.G., Y.G., R.M.C.D.H., J.A.J.)
- Department of Medicine, Gainesville, FL (R.M.C.D.H.)
| | - Francesca Frau
- Department of Health Sciences, Genomics and Bioinformatics Unit, University of Milan and Filarete Foundation, Milan, Italy (F.F., E.S.)
| | - Valeria Glorioso
- Hypertension and Related Disease Centre, AOU‐University of Sassari, Sassari, Italy (V.G., R.Z., N.G.)
| | - Roberta Zaninello
- Hypertension and Related Disease Centre, AOU‐University of Sassari, Sassari, Italy (V.G., R.Z., N.G.)
| | - Erika Salvi
- Department of Health Sciences, Genomics and Bioinformatics Unit, University of Milan and Filarete Foundation, Milan, Italy (F.F., E.S.)
| | - Nicola Glorioso
- Hypertension and Related Disease Centre, AOU‐University of Sassari, Sassari, Italy (V.G., R.Z., N.G.)
| | - Eric Boerwinkle
- University of Florida, Gainesville, FL (E.B.)
- Human Genetics and Institute of Molecular Medicine, University of Texas Health Science Center, Houston, TX (E.B.)
| | - Stephen T. Turner
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN (S.T.T.)
| | - Julie A. Johnson
- Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics, University of Florida, Gainesville, FL (J.G.G., Y.G., R.M.C.D.H., J.A.J.)
| | - Kimmo K. Kontula
- Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland (T.P.H., K.K.K.)
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Keaney JF, Loscalzo J. Pharmacogenomics of hypertension: a genome‐wide, placebo‐controlled cross‐over study, using four classes of antihypertensive drugs. J Am Heart Assoc 2015; 4:e001778. [PMID: 25628411 PMCID: PMC4330084 DOI: 10.1161/jaha.115.001778] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Identification of genetic markers of antihypertensive drug responses could assist in individualization of hypertension treatment. METHODS AND RESULTS We conducted a genome-wide association study to identify gene loci influencing the responsiveness of 228 male patients to 4 classes of antihypertensive drugs. The Genetics of Drug Responsiveness in Essential Hypertension (GENRES) study is a double-blind, placebo-controlled cross-over study where each subject received amlodipine, bisoprolol,hydrochlorothiazide, and losartan, each as a monotherapy, in a randomized order. Replication analyses were performed in 4 studies with patients of European ancestry (PEAR Study, N=386; GERA I and II Studies, N=196 and N=198; SOPHIA Study, N=372). We identified 3 single-nucleotide polymorphisms within the ACY3 gene that showed associations with bisoprolol response reaching genome-wide significance (P<5x10(-8))however, this could not be replicated in the PEAR Study using atenolol. In addition, 39 single-nucleotide polymorphisms showed P values of 10(-5) to 10(-7). The 20 top-associated single-nucleotide polymorphisms were different for each antihypertensive drug. None of these top single-nucleotide polymorphisms co-localized with the panel of >40 genes identified in genome-wide association studies of hypertension. Replication analyses of GENRES results provided suggestive evidence for a missense variant (rs3814995) in the NPHS1 (nephrin) gene influencing losartan response, and for 2 variants influencing hydrochlorothiazide response, located within or close to the ALDH1A3 (rs3825926) and CLIC5 (rs321329) genes. CONCLUSIONS These data provide some evidence for a link between biology of the glomerular protein nephrin and antihypertensive action of angiotensin receptor antagonists and encourage additional studies on aldehyde dehydrogenase–mediated reactions in antihypertensive drug action.
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Affiliation(s)
- John F. Keaney
- UMass Medical School and UMass Memorial Medical Center, Worcester, MA (J.F.K.)
| | - Joseph Loscalzo
- Harvard Medical School and Brigham and Women's Hospital, Boston, MA (J.L.)
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33
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Armando I, Villar VAM, Jose PA. Genomics and Pharmacogenomics of Salt-sensitive Hypertension. Curr Hypertens Rev 2015; 11:49-56. [PMID: 26028245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 04/08/2015] [Accepted: 04/24/2015] [Indexed: 06/04/2023]
Abstract
Salt sensitivity is estimated to be present in 51% of the hypertensive and 26% of the normotensive populations. The individual blood pressure response to salt is heterogeneous and possibly related to inherited susceptibility. Although the mechanisms underlying salt sensitivity are complex and not well understood, genetics can help to determine the blood response to salt intake. So far only a few genes have been found to be associated with salt-sensitive hypertension using candidate gene association studies. The kidney is critical to overall fluid and electrolyte balance and long-term regulation of blood pressure. Thus, the pathogenesis of salt sensitivity must involve a derangement in renal NaCl handling: an inability to decrease renal sodium transport and increase sodium excretion in the face of an increase in NaCl load that could be caused by aberrant counter-regulatory natriuretic/antinatriuretic pathways. We review here the literature regarding the gene variants associated with salt-sensitive hypertension and how the presence of these gene variants influences the response to antihypertensive therapy.
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Affiliation(s)
- Ines Armando
- Division of Nephrology, Department of Medicine, and Department of Physiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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Armando I, Villar VAM, Jose PA. Genomics and pharmacogenomics of salt-sensitive hypertension Minireview. Curr Hypertens Rev 2015; 11:49-56. [PMID: 28392754 PMCID: PMC4875776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Salt sensitivity is estimated to be present in 51% of the hypertensive and 26% of the normotensive populations. The individual blood pressure response to salt is heterogeneous and possibly related to inherited susceptibility. Although the mechanisms underlying salt sensitivity are complex and not well understood, genetics can help to determine the blood response to salt intake. So far only a few genes have been found to be associated with salt-sensitive hypertension using candidate gene association studies. The kidney is critical to overall fluid and electrolyte balance and long-term regulation of blood pressure. Thus, the pathogenesis of salt sensitivity must involve a derangement in renal NaCl handling: an inability to decrease renal sodium transport and increase sodium excretion in the face of an increase in NaCl load that could be caused by aberrant counter-regulatory natriuretic/antinatriuretic pathways. We review here the literature regarding the gene variants associated with salt-sensitive hypertension and how the presence of these gene variants influences the response to antihypertensive therapy.
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Affiliation(s)
- Ines Armando
- Division of Nephrology, Department of Medicine, and Department of Physiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Van Anthony M Villar
- Division of Nephrology, Department of Medicine, and Department of Physiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
| | - Pedro A Jose
- Division of Nephrology, Department of Medicine, and Department of Physiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA
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Peprah E, Xu H, Tekola-Ayele F, Royal CD. Genome-wide association studies in Africans and African Americans: expanding the framework of the genomics of human traits and disease. Public Health Genomics 2014; 18:40-51. [PMID: 25427668 DOI: 10.1159/000367962] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 08/29/2014] [Indexed: 01/11/2023] Open
Abstract
Genomic research is one of the tools for elucidating the pathogenesis of diseases of global health relevance and paving the research dimension to clinical and public health translation. Recent advances in genomic research and technologies have increased our understanding of human diseases, genes associated with these disorders, and the relevant mechanisms. Genome-wide association studies (GWAS) have proliferated since the first studies were published several years ago and have become an important tool in helping researchers comprehend human variation and the role genetic variants play in disease. However, the need to expand the diversity of populations in GWAS has become increasingly apparent as new knowledge is gained about genetic variation. Inclusion of diverse populations in genomic studies is critical to a more complete understanding of human variation and elucidation of the underpinnings of complex diseases. In this review, we summarize the available data on GWAS in recent African ancestry populations within the western hemisphere (i.e. African Americans and peoples of the Caribbean) and continental African populations. Furthermore, we highlight ways in which genomic studies in populations of recent African ancestry have led to advances in the areas of malaria, HIV, prostate cancer, and other diseases. Finally, we discuss the advantages of conducting GWAS in recent African ancestry populations in the context of addressing existing and emerging global health conditions.
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Frau F, Zaninello R, Salvi E, Ortu MF, Braga D, Velayutham D, Argiolas G, Fresu G, Troffa C, Bulla E, Bulla P, Pitzoi S, Piras DA, Glorioso V, Chittani M, Bernini G, Bardini M, Fallo F, Malatino L, Stancanelli B, Regolisti G, Ferri C, Desideri G, Scioli GA, Galletti F, Sciacqua A, Perticone F, Degli Esposti E, Sturani A, Semplicini A, Veglio F, Mulatero P, Williams TA, Lanzani C, Hiltunen TP, Kontula K, Boerwinkle E, Turner ST, Manunta P, Barlassina C, Cusi D, Glorioso N. Genome-wide association study identifies CAMKID variants involved in blood pressure response to losartan: the SOPHIA study. Pharmacogenomics 2014; 15:1643-52. [DOI: 10.2217/pgs.14.119] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Essential hypertension arises from the combined effect of genetic and environmental factors. A pharmacogenomics approach could help to identify additional molecular mechanisms involved in its pathogenesis. Aim: The aim of SOPHIA study was to identify genetic polymorphisms regulating blood pressure response to the angiotensin II receptor blocker, losartan, with a whole-genome approach. Materials & methods: We performed a genome-wide association study on blood pressure response in 372 hypertensives treated with losartan and we looked for replication in two independent samples. Results: We identified a peak of association in CAMK1D gene (rs10752271, effect size -5.5 ± 0.94 mmHg, p = 1.2 × 10-8). CAMK1D encodes a protein that belongs to the regulatory pathway involved in aldosterone synthesis. We tested the specificity of rs10752271 for losartan in hypertensives treated with hydrochlorothiazide and we validated it in silico in the GENRES cohort. Conclusion: Using a genome-wide approach, we identified the CAMK1D gene as a novel locus associated with blood pressure response to losartan. CAMK1D gene characterization may represent a useful tool to personalize the treatment of essential hypertension. Original submitted 7 May 2014; Revision submitted 29 July 2014
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Affiliation(s)
- Francesca Frau
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | - Roberta Zaninello
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Erika Salvi
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | - Maria Francesca Ortu
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Daniele Braga
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | - Dinesh Velayutham
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | - Giuseppe Argiolas
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Giovanni Fresu
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Chiara Troffa
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | | | - Patrizia Bulla
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Silvia Pitzoi
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | | | - Valeria Glorioso
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
| | - Martina Chittani
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | | | - Michele Bardini
- Department of Internal Medicine, University of Pisa, Pisa, Italy
| | | | - Lorenzo Malatino
- Department of Medicine & Hypertension Center, University of Catania at Cannizzaro Hospital, Catania, Italy
| | - Benedetta Stancanelli
- Department of Medicine & Hypertension Center, University of Catania at Cannizzaro Hospital, Catania, Italy
| | | | - Claudio Ferri
- Department of Internal Medicine & Public Health, University of L'Aquila, L'Aquila, Italy
| | | | | | - Ferruccio Galletti
- Department of Clinical Medicine & Surgery, “Federico II University” Medical School, Napoli, Italy
| | - Angela Sciacqua
- Department of Medical & Surgical Sciences, Cardiovascular Disease Unit, University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | - Francesco Perticone
- Department of Medical & Surgical Sciences, Cardiovascular Disease Unit, University of Catanzaro “Magna Graecia”, Catanzaro, Italy
| | | | | | - Andrea Semplicini
- UOC Internal Medicine 1, SS. Giovanni e Paolo Hospital, Campo SS. Giovanni e Paolo, Venice, Italy
| | - Franco Veglio
- Division of Internal Medicine & Hypertension Center, Department of Medical Sciences, AO Città Salute e Scienza, University of Torino, Torino, Italy
| | - Paolo Mulatero
- Division of Internal Medicine & Hypertension Center, Department of Medical Sciences, AO Città Salute e Scienza, University of Torino, Torino, Italy
| | - Tracy A Williams
- Division of Internal Medicine & Hypertension Center, Department of Medical Sciences, AO Città Salute e Scienza, University of Torino, Torino, Italy
| | - Chiara Lanzani
- Università Vita Salute San Raffaele, Nephrology, Dialysis & Hypertension Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Timo P Hiltunen
- Department of Medicine, University of Helsinki & Helsinki University Central Hospital, Helsinki, Finland
| | - Kimmo Kontula
- Department of Medicine, University of Helsinki & Helsinki University Central Hospital, Helsinki, Finland
| | - Eric Boerwinkle
- Human Genetics & Institute of Molecular Medicine, University of Texas Health Science Center, Houston, TX, USA
| | - Stephen T Turner
- Division of Nephrology & Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Paolo Manunta
- Università Vita Salute San Raffaele, Nephrology, Dialysis & Hypertension Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Barlassina
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | - Daniele Cusi
- Department of Health Sciences, University of Milan at San Paolo Hospital, Milan, Italy
- Filarete Foundation, Genomics & Bioinformatics Unit, Milan, Italy
| | - Nicola Glorioso
- Hypertension & Related Disease Centre, AOU-University of Sassari, Sassari, Italy
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An update on the pharmacogenetics of treating hypertension. J Hum Hypertens 2014; 29:283-91. [PMID: 25355012 DOI: 10.1038/jhh.2014.76] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 06/24/2014] [Accepted: 07/10/2014] [Indexed: 02/08/2023]
Abstract
Hypertension is a leading cause of cardiovascular mortality, but only one third of patients achieve blood pressure goals despite antihypertensive therapy. Genetic polymorphisms may partially account for the interindividual variability and abnormal response to antihypertensive drugs. Candidate gene and genome-wide approaches have identified common genetic variants associated with response to antihypertensive drugs. However, there is no currently available pharmacogenetic test to guide hypertension treatment in clinical practice. In this review, we aimed to summarize the recent findings on pharmacogenetics of the most commonly used antihypertensive drugs in clinical practice, including diuretics, angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, beta-blockers and calcium channel blockers. Notably, only a small percentage of the genetic variability on response to antihypertensive drugs has been explained, and the vast majority of the genetic variants associated with antihypertensives efficacy and toxicity remains to be identified. Despite some genetic variants with evidence of association with the variable response related to these most commonly used antihypertensive drug classes, further replication is needed to confirm these associations in different populations. Further studies on epigenetics and regulatory pathways involved in the responsiveness to antihypertensive drugs might provide a deeper understanding of the physiology of hypertension, which may favor the identification of new targets for hypertension treatment and genetic predictors of antihypertensive response.
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Kamide K, Asayama K, Katsuya T, Ohkubo T, Hirose T, Inoue R, Metoki H, Kikuya M, Obara T, Hanada H, Thijs L, Kuznetsova T, Noguchi Y, Sugimoto K, Ohishi M, Morimoto S, Nakahashi T, Takiuchi S, Ishimitsu T, Tsuchihashi T, Soma M, Higaki J, Matsuura H, Shinagawa T, Sasaguri T, Miki T, Takeda K, Shimamoto K, Ueno M, Hosomi N, Kato J, Komai N, Kojima S, Sase K, Miyata T, Tomoike H, Kawano Y, Ogihara T, Rakugi H, Staessen JA, Imai Y. Genome-wide response to antihypertensive medication using home blood pressure measurements: a pilot study nested within the HOMED-BP study. Pharmacogenomics 2014; 14:1709-21. [PMID: 24192120 DOI: 10.2217/pgs.13.161] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Patients with mild-to-moderate essential hypertension in the HOMED-BP trial were randomly allocated to first-line treatment with a calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB). METHODS We recruited 265 (93 for CCB, 71 for ACEI and 101 for ARB) patients who completed the genomic study. Home blood pressure was measured for 5 days off-treatment before randomization and for 5 days after 2-4 weeks of randomized drug treatment. Genotyping was performed by 500K DNA microarray chips. The blood pressure responses to the three drugs were analyzed separately as a quantitative trait. For replication of SNPs with p < 10(-4), we used the multicenter GEANE study, in which patients were randomized to valsartan or amlodipine. RESULTS SNPs in PICALM, TANC2, NUMA1 and APCDD1 were found to be associated with CCB responses and those in ABCC9 and YIPF1 were found to be associated with ARB response with replication. CONCLUSION Our approach, the first based on high-fidelity phenotyping by home blood pressure measurement, might be a step in moving towards the personalized treatment of hypertension.
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Affiliation(s)
- Kei Kamide
- Department of Geriatric Medicine & Nephrology, Osaka University Graduate School of Medicine, Osaka, Japan and Department of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan and Research Institute, National Cerebro & Cardiovascular Research Center, Osaka, Japan and Studies Coordinating Centre, Research Unit Hypertension & Cardiovascular Epidemiology, Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
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Gong Y, McDonough CW, Beitelshees AL, Karnes JH, O'Connell JR, Turner ST, Chapman AB, Gums JG, Bailey KR, Boerwinkle E, Johnson JA, Cooper-DeHoff RM. PROX1 gene variant is associated with fasting glucose change after antihypertensive treatment. Pharmacotherapy 2013; 34:123-30. [PMID: 24122840 DOI: 10.1002/phar.1355] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
STUDY OBJECTIVE To assess the relationship of the 33 single nucleotide polymorphisms (SNPs) previously associated with fasting glucose in Caucasians in genome-wide association studies (GWAS) with glucose response to antihypertensive drugs shown to increase risk for hyperglycemia and diabetes. DESIGN Randomized, multicenter clinical trial. PATIENTS A total of 456 Caucasian men and women with uncomplicated hypertension. MEASUREMENTS AND MAIN RESULTS The Pharmacogenomic Evaluation of Antihypertensives Responses study evaluated blood pressure and glucose response in uncomplicated hypertensive patients randomized to either atenolol or hydrochlorothiazide (HCTZ) monotherapy, followed by combination therapy with both agents. Association of these SNPs with atenolol- or HCTZ-induced glucose response was evaluated in 456 Caucasian patients using linear regression adjusting for age, sex, body mass index, baseline glucose, baseline insulin, and principal component for ancestry. The SNP rs340874 in the 5' region of PROX1 gene was significantly associated with atenolol-induced glucose change (p=0.0013). Participants harboring the C allele of this SNP had greater glucose elevation after approximately 9 weeks of atenolol monotherapy (β = +2.39 mg/dl per C allele), consistent with the direction of effect in fasting glucose GWAS, that showed the C allele is associated with higher fasting glucose. CONCLUSION These data suggest that PROX1 SNP rs340874, discovered in fasting glucose GWAS, may also be a pharmacogenetic risk factor for antihypertensive-induced hyperglycemia. β-blockers and thiazides may interact with genetic risk factors to increase risk for dysglycemia and diabetes.
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Affiliation(s)
- Yan Gong
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics, University of Florida, Gainesville, Florida
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Abstract
The two major classes of drugs that target the RAS are the angiotensin-converting enzyme (ACE) inhibitors and the selective AT1 receptor blockers (ARBs). Although both of these drug classes target angiotensin II, the differences in their mechanisms of action have implications for their effects on other pathways and receptors that may have therapeutic implications. Both ACEIs and ARBs are effective antihypertensive agents that have been shown to reduce the risk of cardiovascular and renal events. Direct inhibition of renin -the most proximal aspect of the RAS -became clinically feasible from 2007 with the introduction of aliskiren. This latter drug has been shown to be efficacious for the management of hypertension. Combined therapy of direct renin-inhibitors with ACEIs or ARBs has been tested in some clinical situations as congestive HF and proteinuria with diverse results. This article tries to offer an updated review of current knowledge on the use of RAS blocking drugs in clinical settings.
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Affiliation(s)
- Nicolás Roberto Robles
- 1Cardiovascular Risk Chair, University of Salamanca School of Medicine, Salamanca, Spain
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Turner ST, Boerwinkle E, O'Connell JR, Bailey KR, Gong Y, Chapman AB, McDonough CW, Beitelshees AL, Schwartz GL, Gums JG, Padmanabhan S, Hiltunen TP, Citterio L, Donner KM, Hedner T, Lanzani C, Melander O, Saarela J, Ripatti S, Wahlstrand B, Manunta P, Kontula K, Dominiczak AF, Cooper-DeHoff RM, Johnson JA. Genomic association analysis of common variants influencing antihypertensive response to hydrochlorothiazide. Hypertension 2013; 62:391-7. [PMID: 23753411 DOI: 10.1161/hypertensionaha.111.00436] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
To identify novel genes influencing blood pressure response to thiazide diuretic therapy for hypertension, we conducted genome-wide association meta-analyses of ≈1.1 million single-nucleotide polymorphisms in a combined sample of 424 European Americans with primary hypertension treated with hydrochlorothiazide from the Pharmacogenomic Evaluation of Antihypertensive Responses study (n=228) and the Genetic Epidemiology of Responses to Antihypertensive study (n=196). Polymorphisms associated with blood pressure response at P<10(-5) were tested for replication of the associations in independent samples of hydrochlorothiazide-treated European hypertensives. The rs16960228 polymorphism in protein kinase C, α replicated for same-direction association with diastolic blood pressure response in the Nordic Diltiazem study (n=420) and the Genetics of Drug Responsiveness in Essential Hypertension study (n=206), and the combined 4-study meta-analysis P value achieved genome-wide significance (P=3.3 × 10(-8)). Systolic or diastolic blood pressure responses were consistently greater in carriers of the rs16960228 A allele than in GG homozygotes (>4/4 mm Hg) across study samples. The rs2273359 polymorphism in the GNAS-EDN3 region also replicated for same-direction association with systolic blood pressure response in the Nordic Diltiazem study, and the combined 3-study meta-analysis P value approached genome-wide significance (P=5.5 × 10(-8)). The findings document clinically important effects of genetic variation at novel loci on blood pressure response to a thiazide diuretic, which may be a basis for individualization of antihypertensive drug therapy and identification of new drug targets.
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Affiliation(s)
- Stephen T Turner
- Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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Current World Literature. Curr Opin Cardiol 2013; 28:369-79. [DOI: 10.1097/hco.0b013e328360f5be] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Turner ST, Schwartz GL, Bailey KR, Chai HS, Chapman AB, Boerwinkle E. Response to Genomic Association Analysis Identifies Multiple Loci Influencing Antihypertensive Response to an Angiotensin II Receptor Blocker. Hypertension 2013; 61:e6. [DOI: 10.1161/hypertensionaha.112.202523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Stephen T. Turner
- Division of Nephrology and Hypertension, Mayo Clinic, College of Medicine, Rochester, MN
| | - Gary L. Schwartz
- Division of Nephrology and Hypertension, Mayo Clinic, College of Medicine, Rochester, MN
| | - Kent R. Bailey
- Department of Medicine and Division of Biostatistics, Mayo Clinic, College of Medicine, Rochester, MN
| | - High Seng Chai
- Division of Biomedical Informatics, Department of Health Sciences Research, Mayo Clinic, College of Medicine, Rochester, MN
| | - Arlene B. Chapman
- Renal Division, Department of Medicine, Emory University, Atlanta, GA
| | - Eric Boerwinkle
- Human Genetics Center, School of Public Health, University of Texas-Houston Health Science Center, Houston, TX
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Frau F, Citterio L, Ortu MF, Zaninello R. Genomic Association Analysis Identifies Multiple Loci Influencing Antihypertensive Response to an Angiotensin II Receptor Blocker. Hypertension 2013; 61:e5. [DOI: 10.1161/hypertensionaha.112.201426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Francesca Frau
- Department of Health Sciences, University of Milano, Milano, Italy
| | - Lorena Citterio
- Division of Nephrology and Dialysis, San Raffaele Scientific Institute Milano, Milano, Italy
| | - Maria Francesca Ortu
- Hypertension and Related Diseases Centre—Azienda Ospedaliero-Universitaria, University of Sassari, Sassari, Italy
| | - Roberta Zaninello
- Hypertension and Related Diseases Centre—Azienda Ospedaliero-Universitaria, University of Sassari, Sassari, Italy
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Ni X, Zhang W, Huang RS. Pharmacogenomics discovery and implementation in genome-wide association studies era. WILEY INTERDISCIPLINARY REVIEWS-SYSTEMS BIOLOGY AND MEDICINE 2012. [PMID: 23188748 DOI: 10.1002/wsbm.1199] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Clinical response to therapeutic treatments often varies among individual patients, ranging from beneficial effect to even fatal adverse reaction. Pharmacogenomics holds the promise of personalized medicine through elucidating genetic determinants responsible for pharmacological outcomes (e.g., cytotoxicities to anticancer drugs) and therefore guide the prescription decision prior to drug treatment. Besides traditional candidate gene-based approaches, technical advances have begun to allow application of whole-genome approaches to pharmacogenomic discovery. In particular, comprehensive understanding of human genetic variation provides the basis for applying GWAS (genome-wide association studies) in pharmacogenomic research to identify genomic loci associated with pharmacological phenotypes (e.g., individual dose requirement for warfarin). We therefore briefly reviewed the background for pharmacogenetic/pharmacogenomic research with statins and warfarin as examples for the GWAS discovery and their clinical implementation. In conclusion, with some challenges, whole-genome approaches such as GWAS have allowed unprecedented progress in identifying genetic variants associated with pharmacological phenotypes, as well as provided foundation for the next wave of pharmacogenomic discovery utilizing sequencing-based approaches. Furthermore, investigation of the complex interactions among genetic and epigenetic factors on the whole-genome scale will become the post-GWAS research focus for pharmacologic complex traits.
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Affiliation(s)
- Xiuqin Ni
- Department of Anatomy, Harbin Medical University-Daqing, Daqing, Heilongjiang Province, China
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Harper AR, Topol EJ. Pharmacogenomics in clinical practice and drug development. Nat Biotechnol 2012; 30:1117-24. [PMID: 23138311 PMCID: PMC3819119 DOI: 10.1038/nbt.2424] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 10/17/2012] [Indexed: 12/30/2022]
Abstract
Genome-wide association studies (GWAS) of responses to drugs, including clopidogrel, pegylated-interferon and carbamazepine, have led to the identification of specific patient subgroups that benefit from therapy. However, the identification and replication of common sequence variants that are associated with either efficacy or safety for most prescription medications at odds ratios (ORs) >3.0 (equivalent to >300% increased efficacy or safety) has yet to be translated to clinical practice. Although some of the studies have been completed, the results have not been incorporated into therapy, and a large number of commonly used medications have not been subject to proper pharmacogenomic analysis. Adoption of GWAS, exome or whole genome sequencing by drug development and treatment programs is the most striking near-term opportunity for improving the drug candidate pipeline and boosting the efficacy of medications already in use.
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Affiliation(s)
- Andrew R Harper
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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