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Eunjin B, Ji Y, Jo J, Kim Y, Lee JP, Won S, Lee J. Effects of polygenic risk score and sodium and potassium intake on hypertension in Asians: A nationwide prospective cohort study. Hypertens Res 2024:10.1038/s41440-024-01784-7. [PMID: 38982292 DOI: 10.1038/s41440-024-01784-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 06/11/2024] [Accepted: 06/15/2024] [Indexed: 07/11/2024]
Abstract
Genetic factors, lifestyle, and diet have been shown to play important roles in the development of hypertension. Increased salt intake is an important risk factor for hypertension. However, research on the involvement of genetic factors in the relationship between salt intake and hypertension in Asians is lacking. We aimed to investigate the risk of hypertension in relation to sodium and potassium intake and the effects of genetic factors on their interactions. We used Korean Genome and Epidemiology Study data and calculated the polygenic risk score (PRS) for the effect of systolic and diastolic blood pressure (SBP and DBP). We also conducted multivariable logistic modeling to evaluate associations among incident hypertension, PRSSBP, PRSDBP, and sodium and potassium intake. In total, 41,351 subjects were included in the test set. The top 10% PRSSBP group was the youngest of the three groups (bottom 10%, middle, top 10%), had the highest proportion of women, and had the highest body mass index, baseline BP, red meat intake, and alcohol consumption. The multivariable logistic regression model revealed the risk of hypertension was significantly associated with higher PRSSBP, higher sodium intake, and lower potassium intake. There was significant interaction between sodium intake and PRSSBP for incident hypertension especially in sodium intake ≥2.0 g/day and PRSSBP top 10% group (OR 1.27 (1.07-1.51), P = 0.007). Among patients at a high risk of incident hypertension due to sodium intake, lifestyle modifications and sodium restriction were especially important to prevent hypertension.
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Affiliation(s)
- Bae Eunjin
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
- Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, Republic of Korea
- Institute of Medical Science, College of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Yunmi Ji
- College of Natural Sciences, Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Republic of Korea
| | - Jinyeon Jo
- Department of Public Health Sciences, Institute of Health & Environment, Seoul National University, Seoul, Republic of Korea
| | - Yaerim Kim
- Department of Internal Medicine, College of Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sungho Won
- Department of Public Health Sciences, Institute of Health & Environment, Seoul National University, Seoul, Republic of Korea.
- Interdisciplinary Program for Bioinformatics, College of Natural Science, Seoul National University, Seoul, Republic of Korea.
- RexSoft Corps, Seoul, Republic of Korea.
| | - Jeonghwan Lee
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Sornlorm K, Thi WM. Health literacy and high blood pressure among Myanmar migrant workers in Northeastern Thailand. PLoS One 2024; 19:e0302057. [PMID: 38662714 PMCID: PMC11045064 DOI: 10.1371/journal.pone.0302057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Hypertension, related to serious consequences unless diagnosed and treated, is a global concern, also affecting migrant workers. Due to the high prevalence of hypertension among migrant workers in Thailand, the influences of health literacy and other factors on blood pressure were needed to explore among Myanmar migrant workers in Northeastern Thailand. Hence, this study aimed to identify the prevalence of high blood pressure (HBP), its association with health literacy and other factors among Myanmar migrant workers in Northeastern Thailand. A cross-sectional analytical study was conducted in Northeastern Thailand. A multistage sampling procedure was applied. Data was gathered through interviews utilizing validated and reliable structured questionnaire. Descriptive statistics and inferential statistics with multiple logistic regression were used. Among 406 participants, about 60% were male and about 70% of them were married. The prevalence of overall HBP was 63.3% (95% CI: 58.49-67.86), 52% in females and 71.86% in males. Participants with limited health literacy were 79% more likely to have HBP than those with excellent and adequate health literacy (AOR = 1.79, 95% CI: 1.13-2.84). Other factors substantially linked with having HBP were being male gender (AOR = 4.68, 95% CI: 2.81-7.78), being overweight (AOR = 2.23, 95% CI: 1.18-4.23), being obese (AOR = 5.69, 95% CI: 2.96-10.96), not having health insurance (AOR = 2.01, 95% CI: 1.11-3.66), staying in Thailand for more than 48 months (AOR = 2.4, 95% CI: 1.48-3.9), and having family history of hypertension (AOR = 2.07, 95% CI: 1.28-3.35). In conclusion, more than half of Myanmar migrant workers had HBP. Factors associated with HBP were limited health literacy, male gender, overnutrition, lack of health insurance, longer duration of stay in Thailand and having family history of hypertension. Therefore, there is a need for a multifaceted strategy to prevent hypertension and its consequences by promoting health literacy as well as by enhancing good behavioural practice among this community.
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Affiliation(s)
- Kittipong Sornlorm
- Faculty of Public Health, Khon Kaen University, Nai Mueang, Mueang Khon Kaen, Khon Kaen, Thailand
| | - Wor Mi Thi
- Faculty of Public Health, Khon Kaen University, Nai Mueang, Mueang Khon Kaen, Khon Kaen, Thailand
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Betti MJ, Aldrich MC, Gamazon ER. Minimum entropy framework identifies a novel class of genomic functional elements and reveals regulatory mechanisms at human disease loci. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.11.544507. [PMID: 37398170 PMCID: PMC10312628 DOI: 10.1101/2023.06.11.544507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
We introduce CoRE-BED, a framework trained using 19 epigenomic features in 33 major cell and tissue types to predict cell-type-specific regulatory function. CoRE-BED identifies nine functional classes de-novo, capturing both known and new regulatory categories. Notably, we describe a previously undercharacterized class that we term Development Associated Elements (DAEs), which are highly enriched in cell types with elevated regenerative potential and distinguished by the dual presence of either H3K4me2 and H3K9ac (an epigenetic signature associated with kinetochore assembly) or H3K79me3 and H4K20me1 (a signature associated with transcriptional pause release). Unlike bivalent promoters, which represent a transitory state between active and silenced promoters, DAEs transition directly to or from a non-functional state during stem cell differentiation and are proximal to highly expressed genes. CoRE-BED's interpretability facilitates causal inference and functional prioritization. Across 70 complex traits, distal insulators account for the largest mean proportion of SNP heritability (~49%) captured by the GWAS. Collectively, our results demonstrate the value of exploring non-conventional ways of regulatory classification that enrich for trait heritability, to complement existing approaches for cis-regulatory prediction.
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Affiliation(s)
| | | | - Eric R Gamazon
- Vanderbilt University Medical Center, Nashville, TN
- Clare Hall, University of Cambridge, Cambridge, England
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Namgung HK, Woo HW, Shin J, Shin MH, Koh SB, Kim HC, Kim YM, Kim MK. Development and validation of hypertension prediction models: The Korean Genome and Epidemiology Study_Cardiovascular Disease Association Study (KoGES_CAVAS). J Hum Hypertens 2023; 37:205-212. [PMID: 35181762 DOI: 10.1038/s41371-021-00645-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/15/2021] [Accepted: 11/26/2021] [Indexed: 12/12/2022]
Abstract
This study aimed to develop and validate the hypertension risk prediction models of the CArdioVascular disease Association Study (CAVAS). Overall, 6,186 participants without hypertension at baseline were randomly divided into derivation and internal validation sets in a 6:4 ratio. We derived two prediction models: the first used the Framingham hypertension risk prediction factors (F-CAVAS-HTN); the second considered additional risk factors identified using stepwise Weibull regression analysis (CAVAS-HTN). These models were externally evaluated among Ansan and Ansung (A&A) participants, and the external validity of the Framingham and A&A prediction models (F-HTN and A&A-HTN) were assessed using the internal validation set of CAVAS. The discrimination, calibration, and net reclassification were determined. During the 4-year follow-up, 777 new cases of hypertension were diagnosed. All four models showed good discrimination (C-statistic ≥ 0.7). Internal calibrations were good for both the coefficient-based and the risk score-based F-CAVAS-HTN models, respectively (Hosmer-Lemeshow chi-square, H-L χ2 < 20, P ≥ 0.05). However, the two CAVAS models (H-L χ2 ≥ 20, P < 0.05, both) as well as the F-HTN and the A&A-HTN prediction models (H-L χ2 = 155.39, P < 0.0001; H-L χ2 = 209.72, P < 0.0001, respectively) were not externally calibrated. The F-CAVAS-HTN may be better than models with additional risk factors or derived for another population in the view of the findings of the internal validation in the present study, although future studies to improve the external validity of the F-CAVAS-HTN are needed.
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Affiliation(s)
- Hyun Kyung Namgung
- Department of Epidemiology and Health Statistics, Graduate School of Public Health, Hanyang University, Seoul, Korea.,Institute for Health and Society, Hanyang University, Seoul, Korea
| | - Hye Won Woo
- Institute for Health and Society, Hanyang University, Seoul, Korea.,Department of Preventive Medicine, Hanyang University, College of Medicine, Seoul, Korea
| | - Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University, College of Medicine, Seoul, South Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University, Medical School, Gwangju, South Korea
| | - Sang Baek Koh
- Department of Preventive Medicine and Institute of Occupational Medicine, Yonsei Wonju College of Medicine, Wonju, South Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine and Public Health, Yonsei University, College of Medicine, Seoul, South Korea
| | - Yu-Mi Kim
- Department of Epidemiology and Health Statistics, Graduate School of Public Health, Hanyang University, Seoul, Korea. .,Institute for Health and Society, Hanyang University, Seoul, Korea. .,Department of Preventive Medicine, Hanyang University, College of Medicine, Seoul, Korea.
| | - Mi Kyung Kim
- Department of Epidemiology and Health Statistics, Graduate School of Public Health, Hanyang University, Seoul, Korea. .,Institute for Health and Society, Hanyang University, Seoul, Korea. .,Department of Preventive Medicine, Hanyang University, College of Medicine, Seoul, Korea.
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Ali M, Hussein Z, Marshall JM. Young South Asian women in the United Kingdom show evidence of blunted endothelium-dependent dilatation: implications for future cardiovascular disease. J Hypertens 2022; 40:2438-2448. [PMID: 35983868 DOI: 10.1097/hjh.0000000000003276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Prevalence of cardiovascular disease (CVD) is higher in South Asians than white Europeans. The offspring of hypertensive parents (OH) have greater risk of hypertension than offspring of normotensive parents (ON). We hypothesized that endothelium-dependent dilatation is already blunted in young South Asians, relative to young white European women, particularly in South Asian OH women. METHODS In young white European ON, South Asian ON and OH women (18-25 years old; 10 per group) who were normotensive, we recorded cutaneous perfusion by laser Doppler fluximetry during reactive hyperaemia and iontophoresis of acetylcholine (ACh), before and after inhibiting NO synthesis (NOS) or/and cyclooxygenase (COX). In these and an additional 135 age-matched South Asian and white European women, physical activity and life-style factors were assessed by questionnaire. RESULTS ACh-evoked dilatation was blunted in young South Asians, relative to white European women. It was attenuated by NOS or COX inhibition in white European ON; by NOS inhibition only in South Asian ON, but not OH women. After combined NOS and COX inhibition, ACh-evoked dilatations were similar to control ACh responses. Similar findings were made for reactive hyperaemia. Questionnaire data indicated young South Asians have lower physical activity levels, fresh fruit and vegetable intake than white European women, South Asian OH being lower than white European ON, or OH women. CONCLUSION Endothelium-dependent dilatation is blunted in young South Asians, relative to white European women, especially in South Asian OH in whom NO-dependent and prostaglandin-dependent dilatation is blunted. We suggest improved diet and greater physical activity could be particularly effective in improving endothelium-dependent dilatation and reducing future CVD risk in young South Asian OH women.
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Affiliation(s)
- Majid Ali
- Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
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Alexander MR, Hank S, Dale BL, Himmel L, Zhong X, Smart CD, Fehrenbach DJ, Chen Y, Prabakaran N, Tirado B, Centrella M, Ao M, Du L, Shyr Y, Levy D, Madhur MS. A Single Nucleotide Polymorphism in SH2B3/LNK Promotes Hypertension Development and Renal Damage. Circ Res 2022; 131:731-747. [PMID: 36169218 PMCID: PMC9588739 DOI: 10.1161/circresaha.121.320625] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 09/15/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND SH2B3 (SH2B adaptor protein 3) is an adaptor protein that negatively regulates cytokine signaling and cell proliferation. A common missense single nucleotide polymorphism in SH2B3 (rs3184504) results in substitution of tryptophan (Trp) for arginine (Arg) at amino acid 262 and is a top association signal for hypertension in human genome-wide association studies. Whether this variant is causal for hypertension, and if so, the mechanism by which it impacts pathogenesis is unknown. METHODS We used CRISPR-Cas9 technology to create mice homozygous for the major (Arg/Arg) and minor (Trp/Trp) alleles of this SH2B3 polymorphism. Mice underwent angiotensin II (Ang II) infusion to evaluate differences in blood pressure (BP) elevation and end-organ damage including albuminuria and renal fibrosis. Cytokine production and Stat4 phosphorylation was also assessed in Arg/Arg and Trp/Trp T cells. RESULTS Trp/Trp mice exhibit 10 mmHg higher systolic BP during chronic Ang II infusion compared to Arg/Arg controls. Renal injury and perivascular fibrosis are exacerbated in Trp/Trp mice compared to Arg/Arg controls following Ang II infusion. Renal and ex vivo stimulated splenic CD8+ T cells from Ang II-infused Trp/Trp mice produce significantly more interferon gamma (IFNg) compared to Arg/Arg controls. Interleukin-12 (IL-12)-induced IFNg production is greater in Trp/Trp compared to Arg/Arg CD8+ T cells. In addition, IL-12 enhances Stat4 phosphorylation to a greater degree in Trp/Trp compared to Arg/Arg CD8+ T cells, suggesting that Trp-encoding SH2B3 exhibits less negative regulation of IL-12 signaling to promote IFNg production. Finally, we demonstrated that a multi-SNP model genetically predicting increased SH2B3 expression in lymphocytes is inversely associated with hypertension and hypertensive chronic kidney disease in humans.. CONCLUSIONS Taken together, these results suggest that the Trp encoding allele of rs3184504 is causal for BP elevation and renal dysfunction, in part through loss of SH2B3-mediated repression of T cell IL-12 signaling leading to enhanced IFNg production.
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Affiliation(s)
- Matthew R. Alexander
- Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA
- Department of Medicine, Division of Cardiovascular Medicine, VUMC, Nashville, TN, USA
- Vanderbilt Institute for Infection, Immunology, and Inflammation, Nashville, TN, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Samuel Hank
- Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA
| | - Bethany L. Dale
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Lauren Himmel
- Department of Pathology, Microbiology and Immunology, VUMC, Nashville, TN, USA
| | - Xue Zhong
- Department of Medicine, Division of Genetic Medicine, VUMC, Nashville, TN, USA
| | - Charles D. Smart
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Daniel J. Fehrenbach
- Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA
| | - Yuhan Chen
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
- Department of Cardiology, Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China
| | | | | | - Megan Centrella
- Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA
| | - Mingfang Ao
- Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA
| | - Liping Du
- Department of Biostatistics, VUMC, Nashville, TN
| | - Yu Shyr
- Department of Biostatistics, VUMC, Nashville, TN
| | - Daniel Levy
- Framingham Heart Study, Framingham, MA and Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Meena S. Madhur
- Department of Medicine, Division of Clinical Pharmacology, Vanderbilt University Medical Center (VUMC), Nashville, TN, USA
- Department of Medicine, Division of Cardiovascular Medicine, VUMC, Nashville, TN, USA
- Vanderbilt Institute for Infection, Immunology, and Inflammation, Nashville, TN, USA
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
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Whole-Genome Sequencing of 100 Genomes Identifies a Distinctive Genetic Susceptibility Profile of Qatari Patients with Hypertension. J Pers Med 2022; 12:jpm12050722. [PMID: 35629146 PMCID: PMC9144388 DOI: 10.3390/jpm12050722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/11/2022] [Accepted: 04/26/2022] [Indexed: 02/05/2023] Open
Abstract
Essential hypertension (EH) is a leading risk condition for cardiovascular and renal complications. While multiple genes are associated with EH, little is known about its genetic etiology. Therefore, this study aimed to screen for variants that are associated with EH in 100 hypertensive/100 control patients comprising Qatari individuals using GWASs of whole-genome sequencing and compare these findings with genetic data obtained from more than 10,000 published peer-reviewed studies on EH. The GWAS analysis performed with 21,096 SNPs revealed 38 SNPs with a significant ≥4 log-p value association with EH. The two highest EH-associated SNPs (rs921932379 and rs113688672) revealed a significance score of ≥5 log-p value. These SNPs are located within the inter-genic region of GMPS-SETP14 and ISCA1P6-AC012451.1, respectively. Text mining yielded 3748 genes and 3078 SNPs, where 51 genes and 24 SNPs were mentioned in more than 30 and 10 different articles, respectively. Comparing our GWAS results to previously published articles revealed 194 that are unique to our patient cohort; of these, 13 genes that have 26 SNPs are the most significant with ≥4 log-p value. Of these genes, C2orf47-SPATS2L contains nine EH-associated SNPs. Most of EH-associated genes are related to ion gate channel activity and cardiac conduction. The disease–gene analysis revealed that a large number of EH-associated genes are associated with a variety of cardiovascular disorders. The clustering analysis using EH-associated SNPs across different ethnic groups showed high frequency for the minor allele in different ethnic groups, including Africans, East Asians, and South Asians. The combination of GWAS and text mining helped in identifying the unique genetic susceptibility profile of Qatari patients with EH. To our knowledge, this is the first small study that searched for genetic factors associated with EH in Qatari patients.
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Chekka LMS, Langaee T, Johnson JA. Comparison of Data Normalization Strategies for Array-Based MicroRNA Profiling Experiments and Identification and Validation of Circulating MicroRNAs as Endogenous Controls in Hypertension. Front Genet 2022; 13:836636. [PMID: 35432462 PMCID: PMC9008777 DOI: 10.3389/fgene.2022.836636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/03/2022] [Indexed: 02/06/2023] Open
Abstract
Introduction: MicroRNAs are small noncoding RNAs with potential regulatory roles in hypertension and drug response. The presence of many of these RNAs in biofluids has spurred investigation into their role as possible biomarkers for use in precision approaches to healthcare. One of the major challenges in clinical translation of circulating miRNA biomarkers is the limited replication across studies due to lack of standards for data normalization techniques for array-based approaches and a lack of consensus on an endogenous control normalizer for qPCR-based candidate miRNA profiling studies. Methods: We conducted genome-wide profiling of 754 miRNAs in baseline plasma of 36 European American individuals with uncomplicated hypertension selected from the PEAR clinical trial, who had been untreated for hypertension for at least one month prior to sample collection. After appropriate quality control with amplification score and missingness filters, we tested different normalization strategies such as normalization with global mean of imputed and unimputed data, mean of restricted set of miRNAs, quantile normalization, and endogenous control miRNA normalization to identify the method that best reduces the technical/experimental variability in the data. We identified best endogenous control candidates with expression pattern closest to the mean miRNA expression in the sample, as well as by assessing their stability using a combination of NormFinder, geNorm, Best Keeper and Delta Ct algorithms under the Reffinder software. The suitability of the four best endogenous controls was validated in 50 hypertensive African Americans from the same trial with reverse-transcription–qPCR and by evaluating their stability ranking in that cohort. Results: Among the compared normalization strategies, quantile normalization and global mean normalization performed better than others in terms of reducing the standard deviation of miRNAs across samples in the array-based data. Among the four strongest candidate miRNAs from our selection process (miR-223-3p, 19b, 106a, and 126-5p), miR-223-3p and miR-126-5p were consistently expressed with the best stability ranking in the validation cohort. Furthermore, the combination of miR-223-3p and 126-5p showed better stability ranking when compared to single miRNAs. Conclusion: We identified quantile normalization followed by global mean normalization to be the best methods in reducing the variance in the data. We identified the combination of miR-223-3p and 126-5p as potential endogenous control in studies of hypertension.
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Affiliation(s)
- Lakshmi Manasa S. Chekka
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, University of Florida, Gainesville, FL, United States
| | - Taimour Langaee
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, University of Florida, Gainesville, FL, United States
| | - Julie A. Johnson
- Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, University of Florida, Gainesville, FL, United States
- Division of Cardiovascular Medicine, Department of Medicine, University of Florida, Gainesville, FL, United States
- *Correspondence: Julie A. Johnson,
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Association between Exercise and Blood Pressure in Hypertensive Residents: A Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2453805. [PMID: 35069755 PMCID: PMC8767394 DOI: 10.1155/2022/2453805] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/02/2021] [Accepted: 12/08/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Exercise is recommended as an effective lifestyle behaviour for adults to prevent and treat hypertension. In this study, a randomized-effect meta-analysis was used to analyse the influence of exercise interventions on blood pressure in patients with hypertension. METHODS Candidate papers were retrieved from PubMed, Web of Science, Embase, and Cochrane Library electronic databases, and 46 studies were finally included and analysed. RESULTS It was shown that preplanned walking (systolic blood pressure (SBP): WMD (weighted mean difference) = -5.94, 95% CI: -8.57, -3.30; diastolic blood pressure (DBP): WMD = -2.66, 95% CI: -3.66, -1.67), yoga (SBP: WMD = -5.09, 95% CI: -9.28, -0.89; DBP: WMD = -3.06, 95% CI: -5.16, -0.96), aquatic sports (SBP WMD = -7.53, 95% CI: -11.40, -3.65; DBP: WMD = -5.35, 95% CI: -9.00, -1.69), and football (SBP: WMD = -6.06, 95% CI: -9.30, -2.82; DBP: WMD = -5.55, 95% CI: -8.98, -2.13) had significant effects on blood pressure reduction. However, Tai Chi (SBP: WMD = -8.31, 95% CI: -20.39, 3.77; DBP: WMD = -3.05, 95% CI: -6.96, 0.87) and Qigong (SBP: WMD = -4.34, 95% CI: -13.5, 4.82; DBP: WMD = -3.44, 95% CI: -7.89, 1.01) did not significantly reduce blood pressure. The heterogeneity of the meta-analysis was high. CONCLUSION Walking, yoga, aquatic sports, and football were feasible and independent lifestyle interventions, and they were effective options for treating hypertension. More scientifically designed randomized controlled trials are needed in the future to further compare different forms of exercise for the treatment of hypertension.
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Madhur MS, Elijovich F, Alexander MR, Pitzer A, Ishimwe J, Van Beusecum JP, Patrick DM, Smart CD, Kleyman TR, Kingery J, Peck RN, Laffer CL, Kirabo A. Hypertension: Do Inflammation and Immunity Hold the Key to Solving this Epidemic? Circ Res 2021; 128:908-933. [PMID: 33793336 DOI: 10.1161/circresaha.121.318052] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Elevated cardiovascular risk including stroke, heart failure, and heart attack is present even after normalization of blood pressure in patients with hypertension. Underlying immune cell activation is a likely culprit. Although immune cells are important for protection against invading pathogens, their chronic overactivation may lead to tissue damage and high blood pressure. Triggers that may initiate immune activation include viral infections, autoimmunity, and lifestyle factors such as excess dietary salt. These conditions activate the immune system either directly or through their impact on the gut microbiome, which ultimately produces chronic inflammation and hypertension. T cells are central to the immune responses contributing to hypertension. They are activated in part by binding specific antigens that are presented in major histocompatibility complex molecules on professional antigen-presenting cells, and they generate repertoires of rearranged T-cell receptors. Activated T cells infiltrate tissues and produce cytokines including interleukin 17A, which promote renal and vascular dysfunction and end-organ damage leading to hypertension. In this comprehensive review, we highlight environmental, genetic, and microbial associated mechanisms contributing to both innate and adaptive immune cell activation leading to hypertension. Targeting the underlying chronic immune cell activation in hypertension has the potential to mitigate the excess cardiovascular risk associated with this common and deadly disease.
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Affiliation(s)
- Meena S Madhur
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Division of Cardiovascular Medicine (M.S.M., M.R.A., D.M.P.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Department of Molecular Physiology and Biophysics, Vanderbilt University (M.S.M., C.D.S., A.K.)
| | - Fernando Elijovich
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Matthew R Alexander
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Division of Cardiovascular Medicine (M.S.M., M.R.A., D.M.P.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Ashley Pitzer
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Jeanne Ishimwe
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Justin P Van Beusecum
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - David M Patrick
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Division of Cardiovascular Medicine (M.S.M., M.R.A., D.M.P.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Charles D Smart
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Department of Molecular Physiology and Biophysics, Vanderbilt University (M.S.M., C.D.S., A.K.)
| | - Thomas R Kleyman
- Departments of Medicine, Cell Biology, Pharmacology and Chemical Biology, University of Pittsburgh, PA (T.R.K.)
| | - Justin Kingery
- Center for Global Health, Weill Cornell Medical College, NY (J.K., R.N.P.).,Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania (J.K., R.N.P.)
| | - Robert N Peck
- Center for Global Health, Weill Cornell Medical College, NY (J.K., R.N.P.).,Department of Medicine, Weill Bugando School of Medicine, Mwanza, Tanzania (J.K., R.N.P.).,Mwanza Intervention Trials Unit (MITU), Mwanza, Tanzania (R.N.P.)
| | - Cheryl L Laffer
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Annet Kirabo
- Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN.,Department of Molecular Physiology and Biophysics, Vanderbilt University (M.S.M., C.D.S., A.K.)
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11
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Choi Y, Nam Y, Choi Y, Kim J, Jang J, Ahn KJ, Kim BS, Shin NY. MRI-visible dilated perivascular spaces in healthy young adults: A twin heritability study. Hum Brain Mapp 2020; 41:5313-5324. [PMID: 32897599 PMCID: PMC7670636 DOI: 10.1002/hbm.25194] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 08/05/2020] [Accepted: 08/12/2020] [Indexed: 12/24/2022] Open
Abstract
We investigated the narrow‐sense heritability of MRI‐visible dilated perivascular spaces (dPVS) in healthy young adult twins and nontwin siblings (138 monozygotic, 79 dizygotic twin pairs, and 133 nontwin sibling pairs; 28.7 ± 3.6 years) from the Human Connectome Project. dPVS volumes within basal ganglia (BGdPVS) and white matter (WMdPVS) were automatically calculated on three‐dimensional T2‐weighted MRI. In univariate analysis, heritability estimates of BGdPVS and WMdPVS after age and sex adjustment were 65.8% and 90.2%. In bivariate analysis, both BGdPVS and WMdPVS showed low to moderate genetic correlations (.30–.43) but high shared heritabilities (71.8–99.9%) with corresponding regional volumes, intracranial volumes, and other regional dPVS volumes. Older age was significantly associated with larger dPVS volume in both regions even after adjusting for clinical and volumetric variables, while blood pressure was not associated with dPVS volume although there was weak genetic correlation. dPVS volume, particularly WMdPVS, was highly heritable in healthy young adults, adding evidence of a substantial genetic contribution in dPVS development and differential effect by location. Age affects dPVS volume even in young adults, while blood pressure might have limited role in dPVS development in its normal range.
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Affiliation(s)
- Yangsean Choi
- Department of Radiology, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoonho Nam
- Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin-Si, Republic of Korea
| | - Yera Choi
- Department of Radiology, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jiwoong Kim
- Department of Radiology, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jinhee Jang
- Department of Radiology, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kook Jin Ahn
- Department of Radiology, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Bum-Soo Kim
- Department of Radiology, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Na-Young Shin
- Department of Radiology, Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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12
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Saroj C, Juthika M, Tao Y, Xi C, Ji-Youn Y, Cameron MG, Camilla WF, Lauren KG, Jennifer HW, Matam VK, Bina J. Metabolites and Hypertension: Insights into Hypertension as a Metabolic Disorder: 2019 Harriet Dustan Award. Hypertension 2020; 75:1386-1396. [PMID: 32336227 PMCID: PMC7225070 DOI: 10.1161/hypertensionaha.120.13896] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
For over 100 years, essential hypertension has been researched from different perspectives ranging from genetics, physiology, and immunology to more recent ones encompassing microbiology (microbiota) as a previously underappreciated field of study contributing to the cause of hypertension. Each field of study in isolation has uniquely contributed to a variety of underlying mechanisms of blood pressure regulation. Even so, clinical management of essential hypertension has remained somewhat static. We, therefore, asked if there are any converging lines of evidence from these individual fields that could be amenable for a better clinical prognosis. Accordingly, here we present converging evidence which support the view that metabolic dysfunction underlies essential hypertension.
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Affiliation(s)
- Chakraborty Saroj
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Mandal Juthika
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Yang Tao
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Cheng Xi
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Yeo Ji-Youn
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - McCarthy G. Cameron
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Wenceslau F. Camilla
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Koch G. Lauren
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Hill W. Jennifer
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Vijay-Kumar Matam
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Joe Bina
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
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13
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Wellman JL, Holmes B, Hill SY. Accuracy of self-reported hypertension: Effect of age, gender, and history of alcohol dependence. J Clin Hypertens (Greenwich) 2020; 22:842-849. [PMID: 32277600 DOI: 10.1111/jch.13854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/28/2020] [Accepted: 03/17/2020] [Indexed: 11/26/2022]
Abstract
Patient awareness of medical conditions may influence treatment seeking and monitoring of these conditions. Accurate awareness of hypertension reported to clinicians evaluating patients for whom clinical history is limited, such as in emergency care, can aid in diagnosis by revealing whether measured hypertension is typical or atypical. Measurement of blood pressure in a laboratory study was assessed at rest, immediately before phlebotomy, and within 10 minutes after. The resting measure was used to determine the accuracy of self-reported hypertension in 283 adults. Parametric analyses were conducted to identify potential variables influencing accuracy of self-reported hypertension. Sensitivity, specificity, and the kappa coefficient of agreement were calculated to determine the influence of alcohol dependence (AD), sex, age, and cigarette smoking on hypertension awareness. Self-report was mildly sensitive, correctly identifying individuals with hypertension in approximately 37% of the cases, but was highly specific (95%) in identifying individuals without hypertension. Similar sensitivities were found in analyses separated by sex. Sensitivity was greater in those over age 55 (53%) in comparison with those <54, as well as in those who were not smoking. Comparison of those with and without a history of AD revealed that both groups show similar accuracy in reporting hypertension. Absence of hypertension can be accurately determined with self-report data in those without hypertension. A significant proportion of those with measured hypertension report an absence of hypertension.
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Affiliation(s)
| | - Brian Holmes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shirley Y Hill
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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14
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The impact of disregarding family structure on genome-wide association analysis of complex diseases in cohorts with simple pedigrees. J Appl Genet 2019; 61:75-86. [PMID: 31755004 DOI: 10.1007/s13353-019-00526-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 09/19/2019] [Accepted: 10/10/2019] [Indexed: 12/12/2022]
Abstract
The generalized linear mixed models (GLMMs) methodology is the standard framework for genome-wide association studies (GWAS) of complex diseases in family-based cohorts. Fitting GLMMs in very large cohorts, however, can be computationally demanding. Also, the modified versions of GLMM using faster algorithms may underperform, for instance when a single nucleotide polymorphism (SNP) is correlated with fixed-effects covariates. We investigated the extent to which disregarding family structure may compromise GWAS in cohorts with simple pedigrees by contrasting logistic regression models (i.e., with no family structure) to three LMMs-based ones. Our analyses showed that the logistic regression models in general resulted in smaller P values compared with the LMMs-based models; however, the differences in P values were mostly minor. Disregarding family structure had little impact on determining disease-associated SNPs at genome-wide level of significance (i.e., P < 5E-08) as the four P values resulted from the tested methods for any SNP were all below or all above 5E-08. Nevertheless, larger discrepancies were detected between logistic regression and LMMs-based models at suggestive level of significance (i.e., of 5E-08 ≤ P < 5E-06). The SNP effects estimated by the logistic regression models were not statistically different from those estimated by GLMMs that implemented Wald's test. However, several SNP effects were significantly different from their counterparts in LMMs analyses. We suggest that fitting GLMMs with Wald's test on a pre-selected subset of SNPs obtained from logistic regression models can ensure the balance between the speed of analyses and the accuracy of parameters.
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15
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Sun D, Zhou T, Li X, Heianza Y, Liang Z, Bray GA, Sacks FM, Qi L. Genetic Susceptibility, Dietary Protein Intake, and Changes of Blood Pressure: The POUNDS Lost Trial. Hypertension 2019; 74:1460-1467. [PMID: 31656094 DOI: 10.1161/hypertensionaha.119.13510] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
High blood pressure (BP) is closely related to obesity, and weight loss lowers BP. Evidence has shown considerable interpersonal variation of changes in BP among people experiencing weight loss, and such variation might be partly determined by genetic factors. We assessed the changes in systolic and diastolic BP (SBP/DBP) among 692 participants randomly assigned to 1 of 4 diets varying in macronutrient content for 2 years. Two separate polygenic scores (SBP/DBP-PGS derived from 52/50 single nucleotide polymorphisms) were built for each participant based on 66 BP-associated single nucleotide polymorphisms. During a 2-year intervention, participants in the bottom versus upper tertile of SBP/DBP-PGS had a greater decrease in SBP (△SBP at 6, 12, and 24 months: -3.84 versus -1.61, -4.76 versus -2.75, -2.49 versus -1.63; P=0.001) or in DBP (△DBP at 6, 12, and 24 months: -3.09 versus -1.34, -2.69 versus -1.44, -1.82 versus -0.53; P<0.001). We also found gene-diet interaction on changes in SBP from baseline to 24 months (Pinteraction=0.009). Among participants assigned to a high-protein diet, those with a lower SBP-polygenic scores had greater decreases in SBP at months 6 (P=0.018), months 12 (P=0.007), and months 24 (P=0.089); while no significant difference was observed across the SBP-polygenic scores tertile groups among those assigned to an average-protein diet (all P values >0.05). Our data indicate that genetic susceptibility may affect BP changes in response to weight-loss diet interventions, and protein intake may modify the genetic associations with changes in BP. This trial was registered at URL: http://www.clinicaltrials.gov. Unique identifier: NCT00072995.
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Affiliation(s)
- Dianjianyi Sun
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., T.Z., X.L., Y.H., Z.L., L.Q.).,Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (D.S.)
| | - Tao Zhou
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., T.Z., X.L., Y.H., Z.L., L.Q.)
| | - Xiang Li
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., T.Z., X.L., Y.H., Z.L., L.Q.)
| | - Yoriko Heianza
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., T.Z., X.L., Y.H., Z.L., L.Q.)
| | - Zhaoxia Liang
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., T.Z., X.L., Y.H., Z.L., L.Q.).,Department of Obstetrics, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China (Z.L.).,Key Laboratory of Reproductive Genetics, Ministry of Education, China (Z.L.)
| | - George A Bray
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA (G.A.B.)
| | - Frank M Sacks
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (F.M.S., L.Q.).,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (F.M.S., L.Q.)
| | - Lu Qi
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (D.S., T.Z., X.L., Y.H., Z.L., L.Q.).,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (F.M.S., L.Q.).,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (F.M.S., L.Q.)
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16
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Pinheiro DS, Santos RS, Jardim PCBV, Silva EG, Reis AAS, Pedrino GR, Ulhoa CJ. The combination of ACE I/D and ACE2 G8790A polymorphisms revels susceptibility to hypertension: A genetic association study in Brazilian patients. PLoS One 2019; 14:e0221248. [PMID: 31430320 PMCID: PMC6701835 DOI: 10.1371/journal.pone.0221248] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 08/04/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Systemic arterial hypertension (SAH) is a multifactorial condition that already affects one third of the worldwide population. The identification of candidate genes for hypertension is a challenge for the next years. Nevertheless, the small contribution of each individual genetic factor to the disease brings the necessity of evaluate genes in an integrative manner and taking into consideration the physiological interaction of functions. Angiotensin I-converting enzymes, ACE and ACE2, are key regulators of blood pressure that have counterbalance roles by acting on vasoactive peptides from Renin-Angiotensin-Aldosterone System (RAAS). Insertion/deletion (I/D) polymorphism of ACE gene and single nucleotide polymorphism G8790A of ACE2 gene have been associated with susceptibility to SAH, but the literature is controversial. We proposed to evaluate these two polymorphisms jointly exploring the combined effects of ACE and ACE2 genotypes on SAH susceptibility, an approach that have not been done yet for ACE and ACE2 polymorphisms. METHODS AND FINDINGS This genetic association study included 117 hypertensive (mean age 59.7 years) patients and 123 normotensive and diabetes-free controls (mean age 57.5 years). ACE and ACE2 polymorphisms were genotyped by SYBR Green real-time PCR and RFLP-PCR, respectively. Crude and adjusted odds ratio (OR) values were calculated to estimate the susceptibility to SAH development. It was obtained homogeneity regarding distribution by sex, age range, smoking, alcohol consumption and body mass index (BMI) between case and control groups. No-association was verified for each gene individually, but the combination of ACE and ACE2 polymorphisms on female gender revealed a significative association for DD/G_ carriers who had a 3-fold increased risk to SAH development (p = 0.03), with a stronger susceptibility on DD/GG carriers (7-fold increased risk, p = 0.01). The D allele of ACE showed association with altered levels of lipid profile variables on case group (VLDL-cholesterol, p = 0.01) and DD genotype in all individuals analysis (triglycerides, p = 0.01 and VLDL-cholesterol, p = 0.01). CONCLUSION These findings indicate that the combination of ACE and ACE2 polymorphisms effects may play a role in SAH predisposition been the DD/G_ genotype the susceptibility profile. This result allowed us to raise the hypothesis that an increased activity of ACE (prohypertensive effects) in conjunction with reduced ACE2 activity (antihypertensive effects) could be the underlining mechanism. The association of ACE D allele with lipid alterations indicate that this can be a marker of poor prognostic on SAH evolution and contribute to CVD development. Although these preliminary findings must be confirmed by further researches with larger sample size, we could observe that the integrative analysis of ACE and ACE2 can be an informative tool in hypertension understanding that needs to be explored in new studies.
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Affiliation(s)
- Denise S. Pinheiro
- Postgraduate Program in Biological Sciences, Institute of Biological Sciences, Federal University of Goiás (UFG), Goiânia, Goiás, Brazil
| | - Rodrigo S. Santos
- Department of Nature Sciences (LEdoC), Special Academic Unit of Human Sciences, Federal University of Goiás (UFG), Goiás, Goiás, Brazil
| | - Paulo C. B. Veiga Jardim
- League of Hypertension, Faculty of Medicine, Federal University of Goiás (UFG), Goiânia, Goiás, Brazil
| | - Elisangela G. Silva
- Postgraduate Program in Biological Sciences, Institute of Biological Sciences, Federal University of Goiás (UFG), Goiânia, Goiás, Brazil
| | - Angela A. S. Reis
- Department of Biochemistry and Molecular Biology, Institute of Biological Sciences, Federal University of Goiás (UFG), Goiânia, Goiás, Brazil
| | - Gustavo R. Pedrino
- Department of Physiological Sciences, Institute of Biological Sciences, Federal University of Goiás (UFG), Goiânia, Goiás, Brazil
- * E-mail:
| | - Cirano J. Ulhoa
- Department of Biochemistry and Molecular Biology, Institute of Biological Sciences, Federal University of Goiás (UFG), Goiânia, Goiás, Brazil
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17
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Wang CL, Kuo CF, Yeh YH, Hsieh MY, Kuo CT, Chang SH. Familial aggregation of myocardial infarction and coaggregation of myocardial infarction and autoimmune disease: a nationwide population-based cross-sectional study in Taiwan. BMJ Open 2019; 9:e023614. [PMID: 30898803 PMCID: PMC6475449 DOI: 10.1136/bmjopen-2018-023614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE This study examined how a history of myocardial infarction (MI) in a person's first-degree relatives affects that person's risk of developing MI and autoimmune diseases. DESIGN Nationwide population-based cross-sectional study SETTING: All healthcare facilities in Taiwan. PARTICIPANTS A total of 24 361 345 individuals were enrolled. METHODS Using data from the National Health Insurance Research Database in Taiwan, we conducted a nationwide cross-sectional study of data collected from all beneficiaries in the Taiwan National Health Insurance system in 2015, of whom 259 360 subjects had at least one first-degree relative affected by MI in 2015. We estimated the absolute risks and relative risks (RRs) of MI and autoimmune disease in those subjects, and the relative contribution of genetic and environmental factors to their MI susceptibility. RESULTS The absolute risks of MI for subjects with at least one affected first-degree relative and the general population were 0.87% and 0.56%, respectively, in 2015. Patients with affected first-degree relatives were significantly associated with a higher RR of MI (1.76, 95% CI: 1.68 to 1.85) compared with the general population. There was no association with a higher RR of autoimmune disease. The sibling, offspring and parental MI history conferred RRs (95% CI) for MI of 2.35 (1.96 to 2.83), 2.21 (2.05 to 2.39) and 1.60 (1.52 to 1.68), respectively. The contributions of heritability, shared environmental factors and non-shared environmental factors to MI susceptibility were 19.6%, 3.4% and 77.0%, respectively. CONCLUSIONS Individuals who have first-degree relatives with a history of MI have a higher risk of developing MI than the general population. Non-shared environmental factors contributed more significantly to MI susceptibility than did heritability and shared environmental factors. A family history of MI was not associated with an increased risk of autoimmune disease.
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Affiliation(s)
- Chun-Li Wang
- Cardiovascular Department, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chang-Fu Kuo
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
- Division of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yung-Hsin Yeh
- Cardiovascular Department, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Mei-Yun Hsieh
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chi-Tai Kuo
- Cardiovascular Department, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shang-Hung Chang
- Cardiovascular Department, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou, Taiwan
- Graduate Institute of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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18
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Endothelium-dependent and cyclooxygenase-dependent cutaneous vasodilatation is blunted in young men with hypertensive parents. J Hypertens 2018; 36:2140-2147. [PMID: 29846330 DOI: 10.1097/hjh.0000000000001794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Across ethnicities, offspring of hypertensive parents (OH) have higher risk of hypertension than offspring of normotensive parents (ON). Sympathetic hyperactivity and reduced nitric oxide availability have been reported in normotensive OH; but the role of vasodilator cyclooxygenase (COX) products is unclear. METHODS In 12 OH and 12 ON men (19-24 years old), each group comprising six white Europeans and six South Asians with resting ABP less than 129/89 mmHg, reactive hyperaemia and responses evoked by iontophoresis pulses of acetylcholine (ACh) were recorded in forearm skin by laser Doppler fluximetry before and after COX inhibition. RESULTS Peak reactive hyperaemia was larger in ON than OH (71.0 ± 7.8 vs. 43.4 ± 8.3 perfusion units (perf.units); P < 0.05). It was attenuated by COX inhibition in ON (24.8 ± 5.2 perf.units, P < 0.01), not OH (54.2 ± 7.5 perf.units). Similarly, increases in perfusion evoked by ACh were greater in ON than OH (169.1 ± 20.4 vs. 142.1 ± 19.9 perf.units; P < 0.05) and attenuated by COX inhibition in ON (94.5 ± 13.7; P < 0.05), not OH (132.6 ± 16.1 perf.units). Considering ethnicities, ACh-evoked dilation, though not reactive hyperaemia was greater in Europeans than Asians (176.8 ± 21.7 vs. 130.4 ± 15.0; P < 0.01; 61.0 ± 8.7 vs. 51.7 ± 9.2 perf.units). However, within both Europeans and Asians, COX inhibition attenuated reactive hyperaemia and ACh-induced dilatation in ON only. CONCLUSION Reactive hyperaemia and ACh-evoked dilatation in cutaneous circulation are blunted in young, normotensive OH relative to ON men irrespective of white European, or South Asian ethnicity and are attributable to impaired contribution of COX vasodilator products in OH. These features may provide early markers of endothelial dysfunction that contribute to hypertensive risk in OH men.
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19
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Fenwick PH, Jeejeebhoy K, Dhaliwal R, Royall D, Brauer P, Tremblay A, Klein D, Mutch DM. Lifestyle genomics and the metabolic syndrome: A review of genetic variants that influence response to diet and exercise interventions. Crit Rev Food Sci Nutr 2018; 59:2028-2039. [PMID: 29400991 DOI: 10.1080/10408398.2018.1437022] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Metabolic syndrome (MetS) comprises a cluster of risk factors that includes central obesity, dyslipidemia, impaired glucose homeostasis and hypertension. Individuals with MetS have elevated risk of type 2 diabetes and cardiovascular disease; thus placing significant burdens on social and healthcare systems. Lifestyle interventions (comprised of diet, exercise or a combination of both) are routinely recommended as the first line of treatment for MetS. Only a proportion of people respond, and it has been assumed that psychological and social aspects primarily account for these differences. However, the etiology of MetS is multifactorial and stems, in part, on a person's genetic make-up. Numerous single nucleotide polymorphisms (SNPs) are associated with the various components of MetS, and several of these SNPs have been shown to modify a person's response to lifestyle interventions. Consequently, genetic variants can influence the extent to which a person responds to changes in diet and/or exercise. The goal of this review is to highlight SNPs reported to influence the magnitude of change in body weight, dyslipidemia, glucose homeostasis and blood pressure during lifestyle interventions aimed at improving MetS components. Knowledge regarding these genetic variants and their ability to modulate a person's response will provide additional context for improving the effectiveness of personalized lifestyle interventions that aim to reduce the risks associated with MetS.
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Affiliation(s)
- Peri H Fenwick
- a Department of Human Health and Nutritional Sciences , University of Guelph , Guelph , Ontario , Canada
| | - Khursheed Jeejeebhoy
- b Emeritus Professor of Medicine and Physician , St. Michael's Hospital , Toronto , Ontario , Canada
| | | | - Dawna Royall
- d Department of Family Relations and Applied Nutrition , University of Guelph , Guelph , Ontario , Canada
| | - Paula Brauer
- d Department of Family Relations and Applied Nutrition , University of Guelph , Guelph , Ontario , Canada
| | - Angelo Tremblay
- e Department of Kinesiology , Faculty of Medicine, Université Laval , Québec City , Québec , Canada
| | - Doug Klein
- f Department of Family Medicine , University of Alberta , Edmonton , Alberta , Canada
| | - David M Mutch
- a Department of Human Health and Nutritional Sciences , University of Guelph , Guelph , Ontario , Canada
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Frith E, Loprinzi PD. Physical activity is associated with higher cognitive function among adults at risk for Alzheimer’s disease. Complement Ther Med 2018; 36:46-49. [DOI: 10.1016/j.ctim.2017.11.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 11/17/2017] [Accepted: 11/20/2017] [Indexed: 10/18/2022] Open
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Marron MM, Singh J, Boudreau RM, Christensen K, Cosentino S, Feitosa MF, Minster RL, Perls T, Schupf N, Sebastiani P, Ukraintseva S, Wojczynski MK, Newman AB. A novel healthy blood pressure phenotype in the Long Life Family Study. J Hypertens 2018; 36:43-53. [PMID: 28837423 PMCID: PMC5893936 DOI: 10.1097/hjh.0000000000001514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Hypertension tends to run in families and has both genetic and environmental determinants. We assessed the hypothesis that a novel healthy blood pressure (BP) phenotype is also familial and sought to identify its associated factors. METHODS We developed a healthy BP phenotype in the Long Life Family Study, a cohort of two-generation families selected for longevity. Participants from the offspring generation (n = 2211, ages 32-88) were classified as having healthy BP if their age-adjusted and sex-adjusted SBP z-score was between -1.5 and -0.5. Offspring on antihypertensive medications were classified as not having healthy BP. Families with at least two offspring (n = 419 families) were defined as meeting the healthy BP phenotype if at least two and at least 50% of their offspring had healthy BP. RESULTS Among 2211 offspring, 476 (21.5%) met the healthy BP phenotype. When examining the 419 families, only 44 (10.5%) families met the criteria for the healthy BP phenotype. Both offspring and probands from families with healthy BP performed better on neuropsychological tests that place demands on complex attention and executive function when compared with offspring and probands from remaining families. Among families with the healthy BP phenotype compared with families without, a higher proportion of offspring met the American Heart Association definition of ideal cardiovascular health (10.8 versus 3.8%, respectively; driven by BP, smoking status, and BMI components). CONCLUSION In this cohort of familial longevity, few families had a novel healthy BP phenotype in multiple members. Families with this healthy BP phenotype may represent a specific pathway to familial longevity.
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Affiliation(s)
- Megan M. Marron
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jatinder Singh
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Robert M. Boudreau
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kaare Christensen
- Department of Public Health, The Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - Stephanie Cosentino
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University Medical Center, New York, New York
| | - Mary F. Feitosa
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri
| | - Ryan L. Minster
- Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Thomas Perls
- Department of Medicine, Geriatrics Section, Boston Medical Center, Boston University School of Medicine
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University Medical Center, New York, New York
| | - Paola Sebastiani
- Department of Biostatistics, Boston University, Boston, Massachusetts
| | - Svetlana Ukraintseva
- Center for Population Health and Aging, Department of Sociology, Duke University, Durham, North Carolina
| | - Mary K. Wojczynski
- Division of Statistical Genomics, Department of Genetics, Washington University School of Medicine, St. Louis, Missouri
| | - Anne B. Newman
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Departments of Medicine and Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Li C, Grove ML, Yu B, Jones BC, Morrison A, Boerwinkle E, Liu X. Genetic variants in microRNA genes and targets associated with cardiovascular disease risk factors in the African-American population. Hum Genet 2018; 137:85-94. [PMID: 29264654 PMCID: PMC5790599 DOI: 10.1007/s00439-017-1858-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 12/06/2017] [Indexed: 02/07/2023]
Abstract
The purpose of this study is to identify microRNA (miRNA) related polymorphism, including single nucleotide variants (SNVs) in mature miRNA-encoding sequences or in miRNA-target sites, and their association with cardiovascular disease (CVD) risk factors in African-American population. To achieve our objective, we examined 1900 African-Americans from the Atherosclerosis Risk in Communities study using SNVs identified from whole-genome sequencing data. A total of 971 SNVs found in 726 different mature miRNA-encoding sequences and 16,057 SNVs found in the three prime untranslated region (3'UTR) of 3647 protein-coding genes were identified and interrogated their associations with 17 CVD risk factors. Using single-variant-based approach, we found 5 SNVs in miRNA-encoding sequences to be associated with serum Lipoprotein(a) [Lp(a)], high-density lipoprotein (HDL) or triglycerides, and 2 SNVs in miRNA-target sites to be associated with Lp(a) and HDL, all with false discovery rates of 5%. Using a gene-based approach, we identified 3 pairs of associations between gene NSD1 and platelet count, gene HSPA4L and cardiac troponin T, and gene AHSA2 and magnesium. We successfully validated the association between a variant specific to African-American population, NR_039880.1:n.18A>C, in mature hsa-miR-4727-5p encoding sequence and serum HDL level in an independent sample of 2135 African-Americans. Our study provided candidate miRNAs and their targets for further investigation of their potential contribution to ethnic disparities in CVD risk factors.
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Affiliation(s)
- Chang Li
- Human Genetics Center and Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Megan L Grove
- Human Genetics Center and Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Bing Yu
- Human Genetics Center and Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Barbara C Jones
- Human Genetics Center and Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Alanna Morrison
- Human Genetics Center and Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Eric Boerwinkle
- Human Genetics Center and Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA.
| | - Xiaoming Liu
- Human Genetics Center and Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
- Center for Precision Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
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Su SL, Chen WT, Hsiao PJ, Lu KC, Lin YF, Lin C, Su W, Yeh SJ, Chang H, Lin FH. Angiotensin II receptor type 1 A1166C modifies the association between angiotensinogen M235T and chronic kidney disease. Oncotarget 2017; 8:107833-107843. [PMID: 29296205 PMCID: PMC5746107 DOI: 10.18632/oncotarget.22121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/02/2017] [Indexed: 11/25/2022] Open
Abstract
Single nucleotide polymorphisms (SNPs) in renin-angiotensin system (RAS) genes are associated with RAS imbalance and chronic kidney disease (CKD). We performed a case-control study and meta-analysis to investigate the association between angiotensinogen (AGT) M235T polymorphism and CKD. A total of 634 patients with end-stage renal disease and 739 healthy controls were studied. We also searched PubMed and the Cochrane Library to identify prospective observational studies published before December 2015. We found that the TT and MT genotypes were associated with a higher risk of CKD than the MM genotype (odds ratio [OR]: 3.56; 95% confidence interval [CI]: 1.14-11.16 and OR: 2.93; 95% CI: 0.91-9.46, respectively). Thirty-eight study populations were included in the meta-analysis. The T allele was associated with a higher risk of CKD than the M allele in all populations (OR: 1.19; 95% CI: 1.08-1.32). The OR was 1.33 in Asians (95% CI: 1.06-1.67) and 1.10 in Caucasians (95% CI: 1.02-1.18). Evaluation of gene-gene and gene-environment interactions using epistasis analysis revealed an interaction between AGT M235T and angiotensin II receptor type 1 A1166C in CKD (OR: 0.767; 95% CI: 0.609-0.965). Genetic testing for CKD in high-risk individuals may be an effective strategy for CKD prevention.
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Affiliation(s)
- Sui-Lung Su
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Teing Chen
- Division of Thoracic Medicine, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Po-Jen Hsiao
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kuo-Cheng Lu
- Division of Nephrology, Department of Medicine, Cardinal Tien Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Yuh-Feng Lin
- Division of Nephrology, Department of Medicine, Shuang Ho Hospital, Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chin Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Wen Su
- Department of Nursing, Tri-Service General Hospital, Taipei, Taiwan
| | - Shih-Jen Yeh
- Office of The President, Da-Yeh University, Changhua, Taiwan
| | - Hung Chang
- Department of Physiology and Biophysics, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Huang Lin
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
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Lindström L, Skjaerven R, Bergman E, Lundgren M, Klungsøyr K, Cnattingius S, Wikström AK. Chronic Hypertension in Women after Perinatal Exposure to Preeclampsia, Being Born Small for Gestational Age or Preterm. Paediatr Perinat Epidemiol 2017; 31:89-98. [PMID: 28218407 DOI: 10.1111/ppe.12346] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND There is an established association between adverse events during perinatal life and chronic hypertension in adult life. However, disadvantageous conditions often co-exist in the same pregnancy. We investigated single and joint perinatal exposure to preeclampsia, being born small for gestational age (SGA) or preterm and subsequent risk of chronic hypertension. METHODS The study population consisted of 731 008 primiparous women from Norway and Sweden registered in the Medical Birth Registers, both as infants and as first time mothers between 1967-2009 (Norway) and 1973-2010 (Sweden). Risk of chronic hypertension in early pregnancy was calculated in women with perinatal exposures to preeclampsia, born SGA or preterm by log-binominal regression analysis, and adjusted for maternal age and level of education in the first generation. RESULTS The rate of chronic hypertension was 0.4%. Risk of chronic hypertension was associated with single perinatal exposure to preeclampsia, being born SGA or preterm with adjusted relative risk (95% confidence interval, CI) of 2.2 (95% CI 1.8, 2.7), 1.1 (95% CI 1.0, 1.3), and 1.3 (95% CI 1.0, 1.5) respectively. The risks increased after joint exposures, with an almost fourfold risk increase after perinatal exposure to preeclampsia and preterm birth. Additional adjustment for BMI and smoking in the second generation in a subset of the cohort only had a minor impact on the results. CONCLUSIONS Perinatal exposure to preeclampsia, being born SGA or preterm is independently associated with increased risk of chronic hypertension. The highest risk was seen after exposure to preeclampsia, especially if combined with SGA or preterm birth.
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Affiliation(s)
- Linda Lindström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Rolv Skjaerven
- Department of Global Public Health and Primary Care, Medical Birth Registry of Norway, Norwegian Institute of Public Health, University of Bergen, Bergen, Norway
| | - Eva Bergman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Maria Lundgren
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, Medical Birth Registry of Norway, Norwegian Institute of Public Health, University of Bergen, Bergen, Norway
| | - Sven Cnattingius
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Anna-Karin Wikström
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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Esteban-Martínez RL, Pérez-Razo JC, Vargas-Alarcón G, Martínez-Rodríguez N, Cano-Martínez LJ, López-Hernández LB, Rojano-Mejía D, Canto P, Coral-Vazquez RM. Polymorphisms of APLN-APLNR system are associated with essential hypertension in Mexican-Mestizo individuals. Exp Mol Pathol 2016; 101:105-9. [DOI: 10.1016/j.yexmp.2016.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 07/19/2016] [Indexed: 11/25/2022]
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Boström AE, Mwinyi J, Voisin S, Wu W, Schultes B, Zhang K, Schiöth HB. Longitudinal genome-wide methylation study of Roux-en-Y gastric bypass patients reveals novel CpG sites associated with essential hypertension. BMC Med Genomics 2016; 9:20. [PMID: 27105587 PMCID: PMC4841955 DOI: 10.1186/s12920-016-0180-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 04/01/2016] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Essential hypertension is a significant risk factor for cardiovascular diseases. Emerging research suggests a role of DNA methylation in blood pressure physiology. We aimed to investigate epigenetic associations of promoter related CpG sites to essential hypertension in a genome-wide methylation approach. METHODS The genome-wide methylation pattern in whole blood was measured in 11 obese patients before and six months after Roux-en-Y gastric bypass surgery using the Illumina 450 k beadchip. CpG sites located within 1500 bp of the transcriptional start site of adjacent genes were included in our study, resulting in 124 199 probes investigated in the subsequent analysis. Percent changes in methylation states and SBP measured before and six months after surgery were calculated. These parameters were correlated to each other using the Spearman's rank correlation method (Edgeworth series approximation). To further investigate the detected relationship between candidate CpG sites and systolic blood pressure levels, binary logistic regression analyses were performed in a larger and independent cohort of 539 individuals aged 19-101 years to elucidate a relationship between EH and the methylation state in candidate CpG sites. RESULTS We identified 24 promoter associated CpG sites that correlated with change in SBP after RYGB surgery (p < 10(-16)). Two of these CpG loci (cg00875989, cg09134341) were significantly hypomethylated in dependency of EH (p < 10(-03)). These results were independent of age, BMI, ethnicity and sex. CONCLUSIONS The identification of these novel CpG sites may contribute to a further understanding of the epigenetic regulatory mechanisms underlying the development of essential hypertension.
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Affiliation(s)
- Adrian E Boström
- Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden.
| | - Jessica Mwinyi
- Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden
| | - Sarah Voisin
- Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden
| | - Wenting Wu
- Institute for Genomic Medicine, University of California, San Diego, CA, 92093, USA
| | - Bernd Schultes
- eSwiss Medical and Surgical Center, St Gallen, Switzerland
| | - Kang Zhang
- Institute for Genomic Medicine, University of California, San Diego, CA, 92093, USA
| | - Helgi B Schiöth
- Department of Neuroscience, Functional Pharmacology, Uppsala University, BMC, Box 593, 751 24, Uppsala, Sweden
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Fenger M, Linneberg A, Jeppesen J. Network-based analysis of the sphingolipid metabolism in hypertension. Front Genet 2015; 6:84. [PMID: 25788903 PMCID: PMC4349157 DOI: 10.3389/fgene.2015.00084] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 02/17/2015] [Indexed: 01/11/2023] Open
Abstract
Common diseases like essential hypertension or diabetes mellitus are complex as they are polygenic in nature, such that each genetic variation only has a small influence on the disease. Genes operates in integrated networks providing the blue-print for all biological processes and conditional of the complex genotype determines the state and dynamics of any trait, which may be modified to various extent by non-genetic factors. Thus, diseases are heterogenous ensembles of conditions with a common endpoint. Numerous studies have been performed to define genes of importance for a trait or disease, but only a few genes with small effect have been identified. The major reasons for this modest progress is the unresolved heterogeneity of the regulation of blood pressure and the shortcomings of the prevailing monogenic approach to capture genetic effects in a polygenic condition. Here, a two-step procedure is presented in which physiological heterogeneity is disentangled and genetic effects are analyzed by variance decomposition of genetic interactions and by an information theoretical approach including 162 single nucleotide polymorphisms (SNP) in 84 genes in the sphingolipid metabolism and related networks in blood pressure regulation. As expected, almost no genetic main effects were detected. In contrast, two-gene interactions established the entire sphingolipid metabolic and related genetic network to be highly involved in the regulation of blood pressure. The pattern of interaction clearly revealed that epistasis does not necessarily reflects the topology of the metabolic pathways i.e., the flow of metabolites. Rather, the enzymes and proteins are integrated in complex cellular substructures where communication flows between the components of the networks, which may be composite in structure. The heritabilities for diastolic and systolic blood pressure were estimated to be 0.63 and 0.01, which may in fact be the maximum heritabilities of these traits. This procedure provide a platform for studying and capturing the genetic networks of any polygenic trait, condition, or disease.
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Affiliation(s)
- Mogens Fenger
- Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Denmark
| | | | - Jørgen Jeppesen
- Department of Cardiology, Glostrup University Hospital Glostrup, Denmark
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Abstract
The definition of hypertension has continuously evolved over the last 50 years. Hypertension is currently defined as a blood pressure greater than 140/90mmHg. One in every four people in the US has been diagnosed with hypertension. The prevalence of hypertension increases further with age, affecting 75% of people over the age of 70. Hypertension is by far the most common risk factor identified in stroke patients. Hypertension causes pathologic changes in the walls of small (diameter<300 microns) arteries and arterioles usually at short branches of major arteries, which may result in either ischemic stroke or intracerebral hemorrhage. Reduction of blood pressure with diuretics, β-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors have all been shown to markedly reduce the incidence of stroke. Hypertensive emergency is defined as a blood pressure greater than 180/120mmHg with end organ dysfunction, such as chest pain, shortness of breath, encephalopathy, or focal neurologic deficits. Hypertensive encephalopathy is believed to be caused by acute failure of cerebrovascular autoregulation. Hypertensive emergency is treated with intravenous antihypertensive agents to reduce blood pressure by 25% within the first hour. Selective inhibition of cerebrovascular blood vessel permeability for the treatment of hypertensive emergency is beginning early clinical trials.
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Affiliation(s)
- Raymond S Price
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Scott E Kasner
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
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Davis JT, Rao F, Naqshbandi D, Fung MM, Zhang K, Schork AJ, Nievergelt CM, Ziegler MG, O'Connor DT. Autonomic and hemodynamic origins of pre-hypertension: central role of heredity. J Am Coll Cardiol 2012; 59:2206-16. [PMID: 22676942 DOI: 10.1016/j.jacc.2012.02.040] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Revised: 02/13/2012] [Accepted: 02/14/2012] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The purpose of this study is to better understand the origins and progression of pre-hypertension. BACKGROUND Pre-hypertension is a risk factor for progression to hypertension, cardiovascular disease, and increased mortality. We used a cross-sectional twin study design to examine the role of heredity in likely pathophysiological events (autonomic or hemodynamic) in pre-hypertension. METHODS Eight hundred twelve individuals (337 normotensive, 340 pre-hypertensive, 135 hypertensive) were evaluated in a sample of twin pairs, their siblings, and other family members. They underwent noninvasive hemodynamic, autonomic, and biochemical testing, as well as estimates of trait heritability (the percentage of trait variance accounted for by heredity) and pleiotropy (the genetic covariance or shared genetic determination of traits) by variance components. RESULTS In the hemodynamic realm, an elevation of cardiac contractility prompted increased stroke volume, in turn increasing cardiac output, which elevated blood pressure into the pre-hypertension range. Autonomic monitoring detected an elevation of norepinephrine secretion plus a decline in cardiac parasympathetic tone. Twin pair variance components documented substantial heritability as well as joint genetic determination for blood pressure and the contributory autonomic and hemodynamic traits. Genetic variation at a pathway locus also indicated pleiotropic effects on contractility and blood pressure. CONCLUSIONS Elevated blood pressure in pre-hypertension results from increased cardiac output, driven by contractility as well as heart rate, which may reflect both diminished parasympathetic and increased sympathetic tone. In the face of increased cardiac output, systemic vascular resistance fails to decline homeostatically. Such traits display substantial heritability and shared genetic determination, although by loci not yet elucidated. These findings clarify the role of heredity in the origin of pre-hypertension and its autonomic and hemodynamic pathogenesis. The results also establish pathways that suggest new therapeutic targets for pre-hypertension, or approaches to its prevention.
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Affiliation(s)
- Jason T Davis
- Department of Medicine, University of California-San Diego, and V.A. San Diego Healthcare System, 9500 Gilman Drive, La Jolla, CA 92093, USA
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Eguchi E, Iso H, Wada Y, Kikuchi S, Watanabe Y, Tamakoshi A. Parental history and lifestyle behaviors in relation to mortality from stroke among Japanese men and women: the Japan Collaborative Cohort Study. J Epidemiol 2012; 22:331-9. [PMID: 22790788 PMCID: PMC3798652 DOI: 10.2188/jea.je20110163] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND We assessed the impact of parental history of stroke on stroke mortality, as well as the effect modification between lifestyle and stroke mortality, among Japanese. METHODS In this community-based, prospective cohort study, 22,763 men and 30,928 women aged 40 to 79 years with no history of cardiovascular disease or cancer at baseline (1988-1990) were followed through 2008. We examined the association between parental history of stroke and stroke mortality and estimated the impact of the combination of lifestyle and parental history on stroke mortality in offspring. RESULTS During a mean follow-up period of 15.9 years, there were 1502 stroke deaths. In both sexes, participants with a parental history of stroke had a higher risk of stroke mortality as compared with those without such a history. The respective multivariable hazard ratio (95% CI) and population attributable fraction were 1.28 (1.10-1.49) and 5.4% in men, 1.22 (1.04-1.43) and 4.3% in women, and 1.25 (1.12-1.40) and 4.8% in all participants, for offspring with a maternal and/or paternal history of stroke. There was an inverse association between healthy-lifestyle score and stroke mortality, irrespective of parental history of stroke. The overall multivariable hazard ratio for the highest (6-8) versus the lowest (0-3) score categories was 0.56 (95% CI, 0.43-0.72) for participants with a maternal and/or paternal history of stroke and 0.44 (0.36-0.53) for those without such a history. CONCLUSIONS Parental history of stroke was associated with stroke mortality in offspring. The inverse association between healthy lifestyle behaviors and stroke mortality, regardless of parental history, suggests that lifestyle modification is beneficial, even among individuals with a parental history of stroke.
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Affiliation(s)
- Eri Eguchi
- Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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Kelsey RM, Alpert BS, Dahmer MK, Krushkal J, Quasney MW. Alpha-adrenergic receptor gene polymorphisms and cardiovascular reactivity to stress in Black adolescents and young adults. Psychophysiology 2011; 49:401-12. [PMID: 22091949 DOI: 10.1111/j.1469-8986.2011.01319.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 09/26/2011] [Indexed: 01/11/2023]
Abstract
Cardiovascular reactivity to stress and α-adrenergic receptor (α-AR) function may contribute to the development of hypertension. As Black Americans have an increased risk of hypertension, we evaluated associations between α(1A) -AR (Arg492Cys), α(2A) -AR (-1291C/G), and α(2B) -AR (Ins/Del301-303) gene variants and cardiovascular reactivity in 500 normotensive Black youth. Heart rate, preejection period, total peripheral resistance, and blood pressure were measured during cold and psychological stress. The Arg492Cys polymorphism in the α(1A) -AR gene was associated with heart rate reactivity to stress, but the association depended on sex. The -1291C/G promoter polymorphism in the α(2A) -AR gene was associated with vascular reactivity to stress; vasoconstriction increased as a linear function of the number of copies of the variant G allele. Thus, specific associations emerged between genetic variations in α-Ars and cardiovascular reactivity in young Blacks.
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Affiliation(s)
- Robert M Kelsey
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38104, USA.
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Fenger M, Linneberg A, Jørgensen T, Madsbad S, Søbye K, Eugen-Olsen J, Jeppesen J. Genetics of the ceramide/sphingosine-1-phosphate rheostat in blood pressure regulation and hypertension. BMC Genet 2011; 12:44. [PMID: 21569466 PMCID: PMC3115901 DOI: 10.1186/1471-2156-12-44] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2011] [Accepted: 05/13/2011] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Several attempts to decipher the genetics of hypertension of unknown causes have been made including large-scale genome-wide association analysis (GWA), but only a few genes have been identified. Unsolved heterogeneity of the regulation of blood pressure and the shortcomings of the prevailing monogenic approach to capture genetic effects in a polygenic condition are the main reasons for the modest results. The level of the blood pressure is the consequence of the genotypic state of the presumably vast network of genes involved in regulating the vascular tonus and hence the blood pressure. Recently it has been suggested that components of the sphingolipid metabolism pathways may be of importance in vascular physiology. The basic metabolic network of sphingolipids has been established, but the influence of genetic variations on the blood pressure is not known. In the approach presented here the impact of genetic variations in the sphingolipid metabolism is elucidated by a two-step procedure. First, the physiological heterogeneity of the blood pressure is resolved by a latent class/structural equation modelling to obtain homogenous subpopulations. Second, the genetic effects of the sphingolipid metabolism with focus on de novo synthesis of ceramide are analysed. The model does not assume a particular genetic model, but assumes that genes operate in networks. RESULTS The stratification of the study population revealed that (at least) 14 distinct subpopulations are present with different propensity to develop hypertension. Main effects of genes in the de novo synthesis of ceramides were rare (0.14% of all possible). However, epistasis was highly significant and prevalent amounting to approximately 70% of all possible two-gene interactions. The phenotypic variance explained by the ceramide synthesis network were substantial in 4 of the subpopulations amounting to more than 50% in the subpopulation in which all subjects were hypertensive. Construction of the network using the epistatic values revealed that only 17% of the interactions detected were in the direct metabolic pathway, the remaining jumping one or more intermediates. CONCLUSIONS This study established the components of the ceramide/sphingosine-1-phosphate rheostat as central to blood pressure regulation. The results in addition confirm that epistasis is of paramount importance and is most conspicuous in the regulation of the rheostat network. Finally, it is shown that applying a simple case-control approach with single gene association analysis is bound to fail, short of identifying a few potential genes with small effects.
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Affiliation(s)
- Mogens Fenger
- Copenhagen University Hospital at Hvidovre, Department of Clinical Biochemistry, Genetics, and Molecular Biology, Kettegaard All 26, 2650 Hvidovre, Denmark.
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G-protein-coupled receptor kinase 4 polymorphisms predict blood pressure response to dietary modification in Black patients with mild-to-moderate hypertension. J Hum Hypertens 2011; 26:334-9. [PMID: 21544086 DOI: 10.1038/jhh.2011.33] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Dopamine via G-protein-coupled receptor kinase 4 (GRK-4) regulates sodium (Na) balance in the proximal tubule of the kidney. Single-nucleotide polymorphisms of GRK-4 have been linked to impaired natriuresis and salt-sensitive hypertension. The purpose of this report was to determine the effect of GRK-4 gene polymorphisms on the blood pressure (BP) responses to dietary intervention. Black subjects aged 50-75 years with mild-to-moderate hypertension were randomised to an 8-week dietary intervention (n=40) or standard diet (n=40). BP was measured at baseline and at 8 weeks using 24-h ambulatory BP. All subjects underwent DNA analysis for the R65L and A142V polymorphisms. Data were analysed using generalised linear models. For the whole group, between-diet differences in mean 24-h ambulatory systolic BP was -4.53 mm Hg (95% confidence interval -9.05 to -0.01, P=0.05). In the intervention arm, the combined CC and CT group of the A142V showed a significant reduction in both systolic and diastolic ambulatory BP (-10 mm Hg, P=0.023 and -6.5 mm Hg, P=0.01, respectively), whereas the TT group demonstrated no reduction. Similarly, the combined GG and GT groups of the R65L showed a significant reduction in ambulatory BP (-10.6 mm Hg for systolic, P=0.004 and 5.8 mm Hg for diastolic, P=0.006). There was no response in the TT group. GRK-4 polymorphisms predict BP response to dietary modification in Black subjects with mild-to-moderate hypertension. These data may provide at least one among a range of clinical tools to target selected hypertensives to dietary intervention.
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Naturally occurring genetic variants in human chromogranin A (CHGA) associated with hypertension as well as hypertensive renal disease. Cell Mol Neurobiol 2011; 30:1395-400. [PMID: 21061160 PMCID: PMC3008929 DOI: 10.1007/s10571-010-9600-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Accepted: 09/07/2010] [Indexed: 10/25/2022]
Abstract
Chromogranin A (CHGA) plays a fundamental role in the biogenesis of catecholamine secretory granules. Changes in storage and release of CHGA in clinical and experimental hypertension prompted us to study whether genetic variation at the CHGA locus might contribute to alterations in autonomic function, and hence hypertension and its target organ consequences such as hypertensive renal disease (nephrosclerosis). Systematic polymorphism discovery across the human CHGA locus revealed both common and unusual variants in both the open reading frame and such regulatory regions as the proximal promoter and 30-UTR. In chromaffin cell-transfected CHGA 30-UTR and promoter/luciferase reporter plasmids, the functional consequences of the regulatory/non-coding allelic variants were documented. Variants in both the proximal promoter and the 30-UTR displayed statistical associations with hypertension. Genetic variation in the proximal CHGA promoter predicted glomerular filtration rate in healthy twins. However, for hypertensive renal damage, both end-stage renal disease and rate of progression of earlier disease were best predicted by variants in the 30-UTR. Finally, mechanistic studies were undertaken initiated by the clue that CHGA promoter variation predicted circulating endothelin-1. In cultured endothelial cells, CHGA triggered co-release of not only the vasoconstrictor and pro-fibrotic endothelin-1, but also the pro-coagulant von Willebrand Factor and the pro-angiogenic angiopoietin-2. These findings, coupled with stimulation of endothelin-1 release from glomerular capillary endothelial cells by CHGA, suggest a plausible mechanism whereby genetic variation at the CHGA locus eventuates in alterations in human renal function. These results document the consequences of genetic variation at the CHGA locus for cardiorenal disease and suggest mechanisms whereby such variation achieves functional effects.
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Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, Foster E, Hlatky MA, Hodgson JM, Kushner FG, Lauer MS, Shaw LJ, Smith SC, Taylor AJ, Weintraub WS, Wenger NK, Jacobs AK, Smith SC, Anderson JL, Albert N, Buller CE, Creager MA, Ettinger SM, Guyton RA, Halperin JL, Hochman JS, Kushner FG, Nishimura R, Ohman EM, Page RL, Stevenson WG, Tarkington LG, Yancy CW. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2011; 56:e50-103. [PMID: 21144964 DOI: 10.1016/j.jacc.2010.09.001] [Citation(s) in RCA: 1001] [Impact Index Per Article: 77.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Effects of chromogranin A deficiency and excess in vivo: biphasic blood pressure and catecholamine responses. J Hypertens 2010; 28:817-25. [PMID: 20139771 DOI: 10.1097/hjh.0b013e328336ed3e] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The phenotype of the chromogranin A (Chga) null (knockout) mouse is hypertensive. However, hypertensive humans and spontaneously hypertensive rats display elevated CHGA expression. This study addresses the paradox that both ablation and elevation of CHGA result in hypertension. METHODS Mice with varying copy number of the CHGA gene were generated. In these mice CHGA, catecholamine and blood pressure (BP) were measured. Also a cohort of healthy human individuals was stratified into tertiles based on plasma CHGA expression and phenotyped for characteristics including their BP response to environmental (cold) stress. RESULTS The mice displayed a direct CHGA gene dose-dependent (0-4 copies/genome) activation of CHGA expression in both plasma and adrenal gland, yet the BP dependence of CHGA gene dose was U-shaped, maximal at 0 and four copies of the gene, whereas minimal at two copies (i.e., the wild-type gene dosage). Plasma catecholamine showed a parallel U-shaped dose/response in mice, whereas adrenal epinephrine exhibited a reciprocal (inverted) U-shaped response, suggesting dysregulated neurotransmission at both extremes of CHGA expression. The human individuals also showed a nonlinear relationship between CHGA expression and pressor responses to environmental (cold) stress, that were maximal in the highest and lowest tertiles, though basal BPs did not differ among the groups. The human CHGA tertiles also differed in epinephrine secretion as well as degree of CHGA processing to catestatin (catecholamine release-inhibitory peptide derived from CHGA processing). CONCLUSION Thus, across mammalian species, an optimal amount of CHGA may be required to establish appropriate catecholamine storage and release, and hence BP homeostasis.
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Greenland P, Alpert JS, Beller GA, Benjamin EJ, Budoff MJ, Fayad ZA, Foster E, Hlatky MA, Hodgson JM, Kushner FG, Lauer MS, Shaw LJ, Smith SC, Taylor AJ, Weintraub WS, Wenger NK, Jacobs AK. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2010; 122:e584-636. [PMID: 21098428 DOI: 10.1161/cir.0b013e3182051b4c] [Citation(s) in RCA: 431] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tiffin N, Meintjes A, Ramesar R, Bajic VB, Rayner B. Computational analysis of candidate disease genes and variants for salt-sensitive hypertension in indigenous Southern Africans. PLoS One 2010; 5:e12989. [PMID: 20886000 PMCID: PMC2946338 DOI: 10.1371/journal.pone.0012989] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 08/29/2010] [Indexed: 01/06/2023] Open
Abstract
Multiple factors underlie susceptibility to essential hypertension, including a significant genetic and ethnic component, and environmental effects. Blood pressure response of hypertensive individuals to salt is heterogeneous, but salt sensitivity appears more prevalent in people of indigenous African origin. The underlying genetics of salt-sensitive hypertension, however, are poorly understood. In this study, computational methods including text- and data-mining have been used to select and prioritize candidate aetiological genes for salt-sensitive hypertension. Additionally, we have compared allele frequencies and copy number variation for single nucleotide polymorphisms in candidate genes between indigenous Southern African and Caucasian populations, with the aim of identifying candidate genes with significant variability between the population groups: identifying genetic variability between population groups can exploit ethnic differences in disease prevalence to aid with prioritisation of good candidate genes. Our top-ranking candidate genes include parathyroid hormone precursor (PTH) and type-1angiotensin II receptor (AGTR1). We propose that the candidate genes identified in this study warrant further investigation as potential aetiological genes for salt-sensitive hypertension.
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Affiliation(s)
- Nicki Tiffin
- Division of Nephrology and Hypertension, University of Cape Town/Groote Schuur Hospital, Cape Town, South Africa.
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Kelsey RM, Alpert BS, Dahmer MK, Krushkal J, Quasney MW. Beta-adrenergic receptor gene polymorphisms and cardiovascular reactivity to stress in Black adolescents and young adults. Psychophysiology 2010; 47:863-73. [PMID: 20374546 DOI: 10.1111/j.1469-8986.2010.01006.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cardiovascular reactivity to stress and beta-adrenergic receptor (beta-AR) function may contribute to the development of hypertension. As Black Americans have an increased risk of hypertension, we evaluated associations between beta(1)-AR (Arg389Gly) and beta(2)-AR (Arg16Gly, Gln27Glu) gene variants and cardiovascular reactivity in 500 Black youth. Heart rate, preejection period, total peripheral resistance, and blood pressure reactivity were measured during cold and psychological stress. The Arg389Gly polymorphism in the beta(1)-AR was associated with preejection period reactivity in males but not in females. The Arg16Gly polymorphism in the beta(2)-AR was associated with diastolic blood pressure reactivity only during video game stress. An association between the Gln27Glu polymorphism in the beta(2)-AR and vascular reactivity depended on sex. Thus, specific patterns of associations emerged between genetic variations in beta-ARs and cardiovascular reactivity in young Blacks.
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Affiliation(s)
- Robert M Kelsey
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee 38105, USA.
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Smith AG, Elder GH. Complex Gene−Chemical Interactions: Hepatic Uroporphyria As a Paradigm. Chem Res Toxicol 2010; 23:712-23. [DOI: 10.1021/tx900298k] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Andrew G. Smith
- MRC Toxicology Unit, Hodgkin Building, University of Leicester, Lancaster Road, Leicester LE1 9HN, U.K., and Department of Medical Biochemistry and Immunology, School of Medicine, Cardiff University, Cardiff CF14 4XN, U.K
| | - George H. Elder
- MRC Toxicology Unit, Hodgkin Building, University of Leicester, Lancaster Road, Leicester LE1 9HN, U.K., and Department of Medical Biochemistry and Immunology, School of Medicine, Cardiff University, Cardiff CF14 4XN, U.K
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Fung MM, O'Connor DT. Complex renal traits: role of adrenergic genetic polymorphism. J Am Soc Nephrol 2009; 20:1172-4. [PMID: 19470671 DOI: 10.1681/asn.2009040395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Kumar R, Nejatizadeh A, Arif E, Akhtar S, Gupta M, Tyagi S, Goyal AK, Jain SK, Qadar Pasha MA. Multi-locus interactions of vascular homeostasis genes in essential hypertension: a gender-based study. Clin Chim Acta 2009; 405:87-93. [PMID: 19379721 DOI: 10.1016/j.cca.2009.04.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 03/21/2009] [Accepted: 04/07/2009] [Indexed: 11/17/2022]
Abstract
BACKGROUND Studies on genes of endothelial and vascular homeostasis are inadequate in females. METHODS We investigated the role of 7 variants of ACE, AGT and NOS3 and their correlation with NO(x) levels and ACE activity in hypertension susceptibility in 910 case-controls of both genders. RESULTS Prevalence of alleles D of ACE I/D; -6A of AGT -6G/A; -786C, 894T and 4a of NOS3 -786T/C, 894G/T and 4b/4a polymorphisms was observed in patients (P< or =0.05). The 3 genotypes-combinations containing 6+5 wild-type alleles of AGT and NOS3 were significantly less prevalent in patients (P< or =0.0003). The haplotypes 235T/174T/-6A of AGT (P=4E-3) and -786T/894G/4a and -786C/894G/4a of NOS3 (P=2E-3, P=0.011, respectively) were significantly more prevalent in patients. The AGT and NOS3 findings were similar in males. Genotypes-combinations with 6+5 wild-type alleles of AGT correlated with higher NO(x) levels (P=0.03). The NOS3 genotypes-combinations having 6 and 6+5 wild-type alleles correlated with decreased ACE activity (P=0.025, P=0.0015, respectively) and increased NO(x) levels (P=0.001, P=0.0001, respectively) in patients. In gene-gene interactions, ACE D allele associated with < or =4 wild-type alleles containing genotypes-combinations of AGT and NOS3 in patients (P< or =0.04). CONCLUSION Within gene and between genes interactions of variants influence ACE activity and NO(x) levels and associate with EH.
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Affiliation(s)
- Rahul Kumar
- Institute of Genomics and Integrative Biology, Delhi, India
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