Key result
FGD5 variant rs294610 linked to ~2.7-mmHg greater diastolic blood pressure reduction with beta-blockers.
Why the study?
European Americans generally respond better to beta-blockers than African Americans but exhibit variability, prompting investigation into the underlying genetic determinants.
Do specific genetic variants influence blood pressure response to beta-blocker therapy in European Americans with hypertension?
Observational (n=641)
Yes
Do specific genetic variants influence blood pressure response to beta-blocker therapy in European Americans with hypertension?
Mean Difference: -2.7
p-value: p=3.41 × 10−6
Variants in FGD5, SLC4A1, and RAB3IP can partially explain interindividual variability in the blood pressure response to beta-blockers in European Americans.
FGD5 variant association with beta-blocker response is hypothesis-generating; does not support changing practice without prospective validation.
European Americans ( EA ) have a better antihypertensive response to β‐blockers when compared with African Americans, albeit with some variability. We undertook a genomewide association study to elucidate the underlying genetic determinants in EA contributing to this variability in blood pressure ( BP ) response. A discovery genomewide association study of change in BP post–metoprolol treatment was performed in EA participants ( n = 201) from the Pharmacogenomic Evaluation of Antihypertensive Responses‐2 (PEAR‐2) study and tested for replication in the atenolol‐treated EA from the PEAR study ( n = 233). Rs294610 in the FGD 5 , which encodes for FYVE, RhoGEF and PH Domain Containing 5, ( expression quantitative trait loci for FGD 5 in the small intestine) was significantly associated with increased diastolic BP response to β‐blockers in the PEAR‐2 study ( P = 3.41 × 10 −6 , β = −2.70) and replicated ( P = 0.01, β = −1.17) in the PEAR study . Post–meta‐analysis of these studies, an additional single nucleotide polymorphism rs45545233 in the SLC 4A1 , encoding for Solute Carrier Family 4 Member 1, ( expression quantitative trait loci for dual specificity phosphatase 3 in the artery tibial) was identified that was significantly associated with a poor response to β‐blockers ( P = 3.43 × 10 −6 , β = 4.57) and was replicated in the atenolol add‐on cohort ( P = 0.007, β = 4.97). We identified variants in FGD 5 and SLC 4A1 , which have been previously cited as candidate genes for hypertension, to be associated with a β‐blocker BP response in EA . Further elucidation is warranted of the underlying mechanisms of these variants and genes by which they influence the BP response to β‐blockers.
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Singh et al. (2019) conducted an observational in Mild to moderate uncomplicated hypertension (n=641). Beta-blocker therapy and genetic variants (FGD5, SLC4A1, RAB3IP) vs. Noncarriers was evaluated on Change in diastolic blood pressure response (β = -2.70, p=3.41 × 10−6). The FGD5 variant rs294610 was significantly associated with an increased diastolic blood pressure reduction following beta-blocker therapy (p = 3.41 × 10−6, β = -2.70) in European Americans.
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