Key result
Genetically predicted long-term reductions in systolic blood pressure were associated with a 16.9% decrease in cardiovascular morbidity (95% CI 12.2-21.3%) per 5-mm Hg decrease in SBP.
Why the study?
The causal relevance of elevated blood pressure for several cardiovascular diseases and the population impact of blood pressure lowering were uncertain.
Does genetically predicted lower systolic blood pressure reduce the risk of various cardiovascular diseases in a middle-aged to early late-aged population?
Observational (n=376,703)
Does genetically predicted lower systolic blood pressure reduce the risk of various cardiovascular diseases in a middle-aged to early late-aged population?
Effect estimate: 16.9% decrease (95% CI 12.2-21.3)
p-value: p=<0.002
Long-term population-wide reductions in systolic blood pressure are genetically predicted to substantially reduce the burden of a broad range of cardiovascular diseases.
MR evidence supports SBP causality across CVDs; leaves open precise population-level prevention estimates.
Background The causal relevance of elevated blood pressure for several cardiovascular diseases (CVDs) is uncertain, as is the population impact of blood pressure lowering. This study systematically assesses evidence of causality for various CVDs in a 2‐sample Mendelian randomization framework, and estimates the potential reduction in the prevalence of these diseases attributable to long‐term population shifts in the distribution of systolic blood pressure (SBP). Methods and Results We investigated associations of genetically predicted SBP as predicted by 256 genetic variants with 21 CVDs in UK Biobank, a population‐based cohort of UK residents. The sample consisted of 376 703 participants of European ancestry, aged 40 to 69 years at recruitment. Genetically predicted SBP was positively associated with 14 of the outcomes ( P <0.002), including dilated cardiomyopathy, endocarditis, peripheral vascular disease, and rheumatic heart disease. Using genetic variation to estimate the long‐term impact of blood pressure lowering on disease in a middle‐aged to early late‐aged UK‐based population, population reductions in SBP were predicted to result in an overall 16.9% (95% CI, 12.2%–21.3%) decrease in morbidity for a 5–mm Hg decrease from a population mean of 137.7 mm Hg, 30.8% (95% CI, 22.8%–38.0%) decrease for a 10–mm Hg decrease, and 56.2% (95% CI, 43.7%–65.9%) decrease for a 22.7–mm Hg decrease in SBP (22.7 mm Hg represents a shift from the current mean SBP to 115 mm Hg). Conclusions Risk of many CVDs is influenced by long‐term differences in SBP. The burden of a broad range of CVDs could be substantially reduced by long‐term population‐wide reductions in the distribution of blood pressure.
No takes yet. Share an insight, caveat, or question.
Higgins et al. (2021) conducted an observational in Cardiovascular diseases (n=376,703). Genetically predicted systolic blood pressure vs. Lower systolic blood pressure was evaluated on Cardiovascular disease morbidity (16.9% decrease, 95% CI 12.2-21.3, p=<0.002). Genetically predicted long-term reductions in systolic blood pressure were associated with a 16.9% decrease in cardiovascular morbidity (95% CI 12.2-21.3%) per 5-mm Hg decrease in SBP.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: