Genetically Predicted Differences in Systolic Blood Pressure and Risk of Cardiovascular and Noncardiovascular Diseases: A Mendelian Randomization Study in Chinese Adults

Figure 1.. Associations of usual systolic blood pressure (SBP) and genetically-predicted SBP with stroke types, major coronary events and major vascular events. The observational analyses are shown in (A) and the genetic analyses in (B). The slopes of the associations of SBP with each disease are shown as hazard ratios (HR, 95% CI) per 10 mm Hg higher SBP above 110 mm Hg measured SBP. The HRs in the observational analyses were adjusted for sex, region, age-at-risk (5-year age groups), education (5 groups), smoking (4 groups), alcohol consumption (4 groups), and body mass index ([BMI], 7 groups), each at baseline. The linear Mendelian randomization (MR) analyses (localized average causal estimates [LACEs]) are meta-analysis summaries of sex- and region-specific LACEs, which were adjusted for age-at-risk (regression of exposure on instrument for age and age-squared at baseline), BMI, and the first 2 regional genetic principal components. The 95% CI in the genetic analyses are represented by the shaded patterns. CVD indicates cardiovascular disease; and GRS, genetic risk score.

Figure 2.. Age-specific and sex-specific associations of systolic blood pressure (SBP) with major vascular events in observational and genetic analyses. The hazard ratios (HRs) are shown as squares and 95% CI are shown as horizontal lines. The χ2 and P are shown for heterogeneity or linear trend between sex- and age-specific groups, respectively. Observational HRs for SBP are meta-analysis summaries of sex- and age-specific estimates (using 3 age bands). Adjusted for sex, region, age-at-risk (5-year age groups), education (5 groups), smoking (4 groups), alcohol consumption (4 groups), and body mass index ([BMI], 7 groups) at baseline. Similarly, genetic HRs are meta-analysis summaries of age-, sex- and region-specific estimates, which were adjusted for age-at-risk (regression of exposure on instrument for age and age-squared at baseline), BMI, and the first 2 genetic principal components. GRS indicates genetic risk score.

Figure 3.. Associations of systolic blood pressure (SBP) with stroke, ischemic heart disease, and other vascular disease in observational and genetic analyses. Symbols and conventions as in Figure 2. Analyses as in Figure 2. GRS indicates genetic risk score; and HR, hazard ratio.

Figure 4.. Associations of systolic blood pressure (SBP) with nonvascular disease stratified by prior cardiovascular disease (CVD) in observational and genetic analyses. Symbols and conventions as in Figure 2. Analyses as in Figure 2. GRS indicates genetic risk score; and HR, hazard ratio.