Key result
Higher quartiles of a hypertension genetic risk score were associated with an increased risk of prevalent coronary heart disease, with the highest quartile showing an odds ratio of 1.29 compared to the lowest quartile.
Why the study?
Recent GWAS identified over 300 SNPs linked to blood pressure variation, but whether a genetic risk score constructed from these variants associates with coronary heart disease burden was unknown.
Does a higher hypertension genetic risk score increase the risk of prevalent CHD and coronary vessel disease burden in patients referred for coronary angiography?
Observational (n=4,809)
Yes
Does a higher hypertension genetic risk score increase the risk of prevalent CHD and coronary vessel disease burden in patients referred for coronary angiography?
Odds Ratio: 1.29 (95% CI 1.09–1.53)
A higher hypertension genetic risk score is independently associated with an increased risk of prevalent coronary heart disease and a higher burden of coronary vessel disease in patients undergoing coronary angiography.
Should not yet inform CHD risk stratification in angiography patients; leaves open incremental value beyond clinical factors.
BACKGROUND: Recent GWAS studies have identified more than 300 SNPs associated with variation in blood pressure. We investigated whether a genetic risk score constructed from these variants is associated with burden of coronary heart disease. METHODS: From 2010-2014, 4,809 individuals admitted to coronary angiography in Capital Region of Copenhagen were genotyped. We calculated hypertension GRS comprised of GWAS identified SNPs associated with blood pressure. We performed logistic regression analyses to estimate the risk of hypertension and prevalent CHD. We also assessed the severity of CHD associated with the GRS. The analyses were performed using GRS quartiles. We used the Inter99 cohort to validate our results and to investigate for possible pleiotropy for the GRS with other CHD risk factors. RESULTS: In COGEN, adjusted odds ratios comparing the 2nd, 3rd and 4th cumulative GRS quartiles with the reference were 1.12(95% CI 0.95-1.33), 1.35(95% CI 1.14-1.59) and 1.29(95% CI 1.09-1.53) respectively, for prevalent CHD. The adjusted multinomial logistic regression showed that 3rd and 4th GRS quartiles were associated with increased odds of developing two(OR 1.33, 95% CI 1.04-1.71 and OR 1.36, 95% CI 1.06-1.75, respectively) and three coronary vessel disease(OR 1.77, 95% CI 1.36-2.30 and OR 1.65, 95% CI 1.26-2.15, respectively). Similar results for incident CHD were observed in the Inter99 cohort. The hypertension GRS did not associate with type 2 diabetes, smoking, BMI or hyperlipidemia. CONCLUSION: Hypertension GRS quartiles were associated with an increased risk of hypertension, prevalent CHD, and burden of coronary vessel disease in a dose-response pattern. We showed no evidence for pleiotropy with other risk factors for CHD.
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Krogager et al. (2018) conducted an observational in Coronary heart disease (n=4,809). Hypertension genetic risk score (GRS) vs. Lowest quartile of GRS (1st quartile) was evaluated on Prevalent coronary heart disease (OR 1.29, 95% CI 1.09-1.53). Higher quartiles of a hypertension genetic risk score were associated with an increased risk of prevalent coronary heart disease, with the highest quartile showing an odds ratio of 1.29 compared to the lowest quartile.
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