Genetically proxied systolic blood pressure showed a predominant effect over diastolic blood pressure on coronary artery disease (OR 1.23; 95% CI 1.05-1.44 per 10 mmHg) and stroke.
Observational
Do genetically proxied systolic and diastolic blood pressures have distinct independent effects on cardiovascular outcomes?
Genetically proxied systolic blood pressure has a predominant independent effect on the risk of CAD, stroke, HF, AF, and T2DM compared to diastolic blood pressure.
Effect estimate: OR 1.23 (95% CI 1.05-1.44)
A true discrepancy between the effect of systolic blood pressure (SBP) and diastolic blood pressure (DBP) on cardiovascular (CV) outcomes remains unclear. This study performed two-sample Mendelian randomization (MR) using genetic instruments that exclusively predict SBP, DBP or both to dissect the independent effect of SBP and DBP on a range of CV outcomes. Genetic predisposition to higher SBP and DBP was associated with increased risk of coronary artery disease (CAD), myocardial infarction (MI), stroke, heart failure (HF), atrial fibrillation (AF), chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). Genetically proxied SBP exclusively was associated with CAD (OR 1.18, 95% CI: 1.03-1.36, per 10 mmHg), stroke (1.441.28-1.62), ischemic stroke (1.491.30-1.69), HF (1.411.20-1.65), AF (1.281.15-1.43), and T2DM (1.21.13-1.46). Genetically proxied DBP exclusively was associated with stroke (1.211.06-1.37, per 5 mmHg), ischemic stroke (1.241.09-1.41), stroke small-vessel (1.351.10-1.65) and CAD (1.191.00-1.41). Multivariable MR using exclusive SBP and DBP instruments showed the predominant effect of SBP on CAD (1.231.05-1.44, per 10 mmHg), stroke (1.391.20-1.60), ischemic stroke (1.441.25-1.67), HF (1.421.18-1.71), AF (1.261.10-1.43) and T2DM (1.311.14-1.52). The discrepancy between effects of SBP and DBP on outcomes warrants further studies on underpinning mechanisms which may be amenable to therapeutic targeting.
Le et al. (Sat,) conducted a observational in Cardiovascular disease risk. Genetically proxied systolic and diastolic blood pressure was evaluated on Coronary artery disease (CAD) (OR 1.23, 95% CI 1.05-1.44). Genetically proxied systolic blood pressure showed a predominant effect over diastolic blood pressure on coronary artery disease (OR 1.23; 95% CI 1.05-1.44 per 10 mmHg) and stroke.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: