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Hypertension associated with genes which reduce vitamin D – meta-analysis June 2014

Association of vitamin D status with arterial blood pressure and hypertension risk: a mendelian randomisation study

The Lancet Diabetes & Endocrinology, Early Online Publication, 26 June 2014, doi:10.1016/S2213-8587(14)70113-5
study leader Professor Elina Hyppönen from the University of South Australia (Huge list of authors)

Background
Low plasma 25-hydroxyvitamin D (25[OH]D) concentration is associated with high arterial blood pressure and hypertension risk, but whether this association is causal is unknown. We used a mendelian randomisation approach to test whether 25(OH)D concentration is causally associated with blood pressure and hypertension risk.

Methods
In this mendelian randomisation study, we generated an allele score (25[OH]D synthesis score) based on variants of genes that affect 25(OH)D synthesis or substrate availability (CYP2R1 and DHCR7), which we used as a proxy for 25(OH)D concentration. We meta-analysed data for up to 108,173 individuals from 35 studies in the D-CarDia collaboration to investigate associations between the allele score and blood pressure measurements. We complemented these analyses with previously published summary statistics from the International Consortium on Blood Pressure (ICBP), the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, and the Global Blood Pressure Genetics (Global BPGen) consortium.

Findings
In phenotypic analyses (up to n=49 363), increased 25(OH)D concentration was associated with decreased systolic blood pressure (β per 10% increase, −0·12 mm Hg, 95% CI −0·20 to −0·04; p=0·003) and reduced odds of hypertension (odds ratio [OR] 0·98, 95% CI 0·97—0·99; p=0·0003), but not with decreased diastolic blood pressure (β per 10% increase, −0·02 mm Hg, −0·08 to 0·03; p=0·37). In meta-analyses in which we combined data from D-CarDia and the ICBP (n=146 581, after exclusion of overlapping studies), each 25(OH)D-increasing allele of the synthesis score was associated with a change of −0·10 mm Hg in systolic blood pressure (−0·21 to −0·0001; p=0·0498) and a change of −0·08 mm Hg in diastolic blood pressure (−0·15 to −0·02; p=0·01). When D-CarDia and consortia data for hypertension were meta-analysed together (n=142 255), the synthesis score was associated with a reduced odds of hypertension (OR per allele, 0·98, 0·96—0·99; p=0·001). In instrumental variable analysis, each 10% increase in genetically instrumented 25(OH)D concentration was associated with a change of −0·29 mm Hg in diastolic blood pressure (−0·52 to −0·07; p=0·01), a change of −0·37 mm Hg in systolic blood pressure (−0·73 to 0·003; p=0·052), and an 8·1% decreased odds of hypertension (OR 0·92, 0·87—0·97; p=0·002).

Interpretation
Increased plasma concentrations of 25(OH)D might reduce the risk of hypertension.
This finding warrants further investigation in an independent, similarly powered study.

One of many tables in the study

Image


PDF is attached at the bottom of this page

See also VitaminDWiki

Pages listed in BOTH the categories Hypertension and Genetics

See also web

  • Clinical trials for Hypertension and "Vitamin D" 50 as of June 2014
  • Medical Express on the study
    They found that for each 10% increase in 25(OH)D concentration there was a drop in
       diastolic blood pressure (-0.29 mm Hg) and
       systolic blood pressure (-0.37 mm Hg), and an
       8.1% decrease in the odds of developing hypertension.
  • NHS (UK) has a good overview of the study and its implications - the following are a few sentences from the article
    The researchers hypothesised that these genes should have an influence on lifelong vitamin D levels, so they could be used to look for an association with blood pressure and hypertension.
    If people were taking antihypertensive drugs, they added 15mmHg to the systolic reading and 10mmHg to the diastolic reading to account for the likely effect of the drugs.
    The study's strengths include the large number of participants, although they were all of European descent, so it is not known if the results could be directly applicable to other ethnicities.

Attached files

ID Name Comment Uploaded Size Downloads
4078 Hypertension.jpg admin 26 Jun, 2014 62.17 Kb 1350
4077 Hypertension Lancet.pdf admin 26 Jun, 2014 362.79 Kb 1025