Identifying new blood pressure genes to combat hypertension

One in three adults suffer from high blood pressure in the UK which is a leading risk factor for heart disease, stroke and death worldwide. It is caused by a complex interplay between genetics and lifestyle factors such as diet, weight, alcohol consumption, and exercise.

The study, led by Imperial College London and Queen Mary University of London (QMUL), suggests that by using genetic testing, doctors could target medication to certain high blood pressure (hypertension) patients and advise on appropriate lifestyle changes to reduce the risk of heart disease and stroke. The findings are published in Nature Genetics.

The researchers tested 9.8 million genetic variants from 420,000 UK Biobank participants and cross-referenced these with their blood pressure data. Of the 107 new gene regions, many were expressed in high levels in blood vessels and cardiovascular tissue, and could be potential new drug targets for hypertension treatments.

The team also developed a genetic ‘risk score’ by linking health and hospital data from UK Biobank participants with their blood pressure genetics, and showed that the score could be used to predict increased risk of stroke and coronary heart disease.

Those on the top end of the risk scale were likely to have 10mmHg higher blood pressure than patients with lower risk scores. For every 10mmHg a person’s blood pressure is above normal, the risk of heart disease and stroke is increased by around 50% or more.

If such a genetic risk score could be measured in early life, it might be possible to take a ‘personalised medicine’ approach to offset a person’s high risk of stroke and heart disease. This could involve lifestyle interventions such as changing sodium and potassium intake, weight management, reducing alcohol consumption and increasing exercise.

Professor Mark Caulfield, co-lead author from QMUL, said: “Finding 107 new genetic regions linked to blood pressure almost doubles the amount of genes we can evaluate to target for drug treatment. These exciting genetic regions could provide the basis for new innovative preventative therapies and lifestyle changes for this major cause of heart disease and stroke.”

Genetic testing to provide risk scores is not available widely for any of the common diseases so far, but it could one day become routine.
The study was funded by the National Institute for Health Research.