Abstract
As part of the Heart Healthy Lenoir Project, we developed a practice level intervention to improve blood pressure control. The goal of this study was: (i) to determine if single nucleotide polymorphisms (SNPs) that associate with blood pressure variation, identified in large studies, are applicable to blood pressure control in subjects from a rural population; (ii) to measure the association of these SNPs with subjects’ responsiveness to the hypertension intervention; and (iii) to identify other SNPs that may help understand patient-specific responses to an intervention. We used a combination of candidate SNPs and genome-wide analyses to test associations with either baseline systolic blood pressure (SBP) or change in systolic blood pressure one year after the intervention in two genetically defined ancestral groups: African Americans (AA) and Caucasian Americans (CAU). Of the 48 candidate SNPs, 13 SNPs associated with baseline SBP in our study; however, one candidate SNP, rs592582, also associated with a change in SBP after one year. Using our study data, we identified 4 and 15 additional loci that associated with a change in SBP in the AA and CAU groups, respectively. Our analysis of gene-age interactions identified genotypes associated with SBP improvement within different age groups of our populations. Moreover, our integrative analysis identified AQP4-AS1 and PADI2 as genes whose expression levels may contribute to the pleiotropy of complex traits involved in cardiovascular health and blood pressure regulation in response to an intervention targeting hypertension. In conclusion, the identification of SNPs associated with the success of a hypertension treatment intervention suggests that genetic factors in combination with age may contribute to an individual’s success in lowering SBP. If these findings prove to be applicable to other populations, the use of this genetic variation in making patient-specific interventions may help providers with making decisions to improve patient outcomes. Further investigation is required to determine the role of this genetic variance with respect to the management of hypertension such that more precise treatment recommendations may be made in the future as part of personalized medicine.
Highlights
Hypertension (HTN) and its end-organ manifestations including stroke, coronary heart disease, and chronic renal failure are major contributors to morbidity and mortality in the United States and globally [1,2]
We evaluated 512 genetic samples obtained from the HHL cohort by principal components analysis using over 700,000 single nucleotide polymorphisms (SNPs) (Figures S1 and S2, Table S1) to identify subjects of either African analysis using over 700,000 SNPs (Figures S1 and S2, Table S1) to identify subjects of either African or European ancestry (Figure 1) as well as relatedness
We removed subjects with admixture to to identify a subset of genetically unrelated subjects assigned to the office-based HTN improvement identify a subset of genetically unrelated subjects assigned to the office-based HTN improvement intervention who had blood pressure (BP) measurements at baseline and 12-month follow-up, referred to hereafter as the intervention who had BP measurements at baseline and 12-month follow-up, referred to hereafter as
Summary
Hypertension (HTN) and its end-organ manifestations including stroke, coronary heart disease, and chronic renal failure are major contributors to morbidity and mortality in the United States and globally [1,2]. Typical intervention strategies used to reduce blood pressure (BP) include implementing strategies at various levels of patient influence (patient, family, healthcare provider, community level) [6]. In some cases implementing strategies to enhance control among specific groups, such as African Americans [7,8]. Such interventions aim to reduce BP by improving medication adherence, guiding better lifestyle choices, using home BP monitors, addressing clinical inertia in intensifying anti-hypertensive treatment, using team-based approaches to improve HTN management, and other strategies [7,8,9,10,11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
