Lifestyle Factors Affect Blood Pressure and Cardiovascular Risk Regardless of Genetic Predisposition

Post on December 27, 2017 by André Broussard, D.C.

December 27, 2017

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  • Data from the UK Biobank study were used to create a genetic risk score for high blood pressure (BP) in adults aged 40 to 69 years without established cardiovascular diseases (CVD) to study the interaction between lifestyle factors and genetic profile and the effect on CVD risk. There was a strong association between healthy lifestyle scores and BP, independent of BP genetic risk. Individuals with a favorable lifestyle had a significantly lower systolic BP than those with an unfavorable lifestyle in the low–genetic risk, intermediate–genetic risk, and high–genetic risk groups. CVD risk was also significantly lower in those with a favorable lifestyle compared with those with an unfavorable lifestyle in all genetic risk groups.
  • Lifestyle modification should be encouraged across the entire population as a healthy lifestyle improves BP, regardless of the underlying genetic risk. Further evaluation is needed to determine the benefits and harms of disclosing genetic predisposition for high BP as a CVD risk-stratification tool.

Abstract

BACKGROUND

High blood pressure (BP) is a major risk factor for cardiovascular diseases (CVD), the leading cause of mortality worldwide. Both heritable and lifestyle risk factors contribute to elevated BP levels. We aimed to investigate the extent to which lifestyle factors could offset the effect of an adverse BP genetic profile, and its effect on CVD risk.

METHODS

We constructed a genetic risk score for high BP using 314 published BP loci in 277,005 individuals without previous CVD from the UK Biobank study, a prospective cohort of individuals aged 40 to 69 years, with median 6.11 years of follow-up. We scored participants according to their lifestyle factors including body mass index, healthy diet, sedentary lifestyle, alcohol consumption, smoking, and urinary sodium excretion levels measured at recruitment. We examined the association between tertiles of genetic risk and tertiles of lifestyle score with BP levels and incident CVD using linear regression and Cox regression models respectively.

RESULTS

Healthy lifestyle score was strongly associated with BP (P<10-320 for systolic and diastolic BP and CVD events regardless of the underlying BP genetic risk. Participants with favorable compared to unfavorable lifestyle (bottom vs. top tertile lifestyle score) had 3.6, 3.5, and 3.6 mmHg lower systolic BP in low, middle and high genetic risk groups respectively (P for interaction= 0.0006). Similarly, favorable compared with unfavorable lifestyle showed 30%, 31%, and 33% lower risk of CVD among participants at low, middle and high genetic risk groups respectively (P for interaction= 0.99).

CONCLUSIONS

Our data further support population-wide efforts to lower BP in the population via lifestyle modification. Advantages and disadvantages of disclosing genetic predisposition to high BP for risk stratification needs careful evaluation.

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