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Relationship Between Ascending Thoracic Aortic Diameter and Blood Pressure: A Mendelian Randomization Study
John DePaolo1, Michael G Levin2, Catherine Tcheandjieu3,4
1Department of Surgery (J.D., S.M.D.), Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Arteriosclerosis, Thrombosis, and Vascular Biology
|January 5, 2023
Summary
Elevated blood pressure (BP) causally contributes to thoracic aortic dilation. However, increased aortic size may lower systolic BP and pulse pressure, suggesting a complex bidirectional relationship.
Area of Science:
- Cardiovascular genetics
- Aortic disease research
- Hypertension studies
Background:
- Observational studies link high blood pressure (BP) to thoracic aortic dilation.
- BP reduction is key for managing aortic aneurysm progression.
- The causal link between BP and aortic size remains unclear.
Purpose of the Study:
- To investigate the causal relationship between blood pressure and ascending thoracic aortic diameter (AscAoD).
- To determine the directionality of the causal effect between BP and AscAoD.
Main Methods:
- Utilized 2-sample Mendelian randomization with genome-wide association study summary statistics for BP and AscAoD.
- Employed pleiotropy-robust methods to estimate causal effects.
- Conducted bidirectional Mendelian randomization analyses.
Main Results:
- Increased systolic BP, diastolic BP, and mean arterial pressure were associated with larger AscAoD.
- Reduced pulse pressure showed an inverse association with AscAoD.
- Bidirectional analysis revealed AscAoD inversely affects systolic BP and pulse pressure but directly affects diastolic BP.
Conclusions:
- Blood pressure is a likely causal factor in ascending thoracic aortic dilation.
- Increased aortic diameter may lead to reduced systolic BP and pulse pressure.
- The findings suggest a complex interplay between BP and aortic size.
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