Impact of blood pressure and antihypertensive drug classes on intracranial aneurysm: a Mendelian randomization study

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Real-Time Monitoring and Modulation of Blood Pressure in a Rabbit Model of Ischemic Stroke
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Real-Time Monitoring and Modulation of Blood Pressure in a Rabbit Model of Ischemic Stroke

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Youjie Zeng1, Ren Guo2, Si Cao1

  • 1Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|September 16, 2023
PubMed

Insights

Elevated blood pressure significantly increases intracranial aneurysm (IA) risk. Thiazide diuretics may be a promising antihypertensive medication for reducing IA risk, warranting further investigation.

Area of Science:

  • Cardiovascular Genetics
  • Neurology
  • Pharmacogenomics

Background:

  • Blood pressure is a known risk factor for intracranial aneurysms (IA).
  • The differential impact of various antihypertensive drug classes on IA risk remains unclear.

Purpose of the Study:

  • To investigate the causal relationship between blood pressure and intracranial aneurysms.
  • To examine whether specific antihypertensive drug classes differentially affect IA risk.

Main Methods:

  • Utilized genome-wide association study summary statistics for blood pressure and IA.
  • Employed Mendelian randomization (MR) with inverse-variance-weighted (IVW) as the primary method.
  • Selected genetic variants near antihypertensive drug targets to proxy drug effects and conducted sensitivity analyses.

Main Results:

  • Confirmed that elevated systolic blood pressure (SBP) and diastolic blood pressure (DBP) significantly increase the risk of both non-ruptured IA and IA with subarachnoid hemorrhage (SAH).
  • Found that SBP mediated by thiazide diuretics (TDs) target genes significantly increased the risk of IA (non-rupture and SAH).
  • Observed no significant causal association between SBP mediated by calcium channel blockers (CCBs) or beta-blockers (BBs) and IA risk.

Conclusions:

  • High blood pressure is a significant risk factor for intracranial aneurysms.
  • Thiazide diuretics may represent a promising antihypertensive treatment strategy for mitigating IA risk.
  • Further large-scale cohort studies are necessary to validate these findings.
Abstract

Keywords:
Antihypertensive medicationCausal relationshipCerebral aneurysmHypertensionIncidence riskSubarachnoid hemorrhage

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