Using Genetics to Inform Interventions Related to Sodium and Potassium in Hypertension

Area of Science:

• Cardiovascular Genetics
• Nutritional Genomics
• Precision Medicine

Background:

• Hypertension is a major risk factor for cardiovascular events, often difficult to manage.
• Dietary interventions can lower blood pressure (BP), but individual responses vary significantly.
• Genetic factors contribute to BP heritability and may explain treatment response heterogeneity.

Purpose of the Study:

• To investigate if genetic predisposition to blood pressure (BP) can identify individuals who benefit most from sodium reduction and potassium increase.
• To explore gene-environment interactions between dietary electrolytes and genetic risk scores for BP.

Main Methods:

• Utilized cross-sectional UK Biobank data from nearly 300,000 individuals.
• Measured BP and urinary electrolytes (sodium, potassium) as biomarkers of intake.
• Constructed biologically directed genetic scores for BP related to sodium/potassium pathways and compared with genome-wide scores.

Main Results:

• Both genetic risk and urinary electrolytes independently correlated with BP.
• Higher urinary sodium intake showed a greater BP increase in individuals with higher genetic risk in sodium/potassium pathways.
• This interaction was significant (P=1.95×10⁻³), with a 1.47 mm Hg vs 0.97 mm Hg systolic BP increase per SD in urinary sodium for top vs. bottom 10% genetic risk groups.

Conclusions:

• Genetic risk in sodium and potassium pathways may enable precision medicine for hypertension management.
• This genetic information can help direct dietary interventions more effectively.
• Further intervention studies are recommended to validate these findings.