The genetic relationship between hypotension and delirium: a Mendelian randomization study

Area of Science:

• Cardiovascular Medicine
• Neurology
• Genetics

Background:

• Observational studies suggest hypotension is a risk factor for delirium.
• Previous studies lack the ability to establish causality.
• This study explores the genetic causal relationship between hypotension and delirium.

Purpose of the Study:

• To investigate the genetic causal relationship between hypotension and delirium using two-sample Mendelian randomization (MR).

Main Methods:

• Utilized genome-wide association study (GWAS) data for hypotension and delirium from the FinnGen Consortium.
• Employed various MR statistical methods including inverse-variance weighted (IVW), weighted median, MR Egger, and MR-PRESSO.
• Assessed heterogeneity and horizontal pleiotropy using Cochrane's Q test, MR-Egger intercept, and MR-PRESSO.

Main Results:

• Hypotension was identified as an independent risk factor for delirium (OR = 1.302, p = 0.010).
• Minimal impact of horizontal pleiotropy (p = 0.999) and no significant heterogeneity (p = 0.379) were observed.
• Leave-one-out analysis confirmed the stability and robustness of the association.

Conclusions:

• Provided evidence for a genetic causal relationship between hypotension and delirium via two-sample MR.
• Individuals with a genetic predisposition for hypotension may face an increased risk of delirium.
• Interventions targeting perioperative hypotension could potentially decrease delirium incidence.