Genetic Evidence for Causal Association Between Hypertension and Chronic Pain: A Bidirectional Two-Sample Mendelian...

Area of Science:

• Genetics and Epidemiology
• Cardiovascular Health
• Pain Medicine

Background:

• Observational studies suggest an association between hypertension and chronic pain, but causality remains unclear.
• Shared risk factors may confound the observed relationship, necessitating robust analytical methods.
• Mendelian randomization (MR) offers a powerful approach to infer causal relationships using genetic variants.

Purpose of the Study:

• To investigate the potential causal relationship between hypertension and the risk of developing chronic pain.
• To differentiate between essential and secondary hypertension in their potential causal links to chronic pain.
• To utilize a bidirectional two-sample Mendelian randomization (MR) analysis for robust causal inference.

Main Methods:

• Genome-wide association study (GWAS) data from a pooled dataset were utilized.
• Bidirectional two-sample MR analysis was performed using various methods including IVW, MR-Egger, weighted median, and weighted mode.
• The study assessed hypertension's causal effect on chronic headache, chest, abdominal, joint, back, limb, and multisite pain.

Main Results:

• Genetically predicted essential hypertension showed a causal association with an increased risk of chronic headache (OR=1.007) and limb pain (OR=1.219).
• No significant causal associations were found for essential hypertension in the reverse direction (pain to hypertension).
• Secondary hypertension did not demonstrate a causal association with any type of chronic pain assessed.

Conclusions:

• This MR study provides genetic evidence for a unidirectional causal link between essential hypertension and increased risks of chronic headache and limb pain.
• No causal relationship was identified between secondary hypertension and chronic pain.
• These findings contribute to understanding the complex interplay between hypertension and chronic pain, informing potential therapeutic strategies.