Gastroesophageal reflux disease influences blood pressure components, lipid profile and cardiovascular diseases:
Qiang Wu1,2,3, Changjing He4,5, Wanzhong Huang1
1Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Guangxi Zhuang Autonomous Region, China.
Insights
Gastroesophageal reflux disease (GERD) causally influences blood pressure, lipid profiles, and increases myocardial infarction and hypertension risk. GERD does not appear to be caused by these cardiovascular factors.
Area of Science:
- Cardiovascular Medicine
- Gastroenterology
- Genetic Epidemiology
Background:
- Gastroesophageal reflux disease (GERD) is common and linked to cardiovascular and metabolic issues.
- The precise relationship between GERD, blood pressure, lipid profiles, and cardiovascular diseases is not fully understood.
Purpose of the Study:
- To investigate the potential causal effects of GERD on blood pressure, lipid profiles, and cardiovascular diseases using Mendelian randomization.
- To explore the reverse causality, examining if these factors influence GERD risk.
Main Methods:
- Mendelian randomization (MR) analysis utilizing genetic variants associated with GERD as instrumental variables.
- Analysis of outcomes including blood pressure components, lipid profiles, and cardiovascular diseases.
- Reverse MR analysis to assess the impact of cardiovascular factors on GERD risk.
Main Results:
- Genetically predicted GERD was positively associated with increased systolic blood pressure, diastolic blood pressure, and mean arterial pressure.
- GERD showed a causal impact on lipid profiles, increasing low-density lipoprotein (LDL) cholesterol and triglycerides, and decreasing high-density lipoprotein (HDL) cholesterol.
- GERD was associated with an increased risk of myocardial infarction and hypertension.
- No significant association was found between GERD and pulse pressure, total cholesterol, heart failure, or atrial fibrillation.
- Reverse MR analysis indicated no causal effect of blood pressure, lipid profiles, or cardiovascular diseases on GERD risk.
- Mediation analysis identified LDL cholesterol, HDL cholesterol, and hypertension as mediators in the pathway between GERD and myocardial infarction.
Conclusions:
- This MR study provides robust evidence for a causal relationship between GERD and adverse changes in blood pressure and lipid profiles.
- GERD is causally linked to an increased risk of myocardial infarction and hypertension.
- The findings highlight GERD as a potential risk factor for cardiovascular diseases, with specific lipid components and hypertension mediating this relationship.
Background:
Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder associated with a range of cardiovascular and metabolic complications. However, the relationship between GERD and blood pressure components, lipid profile, and cardiovascular diseases remains unclear.
Methods:
Leveraging genetic variants associated with GERD as instrumental variables, we performed this Mendelian randomization (MR) analyses. Blood pressure components, lipid profile parameters, as well as cardiovascular diseases were considered as outcomes. Furthermore, we conducted reverse MR analysis to explore the association of these factors with the risk of GERD.
Results:
Our MR analysis discovered a potential causal influence of GERD on blood pressure components, with genetically predicted GERD positively associated with systolic blood pressure (β = 0.053, P = 0.036), diastolic blood pressure (β = 0.100, P < 0.001), and mean arterial pressure (β = 0.106, P < 0.001). Additionally, genetically predicted GERD showed a significant impact on lipid profile, leading to increased genetically predicted levels of low-density lipoprotein (LDL) cholesterol (β = 0.093, P < 0.001), and triglycerides (β = 0.153, P < 0.001), while having a negative effect on high-density lipoprotein (HDL) cholesterol (β = -0.115, P = 0.002). Furthermore, our study indicated a noteworthy causal association between genetically predicted GERD and increased risk of myocardial infarction [odds ratio (OR) = 1.272, P = 0.019)] and hypertension (OR = 1.357, P < 0.001). No significant association was found between GERD and pulse pressure, total cholesterol, heart failure, and atrial fibrillation (P > 0.05). Reverse MR analysis indicates that blood pressure components, lipid profile, and cardiovascular diseases do not lead to an increased risk of GERD (all P > 0.05). Furthermore, mediation MR analysis reveals that LDL cholesterol (proportion mediated: 19.99%, 95% CI: 4.49% to 35.50%), HDL cholesterol (proportion mediated: 11.71%, 95% CI: 5.23% to 18.19%), and hypertension (proportion mediated: 35.09%, 95% CI: 24.66% to 45.53%) mediated the effect of GERD on myocardial infarction, while other factors did not participate in this pathway.
Conclusions:
This MR study provides evidence supporting a causal relationship between GERD and alterations in blood pressure components, lipid profile, and increased risk of cardiovascular diseases.
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