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GWAS and Replication Analysis of Apparent Treatment-Resistant Hypertension.
Joseph E Ebinger1, Anni Kauko2,3, Felix Vaura4
1Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (J.E.E., S.Y.J., S.C.).
Resistant hypertension (RH) has distinct genetic drivers, including those related to aldosterone homeostasis and vascular function. Identifying these genetic variants offers new targets for treating RH and reducing cardiovascular risks.
Area of Science:
- Genetics
- Cardiovascular Medicine
- Pharmacogenomics
Background:
- Resistant hypertension (RH) significantly increases cardiovascular event risk compared to primary hypertension.
- Identifying genetic drivers of RH is crucial for developing targeted treatments.
Purpose of the Study:
- To identify reliable and generalizable genetic drivers of resistant hypertension (RH).
Main Methods:
- Utilized FinnGen and UK Biobank datasets for discovery and replication.
- Performed genome-wide and transcriptome-wide association studies.
- Conducted Mendelian randomization to assess causal associations.
Main Results:
- Replicated 5 genetic loci (CASZ1, WNT2B, KCNK3, LSP1, EVX1/EVX1AS) associated with RH.
- Identified links to aldosterone homeostasis, vasodilation pathways, and vascular/cardiac development.
- Found 37 genes with genetically regulated expression linked to RH, notably KCNK3.
- Mendelian randomization suggested causal links between RH and CRP, triglycerides, waist circumference, and BMI.
Conclusions:
- Distinct genetic variants are associated with RH, implicating hyperaldosteronism.
- These findings highlight novel pathways and potential therapeutic targets for RH treatment.
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