The total and direct effects of systolic and diastolic blood pressure on cardiovascular disease and longevity using Mendelian randomisation

Abstract The 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) guidelines lowered the hypertension threshold to ≥ 130/80 mmHg, but the role of diastolic BP remains contested. This two-sample mendelian randomisation study used replicated genetic variants pre...

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Autores principales:	Io Ieong Chan, Man Ki Kwok, C. Mary Schooling
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2c016c79cdd3428e9ac402485c1ca11e
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spelling	oai:doaj.org-article:2c016c79cdd3428e9ac402485c1ca11e2021-11-14T12:18:58ZThe total and direct effects of systolic and diastolic blood pressure on cardiovascular disease and longevity using Mendelian randomisation10.1038/s41598-021-00895-22045-2322https://doaj.org/article/2c016c79cdd3428e9ac402485c1ca11e2021-11-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-00895-2https://doaj.org/toc/2045-2322Abstract The 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) guidelines lowered the hypertension threshold to ≥ 130/80 mmHg, but the role of diastolic BP remains contested. This two-sample mendelian randomisation study used replicated genetic variants predicting systolic and diastolic BP applied to the UK Biobank and large genetic consortia, including of cardiovascular diseases and parental lifespan, to obtain total and direct effects. Systolic and diastolic BP had positive total effects on CVD (odds ratio (OR) per standard deviation 2.15, 95% confidence interval (CI) 1.95, 2.37 and OR 1.91, 95% CI 1.73, 2.11, respectively). Direct effects were similar for systolic BP (OR 1.83, 95% CI 1.48, 2.25) but completely attenuated for diastolic BP (1.18, 95% CI 0.97, 1.44), although diastolic BP was associated with coronary artery disease (OR 1.24, 95% CI 1.03, 1.50). Systolic and diastolic BP had similarly negative total (− 0.20 parental attained age z-score, 95% CI − 0.22, − 0.17 and − 0.17, 95% CI − 0.20, − 0.15, respectively) and direct negative effects on longevity. Our findings suggest systolic BP has larger direct effects than diastolic BP on CVD, but both have negative effects (total and direct) on longevity, supporting the 2017 ACC/AHA guidelines lowering both BP targets.Io Ieong ChanMan Ki KwokC. Mary SchoolingNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Io Ieong Chan Man Ki Kwok C. Mary Schooling The total and direct effects of systolic and diastolic blood pressure on cardiovascular disease and longevity using Mendelian randomisation
description	Abstract The 2017 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) guidelines lowered the hypertension threshold to ≥ 130/80 mmHg, but the role of diastolic BP remains contested. This two-sample mendelian randomisation study used replicated genetic variants predicting systolic and diastolic BP applied to the UK Biobank and large genetic consortia, including of cardiovascular diseases and parental lifespan, to obtain total and direct effects. Systolic and diastolic BP had positive total effects on CVD (odds ratio (OR) per standard deviation 2.15, 95% confidence interval (CI) 1.95, 2.37 and OR 1.91, 95% CI 1.73, 2.11, respectively). Direct effects were similar for systolic BP (OR 1.83, 95% CI 1.48, 2.25) but completely attenuated for diastolic BP (1.18, 95% CI 0.97, 1.44), although diastolic BP was associated with coronary artery disease (OR 1.24, 95% CI 1.03, 1.50). Systolic and diastolic BP had similarly negative total (− 0.20 parental attained age z-score, 95% CI − 0.22, − 0.17 and − 0.17, 95% CI − 0.20, − 0.15, respectively) and direct negative effects on longevity. Our findings suggest systolic BP has larger direct effects than diastolic BP on CVD, but both have negative effects (total and direct) on longevity, supporting the 2017 ACC/AHA guidelines lowering both BP targets.
format	article
author	Io Ieong Chan Man Ki Kwok C. Mary Schooling
author_facet	Io Ieong Chan Man Ki Kwok C. Mary Schooling
author_sort	Io Ieong Chan
title	The total and direct effects of systolic and diastolic blood pressure on cardiovascular disease and longevity using Mendelian randomisation
title_short	The total and direct effects of systolic and diastolic blood pressure on cardiovascular disease and longevity using Mendelian randomisation
title_full	The total and direct effects of systolic and diastolic blood pressure on cardiovascular disease and longevity using Mendelian randomisation
title_fullStr	The total and direct effects of systolic and diastolic blood pressure on cardiovascular disease and longevity using Mendelian randomisation
title_full_unstemmed	The total and direct effects of systolic and diastolic blood pressure on cardiovascular disease and longevity using Mendelian randomisation
title_sort	total and direct effects of systolic and diastolic blood pressure on cardiovascular disease and longevity using mendelian randomisation
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/2c016c79cdd3428e9ac402485c1ca11e
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The total and direct effects of systolic and diastolic blood pressure on cardiovascular disease and longevity using Mendelian randomisation

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