Genetic Predisposition to Higher Blood Pressure Increases Coronary Artery Disease Risk

Abstract

Hypertension is a risk factor for coronary artery disease. Recent genome-wide association studies have identified 30 genetic variants associated with higher blood pressure at genome-wide significance ( P 1 for coronary artery disease, a proportion much higher than expected by chance ( P =4×10 ⁻⁵ ). The average relative coronary artery disease risk increase per each of the multiple blood pressure–raising alleles observed in the consortium was 3.0% for systolic blood pressure-associated polymorphisms (95% confidence interval, 1.8%–4.3%) and 2.9% for diastolic blood pressure-associated polymorphisms (95% confidence interval, 1.7%–4.1%). In substudies, individuals carrying most systolic blood pressure– and diastolic blood pressure–related risk alleles (top quintile of a genetic risk score distribution) had 70% (95% confidence interval, 50%–94%) and 59% (95% confidence interval, 40%–81%) higher odds of having coronary artery disease, respectively, as compared with individuals in the bottom quintile. In conclusion, most blood pressure–associated polymorphisms also confer an increased risk for coronary artery disease. These findings are consistent with a causal relationship of increasing blood pressure to coronary artery disease. Genetic variants primarily affecting blood pressure contribute to the genetic basis of coronary artery disease.