Genetic analysis of over one million people identifies 535 novel loci for blood pressure

Abstract

High blood pressure is the foremost heritable global risk factor for cardiovascular disease. We report the largest genetic association study of blood pressure traits to date (systolic, diastolic, pulse pressure) in over one million people of European ancestry. We identify 535 novel blood pressure loci that not only offer new biological insights into blood pressure regulation but also reveal shared loci influencing lifestyle exposures. Our findings offer the potential for a precision medicine strategy for future cardiovascular disease prevention.peer-reviewed) is the author/funder. All rights reserved. No reuse allowed without permission.The copyright holder for this preprint (which was not . http://dx.doi.org/10.1101/198234 doi: bioRxiv preprint first posted online 1 0High blood pressure, defined as a systolic blood pressure >140 mm Hg and/or diastolic blood pressure > 90 mm Hg, is the dominant inherited risk factor for stroke and coronary artery disease and is responsible for an estimated 7.8 million deaths and 148 million disability life years lost worldwide in 2015 alone 1 . Family studies indicate that the blood pressure (BP) level is determined in an individual by complex interactions between life course exposures and their genetic background [2][3][4][5] . Previous genetic association studies have included genomewide meta-analyses, customised cardiovascular candidate centric analyses and evaluation of exome variation that have identified and validated variants at 274 loci which have a modest effect on population BP and explain ~3-4% of the trait variance [6][7][8][9][10][11][12][13] .Here, we report genome-wide discovery analyses of BP traits (systolic -SBP, diastolic -DBP and pulse pressure -PP) in people of European ancestry drawn from UK Biobank (UKB) 14 and the International Consortium of Blood Pressure-Genome Wide Association Studies (ICBP) 12,13 . We adopted a combination of a one and two-stage study design to test common and low-frequency single nucleotide polymorphisms (SNPs) with minor allele frequency (MAF) ≥ 1% in association with BP traits (Fig. 1) including over 1 million people of European descent across both discovery and replication, including data from the Million Veterans Program (MVP) and the Estonian Biobank.Briefly, UKB is a prospective cohort study of ~500,000 individuals recruited at ages 40-69 years who have been richly phenotyped including BP measurements 14 . Participants were genotyped using a customized array with imputation from the Haplotype Reference Consortium (HRC) panel, yielding ~7 million SNPs (imputation quality score (INFO) ≥ 0.1) 15 . After quality control (QC) and exclusions we performed genome-wide association studies (GWAS) of BP traits using data from 458,577 individuals of European descent under an additive genetic model 16 (Supplementary Table 1a). Following LD-score regression 17 , genomic control was applied to the UKB data prior to meta-analysis.In addition, we performed GWAS analyses for BP traits in the ICBP GWAS data comprising 77 independent s...

Powerful rare variant association testing in a copula‐based joint analysis of multiple phenotypes

“…Technological advancements and collaborative efforts have revolutionized the way we study the genetic underpinnings of complex traits including molecular and disease phenotypes (Evangelou et al, 2018;PCAWG Transcriptome Core Group et al, 2018). High-throughput sequencing allows now to investigate rare variants in greater depth, which are abundant and have high interindividual variability (Telenti et al, 2016), often unknown phenotypic effects (Schork, Murray, Frazer, & Topol, 2009), and potentially pivotal roles in diseases (Mancuso et al, 2016).…”

Analysis of putative cis-regulatory elements regulating blood pressure variation

“…On the whole, the 25 genes reported here across aorta and tibial artery genes have been identified at previous BP loci [39]. While there are several genes in each analysis with interesting associations with BP traits, here we only highlight the genes that have statistical significance of p < 1 x 10 -4 for both expression and BP in the aorta analyses (Tables 2-3).…”

Cardiovascular disease: The rise of the genetic risk score

“…This realization ushered in a new era of data sharing. Today, as a result of large-scale collaboration, meta-analysis, and the emergence of national projects such as the United Kingdom Biobank [ 16 , 17 ], there are GWAS of common variants drawing on more than 1 million individuals [ 18 ]. Such studies, as modeling would predict [ 19 ], are beginning to demonstrate that genetic factors provide robust and powerful risk estimation across diseases that is additive to traditional risk factors [ 20 – 22 ].…”