Evidence map›Paper›PMID 36601918›Full record

ArticleHypertension (Dallas, Tex. : 1979)2023

Genetically Predicted Differences in Systolic Blood Pressure and Risk of Cardiovascular and Noncardiovascular Diseases: A Mendelian Randomization Study in Chinese Adults.

Robert Clarke, Neil Wright, Robin Walters, Wei Gan, Yu Guo, Iona Y Millwood, Ling Yang, Yiping Chen, Sarah Lewington, Jun Lv and 11 more

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Hypertension (Dallas, Tex. : 1979), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
6.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 28 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

21 authors at 8 institutions in 6 countries.

Robert Clarke *Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).ORCID 0000-0002-9802-8241
Neil Wright *Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).ORCID 0000-0002-3946-1870
Robin WaltersClinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).ORCID 0000-0002-9179-0321
Wei GanNovo Nordisk Research Centre Oxford, Novo Nordisk Ltd, Oxford, United Kingdom (W.G.).
Yu GuoFuwai Hospital Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing, China (Y.G.).
Iona Y MillwoodClinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).ORCID 0000-0002-0807-0682
Ling YangClinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).ORCID 0000-0001-5750-6588
Yiping ChenClinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).ORCID 0000-0002-4973-0296
Sarah LewingtonClinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).ORCID 0000-0002-4496-4771
Jun LvDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Sciences Center, Beijing, China (J.L., C.Y., L.L.).
Canqing YuDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Sciences Center, Beijing, China (J.L., C.Y., L.L.).ORCID 0000-0002-0019-0014
Daniel AveryClinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).ORCID 0000-0002-9823-9575
Kuang LinClinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).ORCID 0000-0002-7360-3385
Kang WangNCDs Prevention and Control Department, Shibei CDC, China (K.W.).
Richard PetoClinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).ORCID 0000-0001-8219-5339
Rory CollinsClinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).
Liming LiDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Sciences Center, Beijing, China (J.L., C.Y., L.L.).ORCID 0000-0001-5873-7089
Derrick A Bennett *Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).ORCID 0000-0002-9170-8447
Sarah Parish *Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).
Zhengming Chen *Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, United Kingdom (R. Clarke, N.W., R.W., I.Y.M., L.Y., Y.C., S.L., D.A., K.L., R.P., R. Collins, D.A.B., S.P., Z.C.).ORCID 0000-0001-6423-105X
China Kadoorie Biobank Collaborative Group‡
Population Council · INPeking University · CNDepartamento de Epidemiología · GTChinese Academy of Medical Sciences & Peking Union Medical College · CNChinese Center For Disease Control and Prevention · CNCollins College · USNovo Nordisk (Finland) · FINuffield Health · GB

Funding

British Heart Foundation CH/1996001/9454Cancer Research UK 29186Medical Research Council G0300622Medical Research Council MC_EX_G0801669Medical Research Council MC_PC_12027Medical Research Council MC_PC_12028Medical Research Council MC_PC_12029Medical Research Council MC_PC_13049Medical Research Council MC_PC_14135Medical Research Council MC_U137686851Medical Research Council MC_U137686854Medical Research Council MC_U137686857Medical Research Council MC_UU_00017/1Medical Research Council MC_UU_12026/2Medical Research Council MC_UU_12026/3Wellcome Trust 088158/Z/09/ZWellcome Trust 104085/Z/14/ZWellcome Trust 202922Wellcome Trust 212946/Z/18/Z
6 · The paper itself

Abstract

backgroundMendelian randomization studies of systolic blood pressure (SBP) can assess the shape and strength of the associations of genetically predicted differences in SBP with major disease outcomes and are less constrained by biases in observational analyses. This study aimed to compare the associations of usual and genetically predicted SBP with major cardiovascular disease (CVD) outcomes, overall and by levels of SBP, age, and sex.

methodsThe China Kadoorie Biobank involved a 12-year follow-up of a prospective study of 489 495 adults aged 40 to 79 years with no prior CVD and 86 060 with genetic data. Outcomes included major vascular events (59 490/23 151 in observational/genetic analyses), and its components (ischemic stroke [n=39 513/12 043], intracerebral hemorrhage [7336/5243], and major coronary events [7871/4187]). Genetically predicted SBP used 460 variants obtained from European ancestry genome-wide studies. Cox regression estimated adjusted hazard ratios for incident CVD outcomes down to usual SBP levels of 120 mm Hg.

resultsBoth observational and genetic analyses demonstrated log-linear positive associations of SBP with major vascular event and other major CVD types in the range of 120 to 170 mm Hg. Consistent with the observational analyses, the hazard ratios per 10 mm Hg higher genetically predicted SBP were 2-fold greater for intracerebral hemorrhage (1.71 [95% CI, 1.58-1.87]) than for ischemic stroke (1.37 [1.30-1.45]) or major coronary event (1.29 [1.18-1.42]). Genetic analyses also demonstrated 2-fold greater hazard ratios for major vascular event in younger (1.69 [95% CI, 1.54-1.86]) than in older people (1.28 [1.18-1.38]).

conclusionsThe findings provide support for initiation of blood pressure-lowering treatment at younger ages and below the conventional cut-offs for hypertension to maximize CVD prevention, albeit the absolute risks of CVD are far greater in older people.

Indexed as

Cardiovascular DiseasesIschemic StrokeAdultAgedBlood PressureCerebral HemorrhageEast Asian PeopleHumansMendelian Randomization AnalysisMiddle AgedProspective StudiesRisk Factorscardiovascular diseasesMendelian randomizationnoncardiovascular diseasesystolic blood pressure

Identifiers

PMID36601918
PMCPMC7614188
OpenAlexW4313544907

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.