Genetic variants associated with uncontrolled blood pressure on thiazide diuretic/β-blocker combination therapy in the PEAR (Pharmacogenomic Evaluation Of Antihypertensive Responses) and INVEST (International Verapamil-SR Trandolapril Study) trials

Oyunbileg Magvanjav, Yan Gong, Caitrin W. McDonough, Arlene B. Chapman, Stephen T Turner, John G. Gums, Kent R Bailey, Eric Boerwinkle, Amber L. Beitelshees, Toshihiro Tanaka, Michiaki Kubo, Carl J. Pepine, Rhonda M. Cooper-DeHoff, Julie A. Johnson

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background--The majority of hypertensive individuals require combination antihypertensive therapy to achieve adequate blood pressure (BP) control. This study aimed to identify genetic variants associated with uncontrolled BP on combination therapy with a thiazide diuretic and a β-blocker. Methods and Results--A genome-wide association study of uncontrolled BP on combination therapy was conducted among 314 white participants of the PEAR (Pharmacogenomic Evaluation of Antihypertensive Responses) trial. Multivariable logistic regression analysis was used. Genetic variants meeting a suggestive level of significance (P < 1.0E-05) were tested for replication in an external cohort, INVEST (International Verapamil-SR Trandolapril study). We also examined genome-wide variant associations with systolic and diastolic BP response on combination therapy and tested for replication. We discovered a single nucleotide polymorphism, the rs261316 major allele, at chromosome 15 in the gene ALDH1A2 associated with an increased odds of having uncontrolled BP on combination therapy (odds ratio: 2.56, 95% confidence interval, 1.69-3.88, P=8.64E-06). This single nucleotide polymorphism replicated (odds ratio: 1.86, 95% confidence interval, 1.35-2.57, P=0.001) and approached genome-wide significance in the metaanalysis between discovery and replication cohorts (odds ratio: 2.16, 95% confidence interval, 1.63-2.86, P=8.60E-08). Other genes in the region surrounding rs261316 (ALDH1A2) include AQP9 and LIPC. Conclusions--A single nucleotide polymorphism in the gene ALDH1A2 may be associated with uncontrolled BP following treatment with a thiazide diuretic/β-blocker combination.

Original languageEnglish (US)
Article numbere006522
JournalJournal of the American Heart Association
Volume6
Issue number11
DOIs
StatePublished - Nov 1 2017

Keywords

  • Combination therapy
  • Genomics
  • High blood pressure
  • Hypertension
  • Pharmacogenomics
  • Thiazide diuretics
  • β-blockers

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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