Genome-wide analysis of blood pressure variability and ischemic stroke

Sunaina Yadav, Ioana Cotlarciuc, Patricia B. Munroe, Muhammad S. Khan, Michael A. Nalls, Steve Bevan, Yu Ching Cheng, Wei Min Chen, Rainer Malik, Nina S. Mccarthy, Elizabeth G. Holliday, Douglas Speed, Nazeeha Hasan, Mateusz Pucek, Paul E. Rinne, Peter Sever, Alice Stanton, Denis C. Shields, Jane M. Maguire, Mark McevoyRodney J. Scott, Luigi Ferrucci, Mary J. Macleod, John Attia, Hugh S. Markus, Michele M. Sale, Bradford B. Worrall, Braxton D. Mitchell, Martin Dichgans, Cathy Sudlow, James F. Meschia, Peter M. Rothwell, Mark Caulfield, Pankaj Sharma

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background and Purpose-Visit-to-visit variability in blood pressure (vBP) is associated with ischemic stroke. We sought to determine whether such variability has genetic causes and whether genetic variants associated with BP variability are also associated with ischemic stroke. Methods-A Genome Wide Association Study (GWAS) for loci influencing BP variability was undertaken in 3802 individuals from the Anglo-Scandinavian Cardiac Outcome Trial (ASCOT) study, in which long-term visit-to-visit and within-visit BP measures were available. Because BP variability is strongly associated with ischemic stroke, we genotyped the sentinel single nucleotide polymorphism in an independent ischemic stroke population comprising 8624 cases and 12 722 controls and in 3900 additional (Scandinavian) participants from the ASCOT study to replicate our findings. Results-The ASCOT discovery GWAS identified a cluster of 17 correlated single nucleotide polymorphisms within the NLGN1 gene (3q26.31) associated with BP variability. The strongest association was with rs976683 (P=1.4×10-8). Conditional analysis of rs976683 provided no evidence of additional independent associations at the locus. Analysis of rs976683 in patients with ischemic stroke found no association for overall stroke (odds ratio, 1.02; 95% CI, 0.97-1.07; P=0.52) or its subtypes: cardioembolic (odds ratio, 1.07; 95% CI, 0.97-1.16; P=0.17), large vessel disease (odds ratio, 0.98; 95% CI, 0.89-1.07; P=0.60), and small vessel disease (odds ratio, 1.07; 95% CI, 0.97-1.17; P=0.19). No evidence for association was found between rs976683 and BP variability in the additional (Scandinavian) ASCOT participants (P=0.18). Conclusions-We identified a cluster of single nucleotide polymorphisms at the NLGN1 locus showing significant association with BP variability. Follow-up analyses did not support an association with risk of ischemic stroke and its subtypes.

Original languageEnglish (US)
Pages (from-to)2703-2709
Number of pages7
Issue number10
StatePublished - Oct 2013


  • Blood pressure variability
  • GWAS
  • Genes
  • Polymorphism
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing


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