Whole genome sequence analysis of apparent treatment resistant hypertension status in participants from the Trans-Omics for Precision Medicine program

Research output: Contribution to journalJournal articleResearchpeer-review

  • Nicole D Armstrong
  • Vinodh Srinivasasainagendra
  • Farah Ammous
  • Themistocles L Assimes
  • Amber L Beitelshees
  • Jennifer Brody
  • Brian E Cade
  • Yii-Der Ida Chen
  • Han Chen
  • Paul S de Vries
  • James S Floyd
  • Nora Franceschini
  • Xiuqing Guo
  • Jacklyn N Hellwege
  • John S House
  • Chii-Min Hwu
  • Sharon L R Kardia
  • Ethan M Lange
  • Leslie A Lange
  • Caitrin W McDonough
  • May E Montasser
  • Jeffrey R O'Connell
  • Megan M Shuey
  • Xiao Sun
  • Rikki M Tanner
  • Zhe Wang
  • Wei Zhao
  • April P Carson
  • Todd L Edwards
  • Tanika N Kelly
  • Eimear E Kenny
  • Charles Kooperberg
  • Alanna C Morrison
  • Alison Motsinger-Reif
  • Bruce M Psaty
  • Dabeeru C Rao
  • Susan Redline
  • Stephen S Rich
  • Jerome I Rotter
  • Jennifer A Smith
  • Albert V Smith
  • Marguerite R Irvin
  • Donna K Arnett

Introduction: Apparent treatment-resistant hypertension (aTRH) is characterized by the use of four or more antihypertensive (AHT) classes to achieve blood pressure (BP) control. In the current study, we conducted single-variant and gene-based analyses of aTRH among individuals from 12 Trans-Omics for Precision Medicine cohorts with whole-genome sequencing data. Methods: Cases were defined as individuals treated for hypertension (HTN) taking three different AHT classes, with average systolic BP ≥ 140 or diastolic BP ≥ 90 mmHg, or four or more medications regardless of BP ( n = 1,705). A normotensive control group was defined as individuals with BP < 140/90 mmHg ( n = 22,079), not on AHT medication. A second control group comprised individuals who were treatment responsive on one AHT medication with BP < 140/ 90 mmHg ( n = 5,424). Logistic regression with kinship adjustment using the Scalable and Accurate Implementation of Generalized mixed models (SAIGE) was performed, adjusting for age, sex, and genetic ancestry. We assessed variants using SKAT-O in rare-variant analyses. Single-variant and gene-based tests were conducted in a pooled multi-ethnicity stratum, as well as self-reported ethnic/racial strata (European and African American). Results: One variant in the known HTN locus, KCNK3, was a top finding in the multi-ethnic analysis ( p = 8.23E-07) for the normotensive control group [rs12476527, odds ratio (95% confidence interval) = 0.80 (0.74-0.88)]. This variant was replicated in the Vanderbilt University Medical Center's DNA repository data. Aggregate gene-based signals included the genes AGTPBP, MYL4, PDCD4, BBS9, ERG, and IER3. Discussion: Additional work validating these loci in larger, more diverse populations, is warranted to determine whether these regions influence the pathobiology of aTRH.

Original languageEnglish
Article number1278215
JournalFrontiers in Genetics
Volume14
ISSN1664-8021
DOIs
Publication statusPublished - 2023
Externally publishedYes

Bibliographical note

Copyright © 2023 Armstrong, Srinivasasainagendra, Ammous, Assimes, Beitelshees, Brody, Cade, Ida Chen, Chen, de Vries, Floyd, Franceschini, Guo, Hellwege, House, Hwu, Kardia, Lange, Lange, McDonough, Montasser, O’Connell, Shuey, Sun, Tanner, Wang, Zhao, Carson, Edwards, Kelly, Kenny, Kooperberg, Loos, Morrison, Motsinger-Reif, Psaty, Rao, Redline, Rich, Rotter, Smith, Smith, Irvin and Arnett.

ID: 378953663