血压与心血管疾病的关系:一项孟德尔随机化研究

Association between blood pressure and cardiovascular diseases:AMendelian randomization study

血压在各种心血管疾病的发展和预后中起着至关重要的作用,但受限于传统流行病学的研究方法,并不能明确血压与心血管疾病之间的因果关系。孟德尔随机化(MR)研究是近年兴起的研究因果关系的方法。本项研究利用两样本MR方法探究血压(舒张压/收缩压)与常见心血管疾病之间的因果关系。结果显示,舒张压与脑动脉瘤(OR=2.00,95%CI:1.58~2.52,P=5.92×10^(-9)),主动脉瘤(OR=2.04,95%CI:1.69~2.46,P=9.02×10^(-14)),胸主动脉瘤(OR=2.21,95%CI:1.61~3.05,P=1.26×10^(-6)),房颤(OR=1.26,95%CI:1.16~1.37,P=4.74×10^(-8)),心肌梗死(OR=1.89,95%CI:1.68~2.13,P=1.06×10^(-25)),心衰(OR=1.34,95%CI:1.23~1.45,P=1.12×10^(-12))和缺血性中风(OR=1.60,95%CI:1.47~1.74,P=2.77×10^(-29))之间均存在显著的因果关系。收缩压与脑动脉瘤(OR=2.04,95%CI:1.62~2.57,P=1.76×10^(-9)),主动脉瘤(OR=1.29,95%CI:1.06~1.56,P=9.37×10^(-3)),房颤(OR=1.29,95%CI:1.18~1.42,P=3.55×10^(-8)),心肌梗死(OR=1.89,95%CI:1.68~2.13,P=8.09×10^(-26)),心衰(OR=1.37,95%CI:1.27~1.47,P=2.01×10^(-16))和缺血性中风(OR=1.49,95%CI:1.37~1.62,P=1.59×10^(-20))之间也存在显著的因果关联。遗传变异预测的收缩压和舒张压与心肌梗死、房颤、心衰和缺血性中风的风险升高显著相关,并大幅度增加动脉瘤的风险。及早发现和积极管理高血压,对心血管健康至关重要。降低血压是预防和控制心血管疾病的重要措施之一。通过调整生活方式和药物治疗,可以有效控制血压,减少心血管疾病的风险。

Blood pressure plays a crucial role in the development and prognosis of various cardiovascular diseases.However,traditional epidemiological research methods have limitations in establishing a causal relationship between blood pressure and cardiovascular diseases.Mendelian randomization(MR)study is a method of studying causality that has emerged in recent years.In this study,a two-sample MR analysis was conducted to explore the causal relationship between blood pressure(diastolic/systolic)and common cardiovascular diseases.The finding revealed a significant causal association between diastolic blood pressure and cardiovascular diseases,such as cerebral aneurysms(OR=2.00,95%CI:1.58~2.52,P=5.92×10^(-9)),aortic aneurysms(OR=2.04,95%CI:1.69~2.46,P=9.02×10^(-14)),thoracic aortic aneurysms(OR=2.21,95%CI:1.61~3.05,P=1.26×10^(-6)),atrial fibrillation(OR=1.26,95%CI:1.16~1.37,P=4.74×10^(-8)),myocardial infarction(OR=1.89,95%CI:1.68~2.13,P=1.06×10^(-25)),heart failure(OR=1.34,95%CI:1.23~1.45,P=1.12×10^(-12))and ischemic stroke(OR=1.60,95%CI:1.47~1.74,P=2.77×10^(-29)).Systolic blood pressure showed a significant relationship with cerebral aneurysms(OR=2.04,95%CI:1.62~2.57,P=1.76×10^(-9)),cerebral aneurysms(OR=1.29,95%CI:1.06~1.56,P=9.37×10^(-3)),atrial fibrillation(OR=1.29,95%CI:1.18~1.42,P=3.55×10^(-8)),myocardial infarction(OR=1.89,95%CI:1.68~2.13,P=8.09×10^(-26)),heart failure(OR=1.37,95%CI:1.27~1.47,P=2.01×10^(-16))and ischemic stroke(OR=1.49,95%CI:1.37~1.62,P=1.59×10^(-20)).Genetic variations predicting systolic and diastolic blood pressure levels were found to be significantly correlated with higher risks of myocardial infarction,atrial fibrillation,heart failure,ischemic stroke,and substantially increased risk of aneurysms.Early detection and effective management of high blood pressure are crucial for cardiovascular well-being,highlighting the importance of reducing blood pressure as a key preventive measure against cardiovascular diseases.By making lifestyle changes and using medications,blood pressure can be effectively managed,leading to a reduction in the risk of cardiovascular diseases.