266S ystolic and diastolic blood pressure (SBP and DBP) are complex phenotypes, with known environmental and genetic risk factors.1 Elevated SBP and DBP are associated with premature mortality 2,3 and cardiovascular diseases.
2,4-9
Clinical Perspective on p 278Recent genome-wide association studies (GWAS) have identified genetic variants associated with adult SBP and DBP and hypertension. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Several of these loci are in biologically plausible candidate genes, for example, those that influence the renin-angiotensin system. 25 There are established patterns of age-related changes in BP in industrialized populations, which support a potential interaction of genetic variants with age-related changes to environmental exposures in these populations. 26,27 For genetic variants that directly modulate childhood BP, effects might change with age, might differ between developmental periods (early life, childhood, and adolescence), and might also differ to those variants that act in adulthood.Children and adolescents are rarely treated with antihypertensives, whereas from middle age onwards, an increasing proportion of adults are using such medications. 26 Consequently, it is easier to examine genetic variants that are associated with untreated SBP and DBP in children. Variation in SBP, and to Background-Our aim was to identify genetic variants associated with blood pressure (BP) in childhood and adolescence.
Methods and Results-Genome-wide association study data from participating European ancestry cohorts of the EarlyGenetics and Lifecourse Epidemiology (EAGLE) Consortium was meta-analyzed across 3 epochs; prepuberty (4-7 years), puberty (8-12 years), and postpuberty (13-20 years). Two novel loci were identified as having genome-wide associations with systolic BP across specific age epochs: rs1563894 (ITGA11, located in active H3K27Ac mark and transcription factor chromatin immunoprecipitation and 5′-C-phosphate-G-3′ methylation site) during prepuberty (P=2.86×10-8) and rs872256 during puberty (P=8.67×10 -9 ). Several single-nucleotide polymorphism clusters were also associated with childhood BP at P<5×10 -3. Using a P value threshold of <5×10 -3 , we found some overlap in variants across the different age epochs within our study and between several single-nucleotide polymorphisms in any of the 3 epochs and adult BPrelated single-nucleotide polymorphisms. Conclusions-Our results suggest that genetic determinants of BP act from childhood, develop over the lifecourse, and show some evidence of age-specific effects.
Parmar et al Blood Pressure GWAS in Children 267a lesser extent DBP, in adolescence and early adulthood is associated with subsequent adult risk of coronary heart disease and stroke. 28,29 Understanding the risk factors, including genetic variation, that are associated with SBP and DBP through childhood and into adolescence may therefore inform an improved understanding of the life course pathogenesis of adult hypertension and cardiovascular disease...