Blood Pressure in a Scottish Town

Hawthorne, Victor M.; Greaves, David; Beevers, D. G.

doi:10.1136/bmj.3.5931.600

Cited by 101 publications

(26 citation statements)

References 13 publications

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“…Blood pressure variables were adjusted by regression for the significant covariates of age, sex, smoking, and physical exercise habit. Plasma potassium was adjusted for the following significant covariates: age (␤, 0.005; P Ͻ 0.001); sex (␤, 0.120; female K ϩ lower than male K ϩ ; P Ͻ 0.001); treatment with diuretics (␤, Ϫ0.272; P Ͻ 0.001); treatment with ACE inhibitors (␤, 0.083; P ϭ 0.008); and current smoking (␤, 0.052; P ϭ 0.029), which, as previously described by others, was associated with a higher plasma potassium level (11,21). Age, sex, and smoking explained 5.38% of the variability in plasma K ϩ , and drug therapy explained a further 5.93%, the majority of that effect being due to diuretics.…”

Section: Resultssupporting

confidence: 59%

Plasma potassium level is associated with common genetic variation in the β-subunit of the epithelial sodium channel

Gaukrodger¹,

Avery²,

Keavney³

2008

American Journal of Physiology-Regulatory, Integrative and Comp

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Gaukrodger N, Avery PJ, Keavney B. Plasma potassium level is associated with common genetic variation in the ␤-subunit of the epithelial sodium channel. Am J Physiol Regul Integr Comp Physiol 294: R1068-R1072, 2008. First published January 9, 2008 doi:10.1152/ajpregu.00732.2007.-Plasma potassium is a moderately heritable phenotype, but no robust associations between common single nucleotide polymorphisms (SNPs) and plasma potassium have previously been described. Genetic influences on renal potassium handling could be important in the etiology of hypertension. We have tested whether common genetic variation in the gene encoding the ␤-subunit of the epithelial sodium channel (SCNN1B) affects plasma potassium and blood pressure level in a study of 1,425 members of 248 families ascertained on a proband with hypertension. We characterized family members for blood pressure using ambulatory monitoring, measured plasma potassium in venous blood samples, and genotyped four SNPs that spanned the SCNN1B gene. We found highly significant association between genotype at the SCNN1B rs889299 SNP situated in intron 4 of the gene and plasma potassium. Homozygotes for the rarer T allele had on average a 0.15 mM lower plasma potassium than homozygotes for the common C allele, with an intermediate value for heterozygotes (trend, P ϭ 0.0003). Genotype at rs889299 accounted for ϳ1% of the total variability in plasma potassium, or around 3% of the total heritable fraction. There was no association between genotype at any SCNN1B SNP and blood pressure considered as a quantitative trait, or with hypertension affection status. We have shown a modest sized but highly significant effect of common genetic variation in the SCNN1B gene on plasma potassium. Interaction between the rs889299 SNP and functional SNPs in other genes influencing aldosterone-responsive distal tubular electrolyte transport may be important in the etiology of essential hypertension.aldosterone; electrolyte; heritability; genetics THE EPITHELIAL SODIUM CHANNEL (ENaC) plays a key role in the maintenance of blood pressure and electrolyte homeostasis in the distal nephron. ENaC consists of three subunits ␣, ␤, and ␥, which combine in a 1-to-1-to-1 ratio to form the functional channel (15). Activating mutations in the ␤-and ␥-subunits of ENaC (encoded by the SCNN1B and SCNN1G genes, respectively) give rise to Liddle's syndrome, an autosomal dominant condition involving amiloride-sensitive hypertension, hypokalemia, and metabolic alkalosis (10,20). Conversely, loss of function mutations in the ␣-, ␤-, or ␥-subunits of ENaC leads to recessive pseudohypoaldosteronism type I, a childhood condition characterized by severe salt wasting and hyperkalemia (6). A number of groups have investigated the role of common polymorphisms in the genes encoding the ENaC subunits as potential susceptibility alleles influencing the risk of essential hypertension to a moderate degree. However, no common single nucleotide polymorphism in any subunit of ENaC has been consistently identified as c...

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Section: Resultssupporting

confidence: 59%

Plasma potassium level is associated with common genetic variation in the β-subunit of the epithelial sodium channel

Gaukrodger¹,

Avery²,

Keavney³

2008

American Journal of Physiology-Regulatory, Integrative and Comp

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“…Though there was a female preponderance in this group, there is no compelling evidence to suggest that lower arterial pressures could be ascribed to this [27]. While the difference is relatively small, any potential biological significance remains to be determined.…”

Section: Discussionmentioning

confidence: 77%

Dietary Composition and Renal Function in Healthy Subjects

Wiseman

Hunt

Goodwin

et al. 1987

Nephron

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Increments in dietary protein intake can increase glomerular filtration rate (GFR) in humans, and the glomerular hyperfiltration induced by high protein intake has been incriminated in the progression of glomerulosclerosis related to age and a number of renal diseases. GFR (as ⁵¹Cr-EDTA clearance) was measured in 18 vegans, 16 lactovegetarians and 18 omnivorous control subjects, matched for age. Omnivores ate significantly more total protein and protein of animal origin than the other two groups. Vegetable protein comprised 100% of the vegans’ daily protein intake and 64% of the lactovegetarians’, both significantly higher than the omnivores’ (32%). Vegans and lactovegetarians also ate more carbohydrate and fibre than omnivores, although fat intake was similar. Mean GFR was significantly lower in the vegans than in the omnivores (100 ± 13 vs. 113 ± 16 ml/min/1.73 m²; p < 0.04) and was intermediate in the lactovegetarians (105 ± 16 ml/min/1.73 m²). Omnivores had significantly higher mean urinary albumin excretion rate (p < 0.05) than vegans, and higher mean diastolic blood pressure than both vegans and lactovegetarians (p < 0.01). The vegan diet is associated with glomerular and systemic haemodynamic changes which may be beneficial in the prevention of glomerular sclerotic changes in health and disease.

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“…The sample size was determined using the nomogram described by Altman. 7 We used a standard deviation of 13 mm Hg diastolic from the Renfrew study, 8 assumed a 5 mm Hg difference to be clinically significant and chose a 5% significance level with a power of 85%. Only one of the clinicians was aware of the null hypothesis in an attempt to reduce observer bias.…”

Section: Methodsmentioning

confidence: 99%

A study of inter-arm blood pressure differences in primary care

Cassidy

Jones

2001

J Hum Hypertens

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Objectives: To investigate whether there are inter-arm blood pressure differences that are of clinical importance to general practice. Design and setting: Pragmatic study with randomised order of use of left or right arm carried out in routine surgeries in an inner city and suburban general practice. Subjects: There were 237 patients presenting opportunistically for blood pressure measurement to a nurse or general practitioner. Main outcome measures: 95% limits of agreement between measurements on the left and right arm and bias between arms. Results: Large inter-arm blood pressure differences exist reflected in wide 95% limits of agreement; ؊16

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Blood Pressure in a Scottish Town

Cited by 101 publications

References 13 publications

Plasma potassium level is associated with common genetic variation in the β-subunit of the epithelial sodium channel

Plasma potassium level is associated with common genetic variation in the β-subunit of the epithelial sodium channel

Dietary Composition and Renal Function in Healthy Subjects

A study of inter-arm blood pressure differences in primary care

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