Using genetic information, investigators have identified a way to predict who will respond to blood pressure treatments that lower sodium, according to results of a study published in Circulation.1,2 In the study, investigators determined that genetic risk pertaining to the sodium and potassium pathways could be used in precision medicine to tailor interventions specifically to patients for the management of hypertension.2
“The way [patients] respond to drugs is different. We can measure an individual’s genetic risk of developing high blood pressure with respect to the physiological systems responsible, including kidneys, heart, or smooth muscle, and then target medications accurately,” Murray Cairns, PhD, professor in the School of Biomedical Sciences and Pharmacy at the University of Newcastle, said in a press release.1
There are some hypertension medications that help lower sodium, affecting blood volume, according to the press release. Cairns said that individuals who have a genetic predisposition to high blood pressure that is triggered by a high intake of salt will respond better to treatment that reduces sodium. However, he added that those who do not have salt as a significant contributor to hypertension may benefit more from treatments targeting other aspects that are relevant to genetic risk factors.1
3 Key Takeaways
- The study reveals a breakthrough in hypertension management by utilizing genetic information to predict patient responses to sodium-lowering blood pressure treatments.
- Patients with a genetic predisposition to high blood pressure triggered by high salt intake may respond better to sodium-lowering treatments. Conversely, those with different genetic risk factors may benefit more from alternative interventions targeting different aspects of hypertension.
- The observational nature of the study, involving a large cohort of 296,475 individuals, provides valuable insights into the correlation between genetic risk, urinary electrolytes, and blood pressure.
In the study, the investigators aimed to determine whether genetics could be used to identify patients who would benefit from boosting potassium levels and lowering sodium intake. The study was observational in nature, including data from approximately 296,475 individuals from the UK Biobank cohort. Blood pressure and urinary electrolytes for sodium and potassium, were measured, according to the study authors.2
Investigators used genome-wide polygenic scores for systolic and diastolic blood pressure. They also generated pharmagenic enrichment scores for the sodium and potassium pathways. Using both scores, the study authors determined the association between both scores. To determine patients who would benefit from interventions related to sodium and potassium, investigators used a “gene-by-environment interaction modeling.”2
The results of the study showed that genetic risk and urinary electrolytes were independently correlated with blood pressure. However, the study authors added that urinary sodium was associated with a larger blood pressure increase for those with higher genetic risk in the sodium and potassium pathways compared to those with lower genetic risk.2
Additionally, each SD of urinary sodium was associated with 1.47 mm Hg increase in systolic blood pressure for those in the top 10% with the genetic risk in the pathways compared to 0.97 mm Hs systolic blood pressure in the lowest 10% of those with the genetic risk, according to the study authors.2
The study authors also reported that the interaction regarding urinary sodium was consistent with estimated glomerular filtration rate and indexing sodium with urinary creatine, according to the results. Furthermore, there was no strong evidence of an interaction between urinary sodium and standard genome-wide polygenic score of blood pressure.2
Investigators said that follow-up studies should be used to further advance the findings of this study. They concluded that the results of the observational study holds promise in usage of genetics to help determine dietary interventions and precision medicine for the management of hypertension.2
References
- Major breakthrough in hypertension diagnosis could save government billions. News release. EurekAlert. December 22, 2023. Accessed January 2, 2024. https://www.eurekalert.org/news-releases/1029848
- Reay WR, Clarke E, Eslick S, Riveros C, et al. Using Genetics to Inform Interventions Related to Sodium and Potassium in Hypertension. Circulation. 2023. doi:10.1161/CIRCULATIONAHA.123.065394
