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The role of a genetic risk score for predicting target organ damage in hypertensive patients
Session:
Painel 7 - Hipertensão 1
Speaker:
Ana Célia Sousa
Congress:
CPC 2020
Topic:
I. Hypertension
Theme:
27. Hypertension
Subtheme:
27.2 Hypertension – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Ana Célia Sousa; Teresa Góis; Sara Gouveia; António Freitas Silva; CATARINA NOBREGA; Andreia Pereira; Eva Henriques; Sónia Freitas; Mariana Rodrigues; Ana Isabel Freitas; Ilídio Ornelas; Roberto Palma dos Reis; Maria Isabel Mendonça
Abstract
<p><strong>Introduction </strong></p> <p>Clinical and subclinical lesions of target organs influence the prognosis of hypertensive individuals and play a crucial role in determining overall cardiovascular risk. Several factors interfere with the development of target organ damage (TOD) in hypertensive individuals. However, the contribution of genetics in TOD remains unclear.</p> <p> </p> <p><strong>Objective:</strong> Study the contribution of a genetic risk score (GRS), consisting of 14 genetic variants related to arterial hypertension (AHT) in TOD risk prediction. Test the improvement of the discrimination and reclassification indices for predicting TOD, when the GRS is added to the model comprising the non-genetic factors related with TOD.</p> <p> </p> <p><strong>Methods:</strong> In a sample of 600 hypertensive patients with a mean age of 50.9±7.7 years, we evaluated the existence of TOD (hypertensive retinopathy, renal failure/microalbuminuria, hypertensive heart disease or cerebrovascular disease). Two groups were constituted: a group with hypertensive patients who presented at least one TOD (n= 308) and another with those who had no TOD (n= 292). In both groups, 14 genetic variants and the predictive factors of TOD development (PF TOD), namely: age, gender, time of diagnosis of AHT and control of AHT. A logistic regression analysis was performed to assess which PF TOD were associated with TOD. GRS was calculated using the multiplicative method. Finally, ROC curves were performed with PF TOD and PF TOD + GRS and results were compared with the <em>Delong</em> test.</p> <p> </p> <p><strong>Results: </strong>After logistic regression, corrected for PF TOD, the GRS increased the risk of TOD, with an OR of 1.40 (95%CI:1.22 - 1.61; p<0.0001). In the first ROC curve, including PF of TOD, the AUC was 0.565 (95% CI:0.519-0.611) and, when GRS was added to the model, it increased to 0.641 (CI 95% 0.598-0.685). Comparing the AUC's by the <em>Delong</em> test, the p-value was significant (p<0.05), indicating a better discriminative power in the joint model.</p> <p> </p> <p><strong>Conclusions:</strong> GRS proved to be an independent risk factor for the appearance of TOD in hypertensive patients and increased the discriminative capacity of PF of TOD. The reclassification analysis revealed that the inclusion of GRS improved our model. This genetic score may be useful in clinical practice, helping to assess hypertensive individuals at higher risk of developing TOD.</p> <p> </p>
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