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Predictive capacity of Essential Hypertension – Family History and Genetic Risk Score
Session:
Posters (Sessão 3 - Écran 3) - Fatores de risco cardiovascular
Speaker:
Ana Célia Sousa
Congress:
CPC 2023
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.14 Risk Factors and Prevention - Other
Session Type:
Pósters Electrónicos
FP Number:
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Authors:
Ana Célia Sousa; Maria Isabel Mendonça; Mauro Fernandes; Duarte Ferreira; Ana Carolina Henriques; Carolina Carvalhinha; Eva Henriques; Sónia Freitas; Mariana Rodrigues; Sofia Borges; Maria João Oliveira; Graça Guerra; Ana Isabel Freitas; Ilídio Ornelas; Roberto Palma Dos Reis; Débora Sá
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong><span style="color:black">Background:</span></strong><span style="color:black"> Essential Hypertension (EH) is a risk factor for cardiovascular disease in the Portuguese population. It is a multifactorial pathology resulting from behavioral and genetic factors. Several studies have shown that the existence of a family history (FH) of EH increases the probability of developing this disease. However, the ability to discriminate hypertensive risk remains to be elucidated.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong><span style="color:black">Objective: </span></strong><span style="color:black">To assess whether the predictive capacity of Essential Hypertension improves when a genetic risk score is associated to Family History of hypertension.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong><span style="color:black">Methods: </span></strong><span style="color:black">A case-control study was performed with 1712 individuals: 860 with EH and 852 controls without EH. FH of hypertension was registered for all participants. 14 genetic variants from </span><span style="color:#231f20">several pathophysiological axes</span><span style="color:black"> were selected: </span><span style="color:black">AGT rs4762; AGT rs699; ACE rs4340; ACE rs4343; AGT1R rs5186; CYP11B2 rs1799998; CYP17A1 rs11191548; SCNN1G rs5718; </span><span style="color:#231f20">SLC4A2 rs2303934</span><span style="color:black">; ADD1 rs4961; ATP2B1 rs2681472; ADRβ1 rs1801253; ADRβ2 rs1042713 and GNβ3 rs5443. </span><span style="color:black">Odds ratio (OR) was calculated for each variant in relation to hypertension and, subsequently, a multiplicative genetic risk score (mGRS) of the risk alleles accumulated in these variants was created. Finally, we constructed two ROC curves for FH of EH (without and with mGRS) and calculated their respective AUCs. We compared the increase in AUCs by the Delong test.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong><span style="color:#231f20">Results:</span></strong><span style="color:#231f20"> In total, 627 individuals had FH of hypertension: 409 in the EH group and 218 in the control group. The mean of mGRS in hypertensive group was 0.76±0.57 and in controls was 0.63±0.39 (p<0.0001). The mGRS showed an increased risk of hypertension of OR=1.871 (95%CI 1.484-2.359; p<0.0001). The AUC of the FH model was 0.610 (95%CI 0.586-0.633) which increased to 0.654 (95%CI 0.631-0.676) when the mGRS was included. Comparing the AUC's by the Delong test, there was a statistical significance (p<0.0001), indicating a better discriminative power in the joint model.</span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,"sans-serif""><strong><span style="color:#231f20">Conclusion: </span></strong><span style="color:#231f20">This study showed an improvement in the predictive power of hypertension when mGRS was included to family history.<strong> </strong>This work emphasizes the importance of an mGRS, built with genes from several pathophysiological systems involved in AHT, to determine the predictive power of arterial hypertension. The mGRS may be object of translational research and have applicability in clinical practice in the near future.</span></span></span></p>
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