000			03867 am a22004333u 4500
042			_adc
100	1	0	_aClarke, Robert _eauthor _93041
700	1	0	_aWright, Neil _eauthor _93042
700	1	0	_aWalters, Robin _eauthor _93043
700	1	0	_aGan, Wei _eauthor _93044
700	1	0	_aGuo, Yu _eauthor _93045
700	1	0	_aMillwood, Iona Y. _eauthor _93046
700	1	0	_aYang, Ling _eauthor _93047
700	1	0	_aChen, Yiping _eauthor _93048
700	1	0	_aLewington, Sarah _eauthor _93049
700	1	0	_aLv, Jun _eauthor _93050
700	1	0	_aYu, Canqing _eauthor _93051
700	1	0	_aAvery, Daniel _eauthor _93052
700	1	0	_aLin, Kuang _eauthor _93053
700	1	0	_aWang, Kang _eauthor _93054
700	1	0	_aPeto, Richard _eauthor _93055
700	1	0	_aCollins, Rory _eauthor _93056
700	1	0	_aLi, Liming _eauthor _93057
700	1	0	_aBennett, Derrick A. _eauthor _93058
700	1	0	_aParish, Sarah _eauthor _93059
700	1	0	_aChen, Zhengming _eauthor _93060
245	0	0	_aGenetically Predicted Differences in Systolic Blood Pressure and Risk of Cardiovascular and Noncardiovascular Diseases: A Mendelian Randomization Study in Chinese Adults
260			_bLippincott Williams & Wilkins, _c2023-01-05.
500			_a/pmc/articles/PMC7614188/
500			_a/pubmed/36601918
520			_aMendelian randomization studies of systolic blood pressure (SBP) can assess the shape and strength of the associations of genetically predicted differences in SBP with major disease outcomes and are less constrained by biases in observational analyses. This study aimed to compare the associations of usual and genetically predicted SBP with major cardiovascular disease (CVD) outcomes, overall and by levels of SBP, age, and sex. METHODS: The China Kadoorie Biobank involved a 12-year follow-up of a prospective study of 489 495 adults aged 40 to 79 years with no prior CVD and 86 060 with genetic data. Outcomes included major vascular events (59 490/23 151 in observational/genetic analyses), and its components (ischemic stroke [n=39 513/12 043], intracerebral hemorrhage [7336/5243], and major coronary events [7871/4187]). Genetically predicted SBP used 460 variants obtained from European ancestry genome-wide studies. Cox regression estimated adjusted hazard ratios for incident CVD outcomes down to usual SBP levels of 120 mm Hg. RESULTS: Both observational and genetic analyses demonstrated log-linear positive associations of SBP with major vascular event and other major CVD types in the range of 120 to 170 mm Hg. Consistent with the observational analyses, the hazard ratios per 10 mm Hg higher genetically predicted SBP were 2-fold greater for intracerebral hemorrhage (1.71 [95% CI, 1.58-1.87]) than for ischemic stroke (1.37 [1.30-1.45]) or major coronary event (1.29 [1.18-1.42]). Genetic analyses also demonstrated 2-fold greater hazard ratios for major vascular event in younger (1.69 [95% CI, 1.54-1.86]) than in older people (1.28 [1.18-1.38]). CONCLUSIONS: The findings provide support for initiation of blood pressure-lowering treatment at younger ages and below the conventional cut-offs for hypertension to maximize CVD prevention, albeit the absolute risks of CVD are far greater in older people.
540			_a© 2022 The Authors.
540			_ahttps://creativecommons.org/licenses/by/4.0/Hypertension is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.
546			_aen
690			_aOriginal Articles
655	7		_aText _2local
786	0		_nHypertension
856	4	1	_uhttp://dx.doi.org/10.1161/HYPERTENSIONAHA.122.20120 _zConnect to this object online.
999			_c506 _d506