A Large-Scale Multi-ancestry Genome-wide Study Accounting for Smoking Behavior Identifies Multiple Significant Loci for Blood Pressure

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Sung, Y. J. | Winkler, T. W. | de Las Fuentes, L. | Bentley, A. R. | Brown, M. R. | Kraja, A. T. | Schwander, K. | Ntalla, I. | Guo, X. | Franceschini, N. | Lu, Y. | Cheng, C. Y. | Sim, X. | Vojinovic, D. | Marten, J. | Musani, S. K. | Li, C. | Feitosa, M. F. | Kilpelainen, T. O. | Richard, M. A. | Noordam, R. | Aslibekyan, S. | Aschard, H. | Bartz, T. M. | Dorajoo, R. | Manning, A. K. | Rankinen, T. | Smith, A. V. | Tajuddin, S. M. | Tayo, B. O. | Warren, H. R. | Zhao, W. | Zhou, Y. | Matoba, N. | Sofer, T. | Alver, M. | Amini, M. | Boissel, M. | Chai, J. F. | Chen, X. | Divers, J. | Gandin, I. | Gao, C. | Giulianini, F. | Goel, A. | Harris, S. E. | Hartwig, F. P. | Horimoto, Arvr | Hsu, F. C. | Jackson, A. U. | Kahonen, M. | Kasturiratne, A. | Kuhnel, B. | Leander, K. | Lee, W. J. | Lin, K. H. | an Luan, J. | Mckenzie, C. A. | Meian, H. | Nelson, C. P. | Rauramaa, R. | Schupf, N. | Scott, R. A. | Sheu, W. H. H. | Stancakova, A. | Takeuchi, F. | van Der Most, P. J. | Varga, T. V. | Wang, H. | Ware, E. B. | Weiss, S. | Wen, W. | Yanek, L. R. | Zhang, W. | Zhao, J. H. | Afaq, S. | Alfred, T. | Amin, N. | Arking, D. | Aung, T. | Barr, R. G. | Bielak, L. F. | Boerwinkle, E. | Bottinger, E. P. | Braund, P. S. | Brody, J. A. | Broeckel, U. | Cabrera, C. P. | Cade, B. | Caizheng, Y. | Campbell, A. | Canouil, M. | Chakravarti, A. | Chauhan, Ganesh | Christensen, K. | Cocca, M. | Collins, F. S. | Connell, J. M. | de Mutsert, R. | de Silva, H. J. | Debette, Stéphanie | Dorr, M. | Duan, Q. | Eaton, C. B. | Ehret, G. | Evangelou, E. | Faul, J. D. | Fisher, V. A. | Forouhi, N. G. | Franco, O. H. | Friedlander, Y. | Gao, H. | Gigante, B. | Graff, M. | Gu, C. C. | Gu, D. | Gupta, P. | Hagenaars, S. P. | Harris, T. B. | He, J. | Heikkinen, S. | Heng, C. K. | Hirata, M. | Hofman, A. | Howard, B. V. | Hunt, S. | Irvin, M. R. | Jia, Y. | Joehanes, R. | Justice, A. E. | Katsuya, T. | Kaufman, J. | Kerrison, N. D. | Khor, C. C. | Koh, W. P. | Koistinen, H. A. | Komulainen, P. | Kooperberg, C. | Krieger, J. E. | Kubo, M. | Kuusisto, J. | Langefeld, C. D. | Langenberg, C. | Launer, L. J. | Lehne, B. | Lewis, C. E. | Li, Y. | Lim, S. H. | Lin, S. | Liu, C. T. | Liu, J. | Liu, K. | Liu, Y. | Loh, M. | Lohman, K. K. | Long, J. | Louie, T. | Magi, R. | Mahajan, A. | Meitinger, T. | Metspalu, A. | Milani, L. | Momozawa, Y. | Morris, A. P. | Mosley, T. H., Jr. | Munson, P. | Murray, A. D. | Nalls, M. A. | Nasri, U. | Norris, J. M. | North, K. | Ogunniyi, A. | Padmanabhan, S. | Palmas, W. R. | Palmer, N. D. | Pankow, J. S. | Pedersen, N. L. | Peters, A. | Peyser, P. A. | Polasek, O. | Raitakari, O. T. | Renstrom, F. | Rice, T. K. | Ridker, P. M. | Robino, A. | Robinson, J. G. | Rose, L. M. | Rudan, I. | Sabanayagam, C. | Salako, B. L. | Sandow, K. | Schmidt, C. O. | Schreiner, P. J. | Scott, W. R. | Seshadri, S. | Sever, P. | Sitlani, C. M. | Smith, J. A. | Snieder, H. | Starr, J. M. | Strauch, K. | Tang, H. | Taylor, K. D. | Teo, Y. Y. | Tham, Y. C. | Uitterlinden, A. G. | Waldenberger, M. | Wang, L. | Wang, Y. X. | Wei, W. B. | Williams, C. | Wilson, G. | Wojczynski, M. K. | Yao, J. | Yuan, J. M. | Zonderman, A. B. | Becker, D. M. | Boehnke, M. | Bowden, D. W. | Chambers, J. C. | Chen, Y. I. | de Faire, U. | Deary, I. J. | Esko, T. | Farrall, M. | Forrester, T. | Franks, P. W. | Freedman, B. I. | Froguel, P. | Gasparini, P. | Gieger, C. | Horta, B. L. | Hung, Y. J. | Jonas, J. B. | Kato, N. | Kooner, J. S. | Laakso, M. | Lehtimaki, T. | Liang, K. W. | Magnusson, P. K. E. | Newman, A. B. | Oldehinkel, A. J. | Pereira, A. C. | Redline, S. | Rettig, R. | Samani, N. J. | Scott, J. | Shu, X. O. | van Der Harst, P. | Wagenknecht, L. E. | Wareham, N. J. | Watkins, H. | Weir, D. R. | Wickremasinghe, A. R. | Wu, T. | Zheng, W. | Kamatani, Y. | Laurie, C. C. | Bouchard, C. | Cooper, R. S. | Evans, M. K. | Gudnason, V. | Kardia, S. L. R. | Kritchevsky, S. B. | Levy, D. | O'Connell, J. R. | Psaty, B. M. | van Dam, R. M. | Sims, M. | Arnett, D. K. | Mook-Kanamori, D. O. | Kelly, T. N. | Fox, E. R. | Hayward, C. | Fornage, M. | Rotimi, C. N. | Province, M. A. | van Duijn, C. M. | Tai, E. S. | Wong, T. Y. | Loos, R. J. F. | Reiner, A. P. | Rotter, J. I. | Zhu, X. | Bierut, L. J. | Gauderman, W. J. | Caulfield, M. J. | Elliott, P. | Rice, K. | Munroe, P. B. | Morrison, A. C. | Cupples, L. A. | Rao, D. C. | Chasman, D. I.

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The authors declare no competing financial interests except for the following. B.M.P. serves on the DSMB of a clinical trial funded by the manufacturer (Zoll LifeCor) and on the Steering Committee of the Yale Open Data Access Project funded by Johnson & Johnson; O.H.F. received grants from Metagenics (on women’s health and epigenetics) and from Nestle (on child health); L.J.B. is listed as an inventor on Issued U.S. Patent 8,080,371,“Markers for Addiction” covering the use of certain SNPs in determining the diagnosis, prognosis, and treatment of addiction; P.S. has received research awards from Pfizer Inc., is a consultant for Mundipharma Co. (Cambridge, UK), is a patent holder with Biocompatibles UK Ltd. (Franham, Surrey, UK) (Title: Treatment of eye diseases using encapsulated cells encoding and secreting neuroprotective factor and/or anti-angiogenic factor; Patent number: 20120263794), and has a patent application with University of Heidelberg (Heidelberg, Germany) (Title: Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia; Europäische Patentanmeldung 15 000 771.4); P.W.F. has been a paid consultant for Eli Lilly and Sanofi Aventis and has received research support from several pharmaceutical companies as part of a European Union Innovative Medicines Initiative (IMI) project; M.A.N.’s participation is supported by a consulting contract between Data Tecnica Internation and the National Institute on Aging (NIH, Bethesda, MD, USA), and he also consults for Illumina, Inc., the Michael J. Fox Foundation, and University of California Healthcare among others; and M.J.C. is Chief Scientist for Genomics England, a UK government company.. International audience. Genome-wide association analysis advanced understanding of blood pressure (BP), a major risk factor for vascular conditions such as coronary heart disease and stroke. Accounting for smoking behavior may help identify BP loci and extend our knowledge of its genetic architecture. We performed genome-wide association meta-analyses of systolic and diastolic BP incorporating gene-smoking interactions in 610,091 individuals. Stage 1 analysis examined approximately 18.8 million SNPs and small insertion/deletion variants in 129,913 individuals from four ancestries (European, African, Asian, and Hispanic) with follow-up analysis of promising variants in 480,178 additional individuals from five ancestries. We identified 15 loci that were genome-wide significant (p < 5 x 10(-8)) in stage 1 and formally replicated in stage 2. A combined stage 1 and 2 meta-analysis identified 66 additional genome-wide significant loci (13, 35, and 18 loci in European, African, and trans-ancestry, respectively). A total of 56 known BP loci were also identified by our results (p < 5 x 10(-8)). Of the newly identified loci, ten showed significant interaction with smoking status, but none of them were replicated in stage 2. Several loci were identified in African ancestry, highlighting the importance of genetic studies in diverse populations. The identified loci show strong evidence for regulatory features and support shared pathophysiology with cardiometabolic and addiction traits. They also highlight a role in BP regulation for biological candidates such as modulators of vascular structure and function (CDKN1B, BCAR1-CFDP1, PXDN, EEA1), ciliopathies (SDCCAG8, RPGRIP1L), telomere maintenance (TNKS, PINX1, AKTIP), and central dopaminergic signaling (MSRA, EBF2).

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