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Circulation
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Circulation
Article . 2020 . Peer-reviewed
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Circulation
Article . 2021
Circulation
Article . 2020 . Peer-reviewed
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White Blood Cells and Blood Pressure

A Mendelian Randomization Study
Authors: Siedlinski, Mateusz; Jozefczuk, Ewelina; Xu, Xiaoguang; Teumer, Alexander; Evangelou, Evangelos; Schnabel, Renate B.; Welsh, Paul; +7 Authors

White Blood Cells and Blood Pressure

Abstract

Background: High blood pressure (BP) is a risk factor for cardiovascular morbidity and mortality. While BP is regulated by the function of kidney, vasculature, and sympathetic nervous system, recent experimental data suggest that immune cells may play a role in hypertension. Methods: We studied the relationship between major white blood cell types and blood pressure in the UK Biobank population and used Mendelian randomization (MR) analyses using the ≈750 000 UK-Biobank/International Consortium of Blood Pressure-Genome-Wide Association Studies to examine which leukocyte populations may be causally linked to BP. Results: A positive association between quintiles of lymphocyte, monocyte, and neutrophil counts, and increased systolic BP, diastolic BP, and pulse pressure was observed (eg, adjusted systolic BP mean±SE for 1st versus 5th quintile respectively: 140.13±0.08 versus 141.62±0.07 mm Hg for lymphocyte, 139.51±0.08 versus 141.84±0.07 mm Hg for monocyte, and 137.96±0.08 versus 142.71±0.07 mm Hg for neutrophil counts; all P <10 –50 ). Using 121 single nucleotide polymorphisms in MR, implemented through the inverse-variance weighted approach, we identified a potential causal relationship of lymphocyte count with systolic BP and diastolic BP (causal estimates: 0.69 [95% CI, 0.19–1.20] and 0.56 [95% CI, 0.23–0.90] of mm Hg per 1 SD genetically elevated lymphocyte count, respectively), which was directionally concordant to the observational findings. These inverse-variance weighted estimates were consistent with other robust MR methods. The exclusion of rs3184504 SNP in the SH2B3 locus attenuated the magnitude of the signal in some of the MR analyses. MR in the reverse direction found evidence of positive effects of BP indices on counts of monocytes, neutrophils, and eosinophils but not lymphocytes or basophils. Subsequent MR testing of lymphocyte count in the context of genetic correlation with renal function or resting and postexercise heart rate demonstrated a positive association of lymphocyte count with urine albumin-to-creatinine ratio. Conclusions: Observational and genetic analyses demonstrate a concordant, positive and potentially causal relationship of lymphocyte count with systolic BP and diastolic BP.

Countries
United Kingdom, Poland, Italy, Poland, Italy
Keywords

Adult, Male, hypertension, Blood Pressure/genetics, white blood cells, Signal Transducing/genetics, Mendelian randomization analysis, 610, Blood Pressure, Adaptor Proteins, Signal Transducing/genetics, Polymorphism, Single Nucleotide, 1117 Public Health and Health Services, Leukocyte Count, Original Research Articles, Humans, Polymorphism, 1102 Cardiorespiratory Medicine and Haematology, Adaptor Proteins, Signal Transducing, Aged, blood pressure; hypertension; Mendelian randomization analysis; white blood cells, blood pressure, Adaptor Proteins, 1103 Clinical Sciences, Single Nucleotide, Mendelian Randomization Analysis, Middle Aged, United Kingdom, Cardiovascular System & Hematology, Genetic Loci, Hypertension, Female, Hypertension/genetics, Genome-Wide Association Study

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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 1%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
140
Top 1%
Top 10%
Top 1%
Green
hybrid