Dissecting the association between blood pressure traits, hypertension, antihypertensive medications and epilepsy: A Mendelian randomization study

IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Epilepsy & Behavior Pub Date : 2024-11-13 DOI:10.1016/j.yebeh.2024.110140
Cheng Yu , Shijiu Jiang , Bingjie Lv , Xuejun Deng , Da Xu
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Abstract

Background

Observational studies suggest that hypertension and epilepsy have a high co-occurrence, and antihypertensive medications may have impacts on the prevention and treatment of epilepsy. However, the directionality of causation between them is elusive.

Method

By leveraging genome-wide association studies (GWAS) summary data of each trait, we firstly performed bidirectional univariate Mendelian randomization (UVMR) to assess the strength and direction of the associations between pairs of traits, then multivariate MR (MVMR) was conducted to adjust for potential confounders in causalities. Cochran’s Q statistics, leave-one-out analysis, MR-Egger regression and MR-Pleiotropy Residual Sum and Outlier methods (MR-PRESSO) were employed to evaluate the robustness of the results. Drug target MR was proceeded to assess the association between five classes of first-line antihypertensive medications and epilepsy. Specifically, single nucleotide polymorphisms (SNPs) extracted from GWAS data on systolic blood pressure (SBP)/diastolic blood pressure (DBP), along with expression quantitative trait loci (eQTL) were utilized as proxies for antihypertensive medications, respectively.

Results

Forward UVMR results provided evidence that genetically predicted blood pressure traits and hypertension have causal effects on epilepsy, while reverse UVMR indicated no causal impacts of epilepsy on blood pressure traits or hypertension. The sensitivity analysis results were robust. The causalities between DBP, hypertension and epilepsy remained remarkable after adjustment by MVMR. Inverse-variance-weighted MR (IVW-MR) yielded evidence of positive association only between Beta-Blockers target genes based on DBP GWAS screening and epilepsy. Summary-data-based MR (SMR) identified a positive correlation between Beta-Blockers target gene ADRA1D and epilepsy risk.

Conclusions

Hypertension has a causal effect on epilepsy and managing DBP in patients with hypertension through Beta-Blockers may help prevent epilepsy.
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剖析血压特征、高血压、抗高血压药物与癫痫之间的关联:孟德尔随机研究
背景:观察性研究表明,高血压和癫痫的并发率很高,抗高血压药物可能会对癫痫的预防和治疗产生影响。然而,它们之间的因果关系却难以确定:方法:我们利用全基因组关联研究(GWAS)中每个性状的汇总数据,首先进行双向单变量孟德尔随机分析(UVMR),以评估性状对之间的关联强度和方向,然后进行多变量MR(MVMR),以调整因果关系中的潜在混杂因素。为了评估结果的稳健性,采用了 Cochran's Q 统计、leave-one-out 分析、MR-Egger 回归和 MR-Pleiotropy Residual Sum and Outlier 方法(MR-PRESSO)。药物靶点磁共振被用来评估五类一线抗高血压药物与癫痫之间的关联。具体来说,从收缩压(SBP)/舒张压(DBP)GWAS数据中提取的单核苷酸多态性(SNPs)和表达量性状位点(eQTL)分别被用作降压药的替代物:正向 UVMR 结果表明,遗传预测的血压性状和高血压对癫痫有因果影响,而反向 UVMR 结果表明,癫痫对血压性状或高血压没有因果影响。敏感性分析结果是稳健的。经 MVMR 调整后,DBP、高血压和癫痫之间的因果关系仍然显著。反方差加权磁共振(IVW-MR)只得出了基于 DBP GWAS 筛选的 Beta 受体阻滞剂目标基因与癫痫之间正相关的证据。基于汇总数据的磁共振(SMR)确定了β受体阻滞剂靶基因ADRA1D与癫痫风险之间的正相关性:结论:高血压与癫痫有因果关系,通过β受体阻滞剂控制高血压患者的DBP可能有助于预防癫痫。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Epilepsy & Behavior
Epilepsy & Behavior 医学-行为科学
CiteScore
5.40
自引率
15.40%
发文量
385
审稿时长
43 days
期刊介绍: Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.
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