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首页> 外文期刊>Journal of Personalized Medicine >Applicability of Precision Medicine Approaches to Managing Hypertension in Rural Populations
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Applicability of Precision Medicine Approaches to Managing Hypertension in Rural Populations

机译：精准医学方法在控制农村人口高血压中的适用性

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As part of the Heart Healthy Lenoir Project, we developed a practice level intervention to improve blood pressure control. The goal of this study was: (i) to determine if single nucleotide polymorphisms (SNPs) that associate with blood pressure variation, identified in large studies, are applicable to blood pressure control in subjects from a rural population; (ii) to measure the association of these SNPs with subjects’ responsiveness to the hypertension intervention; and (iii) to identify other SNPs that may help understand patient-specific responses to an intervention. We used a combination of candidate SNPs and genome-wide analyses to test associations with either baseline systolic blood pressure (SBP) or change in systolic blood pressure one year after the intervention in two genetically defined ancestral groups: African Americans (AA) and Caucasian Americans (CAU). Of the 48 candidate SNPs, 13 SNPs associated with baseline SBP in our study; however, one candidate SNP, rs592582, also associated with a change in SBP after one year. Using our study data, we identified 4 and 15 additional loci that associated with a change in SBP in the AA and CAU groups, respectively. Our analysis of gene-age interactions identified genotypes associated with SBP improvement within different age groups of our populations. Moreover, our integrative analysis identified AQP4-AS1 and PADI2 as genes whose expression levels may contribute to the pleiotropy of complex traits involved in cardiovascular health and blood pressure regulation in response to an intervention targeting hypertension. In conclusion, the identification of SNPs associated with the success of a hypertension treatment intervention suggests that genetic factors in combination with age may contribute to an individual’s success in lowering SBP. If these findings prove to be applicable to other populations, the use of this genetic variation in making patient-specific interventions may help providers with making decisions to improve patient outcomes. Further investigation is required to determine the role of this genetic variance with respect to the management of hypertension such that more precise treatment recommendations may be made in the future as part of personalized medicine.
机译：作为“心脏健康雷诺阿项目”的一部分，我们开发了一种实践水平的干预措施来改善血压控制。这项研究的目的是：（i）确定在大型研究中确定的与血压变化有关的单核苷酸多态性（SNP）是否适用于农村人口受试者的血压控制; （ii）衡量这些SNP与受试者对高血压干预措施反应的相关性; （iii）识别有助于理解患者对干预措施的特定反应的其他SNP。我们使用了候选SNP和全基因组分析的组合来测试与基线收缩压（SBP）或收缩压的变化之间的相关性，这是在两个遗传定义的祖先组进行干预后一年：非洲裔美国人（AA）和高加索裔美国人（CAU）。在本研究的48个候选SNP中，有13个与基线SBP相关联。但是，一年后，一个候选SNP rs592582也与SBP的变化有关。使用我们的研究数据，我们分别在AA组和CAU组中发现了4个和15个与SBP改变相关的位点。我们对基因-年龄相互作用的分析确定了与我们人群不同年龄组中SBP改善相关的基因型。此外，我们的综合分析确定AQP4-AS1和PADI2为基因，其表达水平可能有助于针对心血管疾病的干预干预心血管健康和血压调节的复杂性状的多效性。总之，对与高血压治疗成功相关的SNP的鉴定表明，遗传因素与年龄相结合可能有助于个人成功降低SBP。如果这些发现被证明适用于其他人群，则在进行针对患者的干预措施时使用这种遗传变异可能会帮助提供者做出改善患者预后的决策。需要进一步研究以确定这种遗传变异在高血压管理方面的作用，以便将来可以作为个性化药物的一部分提出更精确的治疗建议。

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