Takeshima Taro, Okayama Masanobu, Ae Ryusuke, Harada Masanori, Kajii Eiji
Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Tochigi, Japan.
Division of Community Medicine and Medical Education, Kobe University, Graduate School of Medicine, Kobe, Japan.
BMJ Open. 2017 Jul 17;7(7):e016322. doi: 10.1136/bmjopen-2017-016322.
It is unclear whether family medical history influences the willingness to undergo genetic testing. This study aimed to determine how family history affected the willingness to undergo genetic testing for salt-sensitive hypertension in patients with and without hypertension.
Cross-sectional study using a self-administered questionnaire.
Six primary care clinics and hospitals in Japan.
Consecutive 1705 outpatients aged >20 years, 578 of whom had hypertension.
The primary outcome variable was the willingness to undergo genetic testing to determine the risk of salt-sensitive hypertension, and the secondary variables were age, sex, education level, family history and concerns about hypertension. Factors associated with a willingness to undergo genetic testing were evaluated in patients with and without hypertension using a logistic regression model.
In the hypertension and non-hypertension groups, 323 (55.9%) and 509 patients (45.2%), respectively, were willing to undergo genetic testing. This willingness was related with a high level of education (adjusted OR (ad-OR): 1.81, 95% CI 1.12 to 2.93), family history of stroke (1.55, 1.04 to 2.31) and concerns about hypertension (2.04, 1.27 to 3.28) in the hypertension group, whereas in the non-hypertension group, it was influenced by education level (ad-OR: 1.45, 95% CI 1.13 to 1.86), family history of hypertension (1.52, 1.17 to 1.98) and concerns about hypertension (2.03, 1.53 to 2.68).
The influence of family history on the willingness to undergo genetic testing for risk of salt-sensitivity hypertension differed between participants with and without hypertension. In particular, participants without hypertension wished to know their likelihood of developing hypertension, whereas those with hypertension were interested to know the risk of stroke (a complication of hypertension). Family history could help better counsel patients about genetic testing on the basis of their medical history.
家族病史是否会影响接受基因检测的意愿尚不清楚。本研究旨在确定家族史如何影响有高血压和无高血压患者对盐敏感性高血压进行基因检测的意愿。
采用自填式问卷的横断面研究。
日本的六家初级保健诊所和医院。
连续纳入1705名年龄大于20岁的门诊患者，其中578人患有高血压。
主要结局变量是接受基因检测以确定盐敏感性高血压风险的意愿，次要变量是年龄、性别、教育水平、家族史和对高血压的担忧。使用逻辑回归模型评估有高血压和无高血压患者中与接受基因检测意愿相关的因素。
在高血压组和非高血压组中，分别有323名（55.9%）和509名患者（45.2%）愿意接受基因检测。在高血压组中，这种意愿与高教育水平（调整后的比值比（ad-OR）：1.81，95%置信区间1.12至2.93）、中风家族史（1.55，1.04至2.31）和对高血压的担忧（2.04，1.27至3.28）有关，而在非高血压组中，它受到教育水平（ad-OR：1.45，95%置信区间1.13至1.86）、高血压家族史（1.52，1.17至1.98）和对高血压的担忧（2.03，1.53至2.68）的影响。
家族史对有高血压和无高血压参与者接受盐敏感性高血压风险基因检测意愿的影响有所不同。特别是，无高血压的参与者希望了解自己患高血压的可能性，而有高血压的参与者则有兴趣了解中风（高血压的一种并发症）的风险。家族史有助于根据患者的病史更好地为其提供基因检测咨询。
