Wei Ning, Liu Ming-Hui, Song Yu-Hu
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China.
World J Clin Cases. 2024 Feb 16;12(5):880-890. doi: 10.12998/wjcc.v12.i5.880.
Clinical studies have reported that patients with gastroesophageal reflux disease (GERD) have a higher prevalence of hypertension.
To performed a bidirectional Mendelian randomization (MR) analysis to investigate the causal link between GERD and essential hypertension.
Eligible single nucleotide polymorphisms (SNPs) were selected, and weighted median, inverse variance weighted (IVW) as well as MR egger (MR-Egger) regression were used to examine the potential causal association between GERD and hypertension. The MR-Pleiotropy RESidual Sum and Outlier analysis was used to detect and attempt to reduce horizontal pleiotropy by removing outliers SNPs. The MR-Egger intercept test, Cochran's test and "leave-one-out" sensitivity analysis were performed to evaluate the horizontal pleiotropy, heterogeneities, and stability of single instrumental variable.
IVW analysis exhibited an increased risk of hypertension (OR = 1.46, 95%CI: 1.33-1.59, = 2.14E-16) in GERD patients. And the same result was obtained in replication practice (OR = 1.002, 95%CI: 1.0008-1.003, = 0.000498). Meanwhile, the IVW analysis showed an increased risk of systolic blood pressure (β = 0.78, 95%CI: 0.11-1.44, = 0.021) and hypertensive heart disease (OR = 1.68, 95%CI: 1.36-2.08, = 0.0000016) in GERD patients. Moreover, we found an decreased risk of Barrett's esophagus (OR = 0.91, 95%CI: 0.83-0.99, = 0.043) in essential hypertension patients.
We found that GERD would increase the risk of essential hypertension, which provided a novel prevent and therapeutic perspectives of essential hypertension.
临床研究报告称，胃食管反流病（GERD）患者高血压患病率较高。
进行双向孟德尔随机化（MR）分析，以研究GERD与原发性高血压之间的因果关系。
选择符合条件的单核苷酸多态性（SNP），并采用加权中位数、逆方差加权（IVW）以及MR埃格（MR-Egger）回归来检验GERD与高血压之间的潜在因果关联。MR多效性残差和离群值分析用于检测并尝试通过去除离群SNP来减少水平多效性。进行MR-Egger截距检验、 Cochr an检验和“留一法”敏感性分析，以评估单个工具变量的水平多效性、异质性和稳定性。
IVW分析显示，GERD患者患高血压的风险增加（OR = 1.46，95%CI：1.33 - 1.59，P = 2.14E-16）。在重复实践中也得到了相同的结果（OR = 1.002，95%CI：1.0008 - 1.003，P = 0.000498）。同时，IVW分析显示，GERD患者收缩压升高的风险增加（β = 0.78，95%CI：0.11 - 1.44，P = 0.021）以及患高血压性心脏病的风险增加（OR = 1.68，95%CI：1.36 - 2.08，P = 0.0000016）。此外，我们发现原发性高血压患者患巴雷特食管的风险降低（OR = 0.91，95%CI：0.83 - 0.99，P = 0.043）。
我们发现GERD会增加原发性高血压的风险，这为原发性高血压提供了新的预防和治疗视角。
