Takase Masato, Hirata Takumi, Nakaya Naoki, Kogure Mana, Hatanaka Rieko, Nakaya Kumi, Chiba Ippei, Tokioka Sayuri, Nochioka Kotaro, Nakamura Tomohiro, Tsuchiya Naho, Metoki Hirohito, Satoh Michihiro, Narita Akira, Obara Taku, Ishikuro Mami, Ohseto Hisashi, Takahashi Ippei, Kobayashi Tomoko, Kodama Eiichi N, Hamanaka Yohei, Orui Masatsugu, Ogishima Soichi, Nagaie Satoshi, Fuse Nobuo, Sugawara Junichi, Kuriyama Shinichi, Tamiya Gen, Hozawa Atsushi, Yamamoto Masayuki
Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.
Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan.
Hypertens Res. 2025 Aug 13. doi: 10.1038/s41440-025-02314-9.
Family history of hypertension may reflect genetic and lifestyle factors. Genetic risk can be assessed using polygenic risk score (PRS); however, whether PRS can stratify hypertension risk when combined with family history and lifestyle information is unclear. This prospective cohort study included 9,001 hypertension-free individuals aged ≥20 years from the Tohoku Medical Megabank Community-Based Cohort Study. Participants were scored on lifestyle factors, including body mass index, urinary sodium-to-potassium ratio, physical activity, alcohol consumption, and smoking at recruitment. During the mean follow-up of 4.3 years, 2822 (31.4%) cases of hypertension occurred. High genetic risk and poor lifestyle were associated with increased hypertension risk. Compared with participants with low genetic risk, ideal lifestyle, and no family history, high genetic risk significantly increased hypertension risk, even among those with ideal lifestyle and no family history (relative risk [RR] 1.28 [95% confidence interval [CI] 1.11-1.46]). Participants with low PRS, ideal lifestyle, but with family history had increased hypertension risk (RR 1.32 [95%CI 1.11-1.57]). Poor lifestyle increased hypertension risk across most genetic risk groups, regardless of family history. Integrating PRS into models with family history and lifestyle risk significantly improved predictive accuracy (area under the curve: 0.671 for family history and lifestyle risk and 0.674 for PRS integrated; P for difference <0.05). Integrating PRS with lifestyle and family history enhances the stratification of individuals at high risk for hypertension.
高血压家族史可能反映遗传和生活方式因素。可使用多基因风险评分（PRS）评估遗传风险；然而，PRS与家族史和生活方式信息相结合时能否对高血压风险进行分层尚不清楚。这项前瞻性队列研究纳入了来自东北医学大数据库社区队列研究的9001名年龄≥20岁的无高血压个体。在招募时，根据体重指数、尿钠钾比、身体活动、饮酒情况和吸烟等生活方式因素对参与者进行评分。在平均4.3年的随访期间，发生了2822例（31.4%）高血压病例。高遗传风险和不良生活方式与高血压风险增加相关。与遗传风险低、生活方式理想且无家族史的参与者相比，高遗传风险显著增加了高血压风险，即使在生活方式理想且无家族史的人群中也是如此（相对风险[RR]1.28[95%置信区间[CI]1.11 - 1.46]）。PRS低、生活方式理想但有家族史的参与者高血压风险增加（RR 1.32[95%CI 1.11 - 1.57]）。无论家族史如何，不良生活方式在大多数遗传风险组中都会增加高血压风险。将PRS纳入家族史和生活方式风险模型可显著提高预测准确性（曲线下面积：家族史和生活方式风险为0.671，PRS整合后为0.674；差异P<0.05）。将PRS与生活方式和家族史相结合可增强对高血压高危个体的分层。
