Hypertension and iron deficiency anemia: Exploring genetic associations and causal inference

Rong Cao; Jia-Xiong Zhang; Zhe Chen; Quan Sun; Yong-Ping Bai; Guo-Gang Zhang

doi:10.1016/j.numecd.2024.06.017

Hypertension and iron deficiency anemia: Exploring genetic associations and causal inference

Nutr Metab Cardiovasc Dis. 2024 Jul 2:S0939-4753(24)00243-6. doi: 10.1016/j.numecd.2024.06.017. Online ahead of print.

Authors

Rong Cao¹, Jia-Xiong Zhang², Zhe Chen³, Quan Sun⁴, Yong-Ping Bai⁵, Guo-Gang Zhang⁶

Affiliations

¹ Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.
² Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
³ Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
⁴ Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
⁵ Department of Geriatric Medicine, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China. Electronic address: baiyongping@csu.edu.cn.
⁶ Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China. Electronic address: zhangguogang@csu.edu.cn.

PMID: 39271387
DOI: 10.1016/j.numecd.2024.06.017

Abstract

Background and aim: Observational studies have suggested a potential association between hypertension and Iron deficiency anemia (IDA). However, it is unclear whether there is a genetic and causal link between hypertension and IDA.

Methods and results: Genome-Wide Association Studies (GWAS) data for hypertension were sourced from the UK Biobank and FinnGen. Genetic variants data for IDA were extracted from FinnGen and the IEU Open GWAS project, all derived from European populations. The genetic association between hypertension and IDA was assessed using Linkage Disequilibrium Score Regression (LDSC), with MR employed to determine causality. Inverse variance weighted (IVW) as a major analytical method for MR. Sensitivity and heterogeneity analyses were conducted to ensure result reliability. Furthermore, validation analysis was performed to further strengthen the robustness of the findings. A genetic association between hypertension and IDA was observed (r_g = 0.121, P = 0.002). Our findings suggest that hypertension increases the risk of developing IDA (OR = 2.493,P = 0.038), and IDA maybe serve as a risk factor for hypertension (OR = 1.006,P < 0.001). Validation analysis yielded consistent results. Importantly, our findings demonstrated no heterogeneity or horizontal pleiotropy.

Conclusion: Additional insights into the connection between hypertension and IDA were gained. Regular testing of iron ions and anemia-related markers in hypertensive patients is crucial for early identification of IDA. Furthermore, it is imperative to closely monitor the blood pressure of patients with IDA to promptly identify and diagnose hypertension. The implementation of these integrated health strategies is vital for global efforts to tackle the dual challenges of hypertension and IDA.

Keywords: Hypertension; Iron deficiency anemia; LDSC; Mendelian randomization.

Copyright © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.