Apolipoprotein L1 Variants and Blood Pressure Traits in African Americans.

Nadkarni GN, Galarneau G, Ellis SB, Nadukuru R, Zhang J, Scott SA, Schurmann C, Li R, Rasmussen-Torvik LJ, Kho AN, Hayes MG, Pacheco JA, Manolio TA, Chisholm RL, Roden DM, Denny JC, Kenny EE, Bottinger EP
J Am Coll Cardiol. 2017 69 (12): 1564-1574

PMID: 28335839 · PMCID: PMC5479565 · DOI:10.1016/j.jacc.2017.01.040

BACKGROUND - African Americans (AA) are disproportionately affected by hypertension-related health disparities. Apolipoprotein L1 (APOL1) risk variants are associated with kidney disease in hypertensive AAs.

OBJECTIVES - This study assessed the APOL1 risk alleles' association with blood pressure traits in AAs.

METHODS - The discovery cohort included 5,204 AA participants from Mount Sinai's BioMe biobank. Replication cohorts included additional BioMe (n = 1,623), Vanderbilt BioVU (n = 1,809), and Northwestern NUgene (n = 567) AA biobank participants. Single nucleotide polymorphisms determining APOL1 G1 and G2 risk alleles were genotyped in BioMe and imputed in BioVU/NUgene participants. APOL1 risk alleles' association with blood pressure-related traits was tested in the discovery cohort, a meta-analysis of replication cohorts, and a combined meta-analysis under recessive and additive models after adjusting for age, sex, body mass index, and estimated glomerular filtration rate.

RESULTS - There were 14% to 16% of APOL1 variant allele homozygotes (2 copies of G1/G2) across cohorts. APOL1 risk alleles were associated under an additive model with systolic blood pressure (SBP) and age at diagnosis of hypertension, which was 2 to 5 years younger in the APOL1 variant allele homozygotes (Cox proportional hazards analysis, p value for combined meta-analysis [p] = 1.9 × 10). APOL1 risk alleles were associated with overall SBP (p = 7.0 × 10) and diastolic blood pressure (p = 2.8 × 10). After adjustment for all covariates, those in the 20- to 29-year age range showed an increase in SBP of 0.94 ± 0.44 mm Hg (p = 0.01) per risk variant copy. APOL1-associated estimated glomerular filtration rate decline was observed starting a decade later in life in the 30- to 39-year age range.

CONCLUSIONS - APOL1 risk alleles are associated with higher SBP and earlier hypertension diagnoses in young AAs; this relationship appears to follow an additive model.

Copyright © 2017 American College of Cardiology Foundation. All rights reserved.

MeSH Terms (14)

Adult African Americans Aged Apolipoprotein L1 Apolipoproteins Blood Pressure Cohort Studies Female Humans Hypertension Lipoproteins, HDL Male Middle Aged Young Adult

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