Relationship between Gene-environment Interaction and Hypertension and Its Implications for Community Management

doi:10.12114/j.issn.1007-9572.2020.00.521

Abstract

Abstract: Hypertension is a complicated disease affected by both gene-gene and gene-environment interactions.Risk factors for hypertension mainly consist of environmental（lifestyle）and genetic factors.Previous genome-wide association studies have indicated the polygenic complexity of hypertension.We summarized the recent advances in gene-environmental interactions in hypertension，finding that non-drug therapy is the basic approach to hypertension.However，whether using drug therapy or not，these patients should maintain a healthy lifestyle，including a healthy diet，quitting smoking，moderate alcohol consumption，improving sleep，and exercising regularly.Although several gene mutation sites associated with hypertension have been found，further experimental studies are needed to explore the regulatory mechanisms of hypertension-related genes.

Key words: Hypertension, Gene, Disorders of environmental origin, Environmental factor, Community health services

摘要： 高血压是一种基因与基因之间以及基因与环境因素交互作用的复杂疾病，其危险因素包括环境因素（生活方式因素）和遗传因素。全基因组关联研究表明了高血压的多基因复杂性。因此，本文总结了近年来基因-环境因素相互作用在高血压中的研究进展，发现非药物治疗是降压治疗的基本措施，无论是否选择药物治疗，均要保持良好的生活方式，如合理饮食、戒烟限酒、改善睡眠、规律运动。虽然目前已经发现了许多与高血压发病相关的基因变异位点，但要进一步深入了解高血压相关基因的调控机制，仍需开展更多实验研究。

关键词: 高血压, 基因, 环境因素诱发疾病, 环境因素, 社区卫生服务

SHI Yuncong,WANG Lili,GUO Yifang. Relationship between Gene-environment Interaction and Hypertension and Its Implications for Community Management　[J]. Chinese General Practice, 2021, 24(2): 138-142. DOI: 10.12114/j.issn.1007-9572.2020.00.521.
史云聪,王立立,郭艺芳. 基因-环境因素相互作用与高血压的关系及其对社区管理的建议[J]. 中国全科医学, 2021, 24(2): 138-142. DOI: 10.12114/j.issn.1007-9572.2020.00.521.

References

［1］中国高血压防治现状蓝皮书2018版［EB/OL］．（2019-08-27）［2020-04-05］．http：//health.people.com.cn/n1/2019/0827/c14739-31319375.html.
［2］中国高血压防治指南修订委员会.中国高血压防治指南2018年修订版［J］．心脑血管病防治，2019，19（1）：1-44.
［3］CHEN M L，HUANG T P，CHEN T W，et al．Interactions of genes and sodium intake on the development of hypertension：a cohort-based case-control study［J］．Int J Environ Res Public Health，2018，15（6）：E1110．DOI：10.3390/ijerph15061110.
［4］HACHIYA T，NARITA A，OHMOMO H，et al．Genome-wide analysis of polymorphism × sodium interaction effect on blood pressure identifies a novel 3'-BCL11B gene desert locus［J］．Sci Rep，2018，8（1）：14162.
［5］PARK Y M，KWOCK C K，KIM K，et al．Interaction between single nucleotide polymorphism and urinary sodium，potassium，and sodium-potassium ratio on the risk of hypertension in Korean adults［J］．Nutrients，2017，9（3）：E235.
［6］IMAIZUMI T，ANDO M，NAKATOCHI M，et al．Association of interactions between dietary salt consumption and hypertension-susceptibility genetic polymorphisms with blood pressure among Japanese male workers［J］．Clin Exp Nephrol，2017，21（3）：457-464．DOI：10.1007/s10157-016-1315-3.
［7］SANEEI P，SALEHI-ABARGOUEI A，ESMAILLZADEH A，et al．Influence of dietary approaches to stop hypertension（DASH）diet on blood pressure：a systematic review and meta-analysis on randomized controlled trials［J］．Nutr Metab Cardiovasc Dis，2014，24（12）：1253-1261.
［8］ZAFARMAND M H，SPANJER M，NICOLAOU M，et al．Influence of dietary approaches to stop hypertension-type diet，known genetic variants and their interplay on blood pressure in early childhood：ABCD study［J］．Hypertension，2020，75（1）：59-70．DOI：10.1161/HYPERTENSIONAHA.118.12292.
［9］GONI L，CUERVO M，MILAGRO F I，et al．Influence of fat intake and BMI on the association of rs1799983 NOS3 polymorphism with blood pressure levels in an Iberian population［J］．Eur J Nutr，2017，56（4）：1589-1596.
［10］TAGETTI A，ERICSON U，MONTAGNANA M，et al．Intakes of omega-3 polyunsaturated fatty acids and blood pressure change over time：possible interaction with genes involved in 20-HETE and EETs metabolism［J］．Prostaglandins Other Lipid Mediat，2015，120：126-133.
［11］KIM Y，KIM J，LIM J E，et al．Genome-wide interaction study of single-nucleotide polymorphisms and alcohol consumption on blood pressure：the Ansan and Ansung study of the Korean Genome and Epidemiology Study（KoGES）［J］．Genet Epidemiol，2020，44（3）：300-310．DOI：10.1002/gepi.22285.
［12］FEITOSA M F，KRAJA A T，CHASMAN D I，et al．Novel genetic associations for blood pressure identified via gene-alcohol interaction in up to 570K individuals across multiple ancestries［J］．PLoS One，2018，13（6）：e0198166.
［13］CARRIZZO A，DAMATO A，AMBROSIO M，et al．The prosurvival protein BAG3：a new participant in vascular homeostasis［J］．Cell Death Dis，2016，7（10）：e2431.
［14］SUNG Y J，WINKLER T W，DE LAS FUENTES L，et al．A large-scale multi-ancestry genome-wide study accounting for smoking behavior identifies multiple significant loci for blood pressure［J］．Am J Hum Genet，2018，102（3）：375-400．
［15］ZHANG H M，JIN L M，MU T L，et al．Associations of CYP4A11 gene-gene and gene-smoking interactions with essential hypertension in the male eastern Chinese Han population［J］．Clin Exp Hypertens，2017，39（5）：448-453.
［16］MELKA M G，BERNARD M，MAHBOUBI A，et al．Genome-wide scan for loci of adolescent obesity and their relationship with blood pressure［J］．J Clin Endocrinol Metab，2012，97（1）：E145-150．DOI：10.1210/jc.2011-1801.
［17］GENELHU V A，CELORIA B M，PIMENTEL M M，et al．Association of a common variant of the leptin gene with blood pressure in an obese Brazilian population［J］．Am J Hypertens，2009，22（5）：577-580．DOI：10.1038/ajh.2009.7.
［18］DLAMINI Z，HULL R，MAKHAFOLA T J，et al．Regulation of alternative splicing in obesity-induced hypertension［J］．Diabetes Metab Syndr Obes，2019，12：1597-1615.
［19］SULIGA E，KOZIEL D，CIESLA E，et al．Associations between vaspin Rs2236242 gene polymorphism，walking time and the risk of metabolic syndrome［J］．Balkan J Med Genet，2019，22（1）：41-48．DOI：10.2478/bjmg-2019-0013.
［20］JO G，KWAK S Y，KIM J Y，et al．Association between genetic variant of apolipoprotein C3 and incident hypertension stratified by obesity and physical activity in Korea［J］．Nutrients，2018，10（11）：E1595．DOI：10.3390/nu10111595.
［21］NOTAY K，KLINGEL S L，LEE J B，et al．TRPV1 and BDKRB2 receptor polymorphisms can influence the exercise pressor reflex［J］．J Physiol（Lond），2018，596（21）：5135-5148．DOI：10.1113/JP276526.
［22］DOMINICZAK A，DELLES C，PADMANABHAN S.Genomics and precision medicine for clinicians and scientists in hypertension［J］．Hypertension 2017；69：e10–13.
［23］ZENNARO M C，BOULKROUN S，FERNANDES-ROSA F.Anupdate on novel mechanisms of primary aldosteronism［J］．J Endocrinol，2015，224：R63–77.
［24］GOYAL A，ASLAM N，KAUR S，et al．Factors affecting seasonal changes in blood pressure in North India：a population based four-seasons study［J］．Indian Heart J，2018，70（3）：360-367．DOI：10.1016/j.ihj.2017.09.012.
［25］HOWARD G，CUSHMAN M，MOY C S，et al．Association of clinical and social factors with excess hypertension risk in black compared with white US adults［J］．JAMA，2018，320（13）：1338-1348．DOI：10.1001/jama.2018.13467.

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