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A linear and non-linear Mendelian randomization analysis of the association between diastolic blood pressure and cardiovascular events: The J curve revisited

Circulation Dec 09, 2020

Arvanitis M, Qi G, Bhatt DL, et al. - Given that intensive blood pressure (BP) treatment targets are supported by recent clinical guidelines, but observational data indicate that the risk of myocardial infarction (MI) might be raised by excessive diastolic BP (DBP) lowering; reflecting a J- or U-shaped association, therefore, researchers performed this study with 47,407 participants from 5 cohorts (median age 60 years) to confirm prior observational analyses. For this purpose, the shape of link between DBP and CVD was examined using traditional statistical methods. Polygenic risk scores of DBP and SBP were constructed and linear Mendelian randomization (MR) estimates were produced for the impact of DBP on CVD. Experts assessed for non-linearity in the genetic link between DBP and CVD, employing novel non-linear MR approaches. Findings of this inquiry of the genetic impact of DBP revealed no evidence for a non-linear J- or U-shaped association between DBP and adverse CVD results; including MI.

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