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ABSTRACT
Background: White coat effect (WCE), the blood pressure (BP) difference between clinical and non-clinical settings, can lead to clinical problems such as misdiagnosis of hypertension. Etiology of WCE has been still unclear, especially from genetic aspects. The present article investigated association between genome-wide single nucleotide polymorphisms (SNPs) and WCE in patients with essential hypertension.
Methods: The present cross-sectional analyses were based on 295 Japanese essential hypertensive outpatients aged ≧40 years enrolled in randomized control study, Hypertension Objective Treatment Based on Measurement by Electrical Devices of Blood Pressure (HOMED-BP) study, who were not taking antihypertensive medications before the randomization. Home and clinic BP were measured. WCE was defined by subtracting home BP from clinic BP. Genotyping was conducted with 500K DNA microarray chips. Association between genome-wide SNPs and WCE were analyzed. For replication (p < 10–4), we analyzed participants from Ohasama study who took no antihypertension medications and whose SNPs were collected.
Results: Genome-wide SNPs were not significantly associated with WCE of systolic and diastolic BP after corrections of multiple comparisons (p < 2 × 10–7). We found suggestive SNPs associated with WCE of systolic and diastolic BP (p < 10–4). However, the consistent results were not obtained in the replication study.
Conclusion: The present article showed no significant association between genome-wide SNPs and WCE. Since there were several suggestive SNPs associated with WCE, the present study warrants a further study with bigger sample size for investigating the genetic influence on WCE.
Acknowledgment
We are grateful to all HOMED-BP study collaborators, as listed in [10], for their valuable contribution. Furthermore, we appreciate the following contributors participating in the HOMED-BP-GENE study: K Fukuda, T Hayashi, N Hirobe, Y Imai, K Ito, S Katsuya, H Nishino, H Sawaoka, H Suzuki, K Takayama, Y Tanno and K Yoshida. We would like to say thank you to Y Imaizumi and Y Takamine for their technical assistances, and also Y Aoshima for their secretarial assistance.
Declaration of interest
The Japanese Society of Hypertension endorsed the HOMED-BP trial. Fujitsu Systems East Limited (Tokyo, Japan) and Omron Healthcare Co. (Kyoto, Japan) developed and maintained the internet-based infrastructure for the measurement of blood pressure at home and the management of patients. The HOMED-BP study was funded by grants from the Japan Cardiovascular Research Foundation, the Japan Arteriosclerosis Prevention Fund and Tohoku University. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.
Funding
This work was supported by the following grants: This study was supported in part by grants-in-aid from the Ministry of Education, Culture, Sports, Science, and Technology of Japan (YI:25253059). Soshiro Ogata is supported by a post-doctoral fellowship in Japan Society for the Promotion of Science, Tokyo, Japan (JSPS KAKENHI Grant Number JP15J03698).
Supplementary material
Supplemental data for this article can be accessed here.