Nature Communications ( IF 14.7 ) Pub Date : 2024-07-24 , DOI: 10.1038/s41467-024-50297-x Alfred Pozarickij 1 , Wei Gan 1, 2 , Kuang Lin 1 , Robert Clarke 1 , Zammy Fairhurst-Hunter 1 , Masaru Koido 3 , Masahiro Kanai 4, 5 , Yukinori Okada 6, 7, 8, 9 , Yoichiro Kamatani 3 , Derrick Bennett 1 , Huaidong Du 1 , Yiping Chen 1 , Ling Yang 1 , Daniel Avery 1 , Yu Guo 10 , Min Yu 11 , Canqing Yu 12, 13, 14 , Dan Schmidt Valle 1 , Jun Lv 12, 13, 14 , Junshi Chen 15 , Richard Peto 1 , Rory Collins 1 , Liming Li 12, 13, 14 , Zhengming Chen 1 , Iona Y Millwood 1 , Robin G Walters 1 ,
Elevated blood pressure (BP) is major risk factor for cardiovascular diseases (CVD). Genome-wide association studies (GWAS) conducted predominantly in populations of European ancestry have identified >2,000 BP-associated loci, but other ancestries have been less well-studied. We conducted GWAS of systolic, diastolic, pulse, and mean arterial BP in 100,453 Chinese adults. We identified 128 non-overlapping loci associated with one or more BP traits, including 74 newly-reported associations. Despite strong genetic correlations between populations, we identified appreciably higher heritability and larger variant effect sizes in Chinese compared with European or Japanese ancestry populations. Using instruments derived from these GWAS, multivariable Mendelian randomisation demonstrated that BP traits contribute differently to the causal associations of BP with CVD. In particular, only pulse pressure was independently causally associated with carotid plaque. These findings reinforce the need for studies in diverse populations to understand the genetic determinants of BP traits and their roles in disease risk.