Genetic proxies for antihypertensive drugs and mental disorders: Mendelian randomization study in European and East Asian populations

Abstract Background Mental disorders are among the top causes of disease burden worldwide. Existing evidence regarding the repurposing of antihypertensives for mental disorders treatment is conflicting and cannot establish causation. Methods We used Mendelian randomization to assess the effects of a...

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Main Authors: Bohan Fan, Jie V. Zhao
Format: Article
Language:English
Published: BMC 2024-01-01
Series:BMC Medicine
Subjects:
Online Access:https://doi.org/10.1186/s12916-023-03218-6
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author Bohan Fan
Jie V. Zhao
author_facet Bohan Fan
Jie V. Zhao
author_sort Bohan Fan
collection DOAJ
description Abstract Background Mental disorders are among the top causes of disease burden worldwide. Existing evidence regarding the repurposing of antihypertensives for mental disorders treatment is conflicting and cannot establish causation. Methods We used Mendelian randomization to assess the effects of angiotensin-converting-enzyme inhibitors (ACEIs), beta blockers (BBs), and calcium channel blockers (CCBs) on risk of bipolar disorder (BD), major depression disorder (MDD), and schizophrenia (SCZ). We used published genetic variants which are in antihypertensive drugs target genes and correspond to systolic blood pressure (SBP) in Europeans and East Asians, and applied them to summary statistics of BD (cases = 41,917; controls = 371,549 in Europeans), MDD (cases = 170,756; controls = 329,443 in Europeans and cases = 15,771; controls = 178,777 in East Asians), and SCZ (cases = 53,386; controls = 77,258 in Europeans and cases = 22,778; controls = 35,362 in East Asians) from the Psychiatric Genomics Consortium. We used inverse variance weighting with MR-Egger, weighted median, weighted mode, and Mendelian Randomization Pleiotropy RESidual Sum and Outlier. We performed gene-specific analysis and utilized various methods to address potential pleiotropy. Results After multiple testing correction, genetically proxied ACEIs were associated with an increased risk of SCZ in Europeans (odds ratio (OR) per 5 mmHg lower in SBP 2.10, 95% CI 1.54 to 2.87) and East Asians (OR per 5 mmHg lower in SBP 2.51, 95% CI 1.38 to 4.58). Genetically proxied BBs were not associated with any mental disorders in both populations. Genetically proxied CCBs showed no benefits on mental disorders. Conclusions Antihypertensive drugs have no protection for mental disorders but potential harm. Their long-term use among hypertensive patients with, or with high susceptibility to, psychiatric illness needs careful evaluation.
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spelling doaj.art-68a6e47056254c9286eceaf10c387c192024-01-07T12:29:34ZengBMCBMC Medicine1741-70152024-01-012211910.1186/s12916-023-03218-6Genetic proxies for antihypertensive drugs and mental disorders: Mendelian randomization study in European and East Asian populationsBohan Fan0Jie V. Zhao1School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongSchool of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong KongAbstract Background Mental disorders are among the top causes of disease burden worldwide. Existing evidence regarding the repurposing of antihypertensives for mental disorders treatment is conflicting and cannot establish causation. Methods We used Mendelian randomization to assess the effects of angiotensin-converting-enzyme inhibitors (ACEIs), beta blockers (BBs), and calcium channel blockers (CCBs) on risk of bipolar disorder (BD), major depression disorder (MDD), and schizophrenia (SCZ). We used published genetic variants which are in antihypertensive drugs target genes and correspond to systolic blood pressure (SBP) in Europeans and East Asians, and applied them to summary statistics of BD (cases = 41,917; controls = 371,549 in Europeans), MDD (cases = 170,756; controls = 329,443 in Europeans and cases = 15,771; controls = 178,777 in East Asians), and SCZ (cases = 53,386; controls = 77,258 in Europeans and cases = 22,778; controls = 35,362 in East Asians) from the Psychiatric Genomics Consortium. We used inverse variance weighting with MR-Egger, weighted median, weighted mode, and Mendelian Randomization Pleiotropy RESidual Sum and Outlier. We performed gene-specific analysis and utilized various methods to address potential pleiotropy. Results After multiple testing correction, genetically proxied ACEIs were associated with an increased risk of SCZ in Europeans (odds ratio (OR) per 5 mmHg lower in SBP 2.10, 95% CI 1.54 to 2.87) and East Asians (OR per 5 mmHg lower in SBP 2.51, 95% CI 1.38 to 4.58). Genetically proxied BBs were not associated with any mental disorders in both populations. Genetically proxied CCBs showed no benefits on mental disorders. Conclusions Antihypertensive drugs have no protection for mental disorders but potential harm. Their long-term use among hypertensive patients with, or with high susceptibility to, psychiatric illness needs careful evaluation.https://doi.org/10.1186/s12916-023-03218-6Antihypertensive drugsMental disordersMendelian randomization
spellingShingle Bohan Fan
Jie V. Zhao
Genetic proxies for antihypertensive drugs and mental disorders: Mendelian randomization study in European and East Asian populations
BMC Medicine
Antihypertensive drugs
Mental disorders
Mendelian randomization
title Genetic proxies for antihypertensive drugs and mental disorders: Mendelian randomization study in European and East Asian populations
title_full Genetic proxies for antihypertensive drugs and mental disorders: Mendelian randomization study in European and East Asian populations
title_fullStr Genetic proxies for antihypertensive drugs and mental disorders: Mendelian randomization study in European and East Asian populations
title_full_unstemmed Genetic proxies for antihypertensive drugs and mental disorders: Mendelian randomization study in European and East Asian populations
title_short Genetic proxies for antihypertensive drugs and mental disorders: Mendelian randomization study in European and East Asian populations
title_sort genetic proxies for antihypertensive drugs and mental disorders mendelian randomization study in european and east asian populations
topic Antihypertensive drugs
Mental disorders
Mendelian randomization
url https://doi.org/10.1186/s12916-023-03218-6
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