Discovery of rare variants associated with blood pressure regulation through meta-analysis of 1.3 million individuals.

British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. British Heart Foundation Centre of Research Excellence, University of Cambridge, Cambridge, UK. Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK. Rutherford Fund Fellow, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. Human Genetics Center, Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA. Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA. Cardiovascular Research Center, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA. Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences Amsterdam, Amsterdam, the Netherlands. William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. Department of Biostatistics, University of Liverpool, Liverpool, UK. College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar. Framingham Heart Study, Framingham, MA, USA. Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. Division of Statistical Genomics, Department of Genetics and Center for Genome Sciences and Systems Biology, Washington University School of Medicine, St Louis, MO, USA. Division of Epidemiology, Department of Medicine, Institute for Medicine and Public Health, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Tennessee Valley Healthcare System (626)/Vanderbilt University, Nashville, TN, USA. Division of Quantitative Sciences, Department of Obstetrics & Gynecology, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Tennessee Valley Healthcare System (626)/Vanderbilt University, Nashville, TN, USA. Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. deCODE genetics/Amgen, Inc, Reykjavik, Iceland. Institute of Personalized Medicine, Penn State College of Medicine, Hershey, PA, USA. MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK. National Institute for Health Research Barts Cardiovascular Biomedical Research Centre, Queen Mary University of London, London, UK. Division of Cardiovascular Sciences, Faculty of Medicine, Biology and Health, University of Manchester, Manchester, UK. Joseph J Zilber School of Public Health, University of Wisconsin, Milwaukee, WI, USA. Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA. Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA. MRC Nutrition and Bone Health Group, University of Cambridge, Cambridge, UK. MRC Unit The Gambia at London School of Hygiene & Tropical Medicine, Banjul, Gambia. Department of Life Sciences, College of Health and Life Sciences, Brunel University London, London, UK. Institute of Cardiovascular Science, Faculty of Population Health Sciences, University College London, London, UK. Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark. Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA. Internal Medicine Research Unit, Pfizer, Cambridge, MA, USA. Department of Medicine, University of Verona, Verona, Italy. Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden. The Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK. MRC Biostatistics Unit, University of Cambridge, Cambridge, UK. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA. Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK. National Institute for Health Research (NIHR) Imperial Biomedical Research Centre, Imperial College London, London, UK. Centre for Genomic Health, Queen Mary University of London, London, UK. Division of Psychiatry, University College of London, London, UK. Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA. School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland. Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA. Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK. Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK. Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland. MRC Human Genetics Unit, IGMM, University of Edinburgh, Western General Hospital, Edinburgh, Scotland, UK. Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA. Boston University and National Heart, Lung and Blood Institute Framingham Heart Study, Framingham, MA, USA. Centre for Genomic Health, Life Sciences, Queen Mary University of London, London, UK. Biostatistics Department, Boston University School of Public Health, Boston, MA, USA. Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands. The Charles Bronfman Institute for Personalized Medicine at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA. Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK. Oxford Centre for Diabetes, Endocrinology and Metabolism, Radcliffe Department of Medicine, University of Oxford, Oxford, UK. Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy. Department of Cardiovascular Sciences, University of Leicester, Leicester, UK. National Institute for Health Research Leicester Biomedical Research Centre, Leicester, UK. Department of Data Science, School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA. Department of Twin Research and Genetic Epidemiology, King's College London, London, UK. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands. Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany. Department of Medicine I, Ludwig-Maximilians-University Munich, Munich, Germany. Chair of Genetic Epidemiology, IBE, Faculty of Medicine, LMU, Munich, Germany. Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada. National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK. Clinical and Molecular Metabolism Research Program (CAMM), Faculty of Medicine, University of Helsinki, Helsinki, Finland. Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Skåne University Hospital Malmö, Malmö, Sweden. Kuopio Research Institute of Exercise Medicine, Kuopio, Finland. Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland. Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA. MRC Integrative Epidemiology Unit (IEU), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. Department of Infection Biology, Faculty of Tropical and Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK. Centre of Statistics and Applications of University of Lisbon, Lisbon, Portugal. Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, USA. Saw Swee Hock School of Public Health, National University of, Singapore, Singapore. Icelandic Heart Association, Kopavogur, Iceland. Faculty of Medicine, University of Iceland, Reykjavik, Iceland. Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA. University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland. Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada. Department of Molecular Biology, Medical Biochemistry and Pathology, Laval University, Quebec City, Quebec, Canada. Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands. Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands. Vanderbilt Genetics Institute, Vanderbilt Epidemiology Center, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Tennessee Valley Health Systems VA, Nashville, TN, USA. Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy. Interfaculty Institute for Genetics and Functional Genomics, University Medicine and University of Greifswald, Greifswald, Germany. DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany. Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK. Human Genetics Center, University of Texas Health Science Center at Houston, Houston, TX, USA. Department of Cardiology, Ealing Hospital, Middlesex, UK. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, USA. Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece. Division of Cardiology, University Hospital, Basel, Switzerland. Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany. Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands. Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany. University Medical Center Hamburg Eppendorf, Hamburg, Germany. German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Hamburg, Germany. Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, NIH, Bethesda, MD, USA. Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. Department of Clinical Biochemistry, Lillebaelt Hospital, Vejle, Denmark. Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark. Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA, USA. Division of Aging, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. Department of Medicine, Harvard Medical School, Boston, MA, USA. Medical Department, Lillebaelt Hospital, Vejle, Denmark. University of Dundee, Ninewells Hospital & Medical School, Dundee, UK. Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, Scotland, UK. Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany. Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece. Department of Population Science and Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. Steno Diabetes Center, Copenhagen, Gentofte, Denmark. PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway. Hospital for Children and Adolescents, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland. Department of Primary Health Care, Vaasa Central Hospital, Vaasa, Finland. Diabetes Center, Vaasa Health Care Center, Vaasa, Finland. Oxford NIHR Biomedical Research Centre, Oxford University Hospitals Trust, Oxford, UK. Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland. Minerva Foundation Institute for Medical Research, Helsinki, Finland. Nephrology Section, Memphis VA Medical Center, Memphis, TN, USA. Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. School of Medicine, National Yang-Ming University, Taipei, Taiwan. School of Medicine, , Chung Shan Medical University, Taichung, Taiwan. College of Science, Tunghai University, Taichung, Taiwan. Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan. Department of Social Work, Tunghai University, Taichung, Taiwan. Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. George Washington University School of Medicine and Health Sciences, Washington DC, USA. Department of Public health, Strasbourg University Hospital, University of Strasbourg, Strasbourg, France. Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland, UK. Epidemiology Branch, NHLBI, Bethesda, MD, USA. Department of Immunology and Inflammation, Imperial College London, London, UK. International Centre for Circulatory Health, Imperial College London, London, UK. Centre for Non-Communicable Diseases, Karachi, Pakistan. Institute of Genomics, University of Tartu, Tartu, Estonia. Institute of Physiology, University Medicine Greifswald, Karlsburg, Germany. Division of Cardiovascular Sciences, NHLBI, Bethesda, MD, USA. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA. National Heart and Lung Institute, Imperial College London, London, UK. Department of Family Medicine, University of Iceland, Reykjavik, Iceland. Development Centre for Primary Health Care in Iceland, Reykjavik, Iceland. Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark. Department of Epidemiology, Emory University Rollins School of Public Health, Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA. Department of Medical Sciences, Uppsala University, Uppsala, Sweden. Department of Internal Medicine, Division of Cardiology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. Medical and Population Genetics, Broad Institute, Cambridge, MA, USA. VA Palo Alto Health Care System, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA. Folkhälsan Research Centre, Helsinki, Finland. Department of Endocrinology, Helsinki University Central Hospital, Helsinki, Finland. Department of Clinical Sciences, Diabetes and Endocrinology, Lund University Diabetes Centre, Malmö, Sweden Institute for Molecular Medicine Helsinki (FIMM), Helsinki University, Helsinki, Finland. Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, University of Utrecht, Utrecht, the Netherlands. Center for Circulatory Health, University Medical Center Utrecht, University of Utrecht, Utrecht, the Netherlands. Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA. Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA. Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA. Atlanta VAMC and Emory Clinical Cardiovascular Research Institute, Atlanta, GA, USA. Department of Public Health, Aarhus University, Aarhus, Denmark. Danish Diabetes Academy, Odense, Denmark. Steno Diabetes Center Aarhus, Aarhus, Denmark. International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh. Department of Medicine, Lund University, Malmö, Sweden. Univ Lille, U1167 - RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies Liées au Vieillissement, Lille, France. INSERM, U1167, Lille, France. CHU Lille, U1167, Lille, France. Institut Pasteur de Lille, U1167, Lille, France. Health Data Research UK, Institute of Health Informatics, University College London, London, UK. Section of Investigative Medicine, Imperial College London, Hammersmith Hospital Campus, Du Cane Road, London, UK. Harvard Medical School, Boston, MA, USA. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. Imperial College Healthcare NHS Trust, London, UK. Centre for Non-communicable Disease Research (CNCR), Dhaka, Bangladesh. Cardiovascular Research Institute Basel, Basel, Switzerland. Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA. University of Groningen, University Medical Center Groningen, Department of Cardiology, Groningen, the Netherlands. Department of Psychology, University of Edinburgh, Edinburgh, UK. Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders (PACER-HD), King Abdulaziz University, Jeddah, Saudi Arabia. National Institute for Health Research (NIHR) Blood and Transplant Research Unit (BTRU) in Donor Health and Genomics at the University of Cambridge, Cambridge, UK. Health Data Research UK-London at Imperial College London, London, UK. UKDRI, Dementia Research Institute at Imperial College London, London, UK. British Heart Foundation (BHF) Centre of Research Excellence, Imperial College London, London, UK. Department of Cardiology and Department of Epidemiology, INSERM UMR 1027, Toulouse University Hospital, Toulouse, France. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA. Department of Public Health & Clinical Medicine, Umeå University, Umeå, Sweden. Oxford Center for Diabetes, Endocrinology & Metabolism, Radcliff Department of Medicine, University of Oxford, Oxford, UK. Institute of Reproductive & Developmental Biology, Imperial College London, London, UK. Division of Nephrology, Department of Medicine, University of Verona, Verona, Italy. Department of Clinical Sciences, Diabetes and Endocrinology, Lund University Diabetes Centre, Malmö, Sweden. Institute for Molecular Medicine Helsinki (FIMM), Helsinki University, Helsinki, Finland. Laboratory of Epidemiology and Population Sciences, National Institute of Aging, Bethesda, MD, USA. Wellcome Trust, London, UK. Institute of Biomedicine, Medical Research Center (MRC), University of Oulu, and University Hospital Oulu, Oulu, Finland. Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland. Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA. Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden. Stanford Cardiovascular Institute, Stanford University, Stanford, CA, USA. Stanford Diabetes Research Center, Stanford University, Stanford, CA, USA. Department of Public Health, University of Helsinki, Helsinki, Finland. Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia. National Institute of Public Health, Madrid, Spain. Unit of Primary Care, Oulu University Hospital, Kajaanintie, Oulu, Finland. Center for Life-Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland. Netherlands Heart Institute, Utrecht, the Netherlands. Centre for Public Health, Queens University Belfast, Belfast, UK. Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA, USA. The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. National Institute of Cardiovascular Diseases, Sher-e-Bangla Nagar, Dhaka, Bangladesh. Genentech, South San Francisco, San Francisco, CA, USA. Department of Genetics, University of North Carolina, Chapel Hill, NC, USA. The Institute of Medical Sciences, Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, UK. University of Glasgow, Glasgow, UK. Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. Department of Medicine, Columbia University Medical Center, New York, NY, USA. Department of Public Health, University of Split School of Medicine, Split, Croatia. Centre for Genomic and Experimental Medicine, Institute of Genetics & Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK. Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK. MRC International Nutrition Group at London School of Hygiene and Tropical Medicine, Keppel St, London, UK. Department of Biostatistics, University of Washington, Seattle, WA, USA. Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Scotland, UK. School of Medicine, National Defense Medical Center, Taipei, Taiwan. Institute of Medical Technology, National Chung-Hsing University, Taichung, Taiwan. Division of Population Health and Genomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK. Department of Human Genetics, Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK. Department of Haematology, University of Cambridge, Cambridge, UK. Alzheimer Scotland Research Centre, University of Edinburgh, Edinburgh, UK. Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio, Finland. Department of Health Sciences, University of Leicester, Leicester, UK. University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, the Netherlands. Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, the Netherlands. Boston University Schools of Medicine and Public Health, Boston, MA, USA. University Medical Center Groningen, Groningen, the Netherlands. Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK. Institute of Translational Genomics, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany. TUM School of Medicine, Technical University of Munich and Klinikum Rechts der Isar, Munich, Germany. Health Innovation and Transformation Center, Federation University Australia, Ballarat, Victoria, Australia. Department of Physiology, University of Melbourne, Melbourne, Victoria, Australia. Division of Medicine, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK. VA Tennessee Valley Healthcare System, Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt Center for Kidney Disease, Vanderbilt University Medical Center, Nashville, TN, USA. Wellcome Centre for Human Genetics, University of Oxford, Oxford, UK. Boston University School of Public Health, Boston, MA, USA. Clinical and Translational Epidemiology Unit, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA. Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester, UK. VA Boston Healthcare, Section of Cardiology and Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Department of Epidemiology, University of Washington, Seattle, WA, USA. Department of Health Services, University of Washington, Seattle, WA, USA. Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA. Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Center for Non-Communicable Diseases, Karachi, Pakistan. Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA. Population Sciences, Branch, National Heart, Lung, and Blood Institute, National Institute of Health, Bethesda, MD, USA. William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. p.b.munroe@qmul.ac.uk. National Institute for Health Research Barts Cardiovascular Biomedical Research Centre, Queen Mary University of London, London, UK. p.b.munroe@qmul.ac.uk. British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. JMMHowson@gmail.com. National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK. JMMHowson@gmail.com. Department of Genetics, Novo Nordisk Research Centre Oxford, Oxford, UK. JMMHowson@gmail.com. Novo Nordisk Research Centre Oxford, Novo Nordisk Ltd, Oxford, UK. JMMHowson@gmail.com.

Nature genetics. 2020;(12):1314-1332

Abstract

Genetic studies of blood pressure (BP) to date have mainly analyzed common variants (minor allele frequency > 0.05). In a meta-analysis of up to ~1.3 million participants, we discovered 106 new BP-associated genomic regions and 87 rare (minor allele frequency ≤ 0.01) variant BP associations (P < 5 × 10-8), of which 32 were in new BP-associated loci and 55 were independent BP-associated single-nucleotide variants within known BP-associated regions. Average effects of rare variants (44% coding) were ~8 times larger than common variant effects and indicate potential candidate causal genes at new and known loci (for example, GATA5 and PLCB3). BP-associated variants (including rare and common) were enriched in regions of active chromatin in fetal tissues, potentially linking fetal development with BP regulation in later life. Multivariable Mendelian randomization suggested possible inverse effects of elevated systolic and diastolic BP on large artery stroke. Our study demonstrates the utility of rare-variant analyses for identifying candidate genes and the results highlight potential therapeutic targets.

Methodological quality

Publication Type : Meta-Analysis

Metadata