Causal associations between gastroesophageal reflux disease and essential hypertension: A bidirectional Mendelian randomization study.

ABSTRACT

BACKGROUND: Clinical studies have reported that patients with gastroesophageal reflux disease (GERD) have a higher prevalence of hypertension. AIM: To performed a bidirectional Mendelian randomization (MR) analysis to investigate the causal link between GERD and essential hypertension. METHODS: Eligible single nucleotide polymorphisms (SNPs) were selected, and weighted median, inverse variance weighted (IVW) as well as MR egger (MR-Egger) regression were used to examine the potential causal association between GERD and hypertension. The MR-Pleiotropy RESidual Sum and Outlier analysis was used to detect and attempt to reduce horizontal pleiotropy by removing outliers SNPs. The MR-Egger intercept test, Cochran's Q test and "leave-one-out" sensitivity analysis were performed to evaluate the horizontal pleiotropy, heterogeneities, and stability of single instrumental variable. RESULTS: IVW analysis exhibited an increased risk of hypertension (OR = 1.46, 95%CI 1.33-1.59, P = 2.14E-16) in GERD patients. And the same result was obtained in replication practice (OR = 1.002, 95%CI 1.0008-1.003, P = 0.000498). Meanwhile, the IVW analysis showed an increased risk of systolic blood pressure (ß = 0.78, 95%CI 0.11-1.44, P = 0.021) and hypertensive heart disease (OR = 1.68, 95%CI 1.36-2.08, P = 0.0000016) in GERD patients. Moreover, we found an decreased risk of Barrett's esophagus (OR = 0.91, 95%CI 0.83-0.99, P = 0.043) in essential hypertension patients. CONCLUSION: We found that GERD would increase the risk of essential hypertension, which provided a novel prevent and therapeutic perspectives of essential hypertension.