Association of Prehypertension with Renin Angiotensin System: A Cross-Sectional Study on Tribal Population of Northern India

Introduction: Hypertension (HTN), the third risk factor driving death and disability as per Global Burden of Disease 2019, is a major public health concern. Prehypertension, the intermediate stage between HTN and normal blood pressure (BP), is associated with subclinical atherosclerosis and target-o...

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Main Authors: Vani Kandpal, Mohinder Pal Sachdeva, Kallur Nava Saraswathy
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-12-01
Series:Journal of the Practice of Cardiovascular Sciences
Subjects:
Online Access:https://journals.lww.com/10.4103/jpcs.jpcs_87_23
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author Vani Kandpal
Mohinder Pal Sachdeva
Kallur Nava Saraswathy
author_facet Vani Kandpal
Mohinder Pal Sachdeva
Kallur Nava Saraswathy
author_sort Vani Kandpal
collection DOAJ
description Introduction: Hypertension (HTN), the third risk factor driving death and disability as per Global Burden of Disease 2019, is a major public health concern. Prehypertension, the intermediate stage between HTN and normal blood pressure (BP), is associated with subclinical atherosclerosis and target-organ damage. Evaluating the prevalence of prehypertension is imperative to prevent disease progression. Prehypertension, alike HTN, is a complex disorder that manifests when genes are triggered by the environment. The current study attempts to evaluate the prevalence of prehypertension in a tribal population of Northern India. Further, the association with extensively studied renin–angiotensin system (RAS) pathway genes with prehypertension has been explored. Methods: A cross-sectional study was conducted on adults of 20–60 years old belonging to a tribal community, Rang Bhotia of Northern India. Information on demographic, lifestyle, and anthropometric risk factors was collected. The blood sample was collected for lipid and genetic analysis. DNA extraction and genotyping of five genetic markers of RAS-related pathway were performed. Chi-square and t-tests were used for assessing significant differences between the groups. Logistic regression was used to examine the association of genes with prehypertension and HTN. Results: Among 254 adults participating in the study, 39% and 42% had prehypertension and HTN, respectively. T allele of M235T genetic marker was found to be posing two-fold risk for prehypertension (odds ratio [OR] = 2.9; 95% confidence interval [CI] =1.10–7.72; P = 0.03 in dominant model and OR = 1.83; 95% CI = 1.09-3.09; P = 0.02 in additive model) after adjusting for age and sex. On the other hand, G allele of A6G polymorphism was found to be providing protection toward prehypertension (OR = 0.32; 95% CI = 0.11–0.92; P = 0.03 in recessive model and OR = 0.55; 95% CI = 0.32–0.94; P = 0.03 in additive model). Conclusion: More than one-third of individuals exhibited prehypertension, suggesting an impending burden of HTN and comorbidities among the tribal population in the near future. Moreover, increased genetic susceptibility toward elevated BP commands immediate attention. Effective management strategies including interventions on lifestyle, diet modification, and weight management need to be introduced to combat increasing HTN among the tribal population.
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spelling doaj-art-454ae5cc48094998ae57ffefffe0a7ef2025-01-14T05:55:11ZengWolters Kluwer Medknow PublicationsJournal of the Practice of Cardiovascular Sciences2395-54142454-28302024-12-0110315716410.4103/jpcs.jpcs_87_23Association of Prehypertension with Renin Angiotensin System: A Cross-Sectional Study on Tribal Population of Northern IndiaVani KandpalMohinder Pal SachdevaKallur Nava SaraswathyIntroduction: Hypertension (HTN), the third risk factor driving death and disability as per Global Burden of Disease 2019, is a major public health concern. Prehypertension, the intermediate stage between HTN and normal blood pressure (BP), is associated with subclinical atherosclerosis and target-organ damage. Evaluating the prevalence of prehypertension is imperative to prevent disease progression. Prehypertension, alike HTN, is a complex disorder that manifests when genes are triggered by the environment. The current study attempts to evaluate the prevalence of prehypertension in a tribal population of Northern India. Further, the association with extensively studied renin–angiotensin system (RAS) pathway genes with prehypertension has been explored. Methods: A cross-sectional study was conducted on adults of 20–60 years old belonging to a tribal community, Rang Bhotia of Northern India. Information on demographic, lifestyle, and anthropometric risk factors was collected. The blood sample was collected for lipid and genetic analysis. DNA extraction and genotyping of five genetic markers of RAS-related pathway were performed. Chi-square and t-tests were used for assessing significant differences between the groups. Logistic regression was used to examine the association of genes with prehypertension and HTN. Results: Among 254 adults participating in the study, 39% and 42% had prehypertension and HTN, respectively. T allele of M235T genetic marker was found to be posing two-fold risk for prehypertension (odds ratio [OR] = 2.9; 95% confidence interval [CI] =1.10–7.72; P = 0.03 in dominant model and OR = 1.83; 95% CI = 1.09-3.09; P = 0.02 in additive model) after adjusting for age and sex. On the other hand, G allele of A6G polymorphism was found to be providing protection toward prehypertension (OR = 0.32; 95% CI = 0.11–0.92; P = 0.03 in recessive model and OR = 0.55; 95% CI = 0.32–0.94; P = 0.03 in additive model). Conclusion: More than one-third of individuals exhibited prehypertension, suggesting an impending burden of HTN and comorbidities among the tribal population in the near future. Moreover, increased genetic susceptibility toward elevated BP commands immediate attention. Effective management strategies including interventions on lifestyle, diet modification, and weight management need to be introduced to combat increasing HTN among the tribal population.https://journals.lww.com/10.4103/jpcs.jpcs_87_23genetic polymorphismprehypertensionrenin–angiotensin systemtribal population
spellingShingle Vani Kandpal
Mohinder Pal Sachdeva
Kallur Nava Saraswathy
Association of Prehypertension with Renin Angiotensin System: A Cross-Sectional Study on Tribal Population of Northern India
Journal of the Practice of Cardiovascular Sciences
genetic polymorphism
prehypertension
renin–angiotensin system
tribal population
title Association of Prehypertension with Renin Angiotensin System: A Cross-Sectional Study on Tribal Population of Northern India
title_full Association of Prehypertension with Renin Angiotensin System: A Cross-Sectional Study on Tribal Population of Northern India
title_fullStr Association of Prehypertension with Renin Angiotensin System: A Cross-Sectional Study on Tribal Population of Northern India
title_full_unstemmed Association of Prehypertension with Renin Angiotensin System: A Cross-Sectional Study on Tribal Population of Northern India
title_short Association of Prehypertension with Renin Angiotensin System: A Cross-Sectional Study on Tribal Population of Northern India
title_sort association of prehypertension with renin angiotensin system a cross sectional study on tribal population of northern india
topic genetic polymorphism
prehypertension
renin–angiotensin system
tribal population
url https://journals.lww.com/10.4103/jpcs.jpcs_87_23
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AT mohinderpalsachdeva associationofprehypertensionwithreninangiotensinsystemacrosssectionalstudyontribalpopulationofnorthernindia
AT kallurnavasaraswathy associationofprehypertensionwithreninangiotensinsystemacrosssectionalstudyontribalpopulationofnorthernindia