Background: The 2024 ESC Hypertension Guidelines identified a number of key gaps in the evidence (1). The first of these was “drivers of worsening trajectories of BP control in women and men”, elaborated on further in the second point related to specific risk factors, hormonal, genetic, and molecular mechanisms.
Aim: The purpose of this project is to identify such drivers as those discussed above, with a view to support improvements in sex-specific risk stratification and treatment.
Methods: Data will be retrieved from the UK Biobank, which includes clinical records (e.g. pharmacy prescriptions, primary care blood pressure measurements), genetic data, proteomic and metabolomic data, as well as demographics, lifestyle and environment exposures. The intent is to utilise this data to develop a model featuring specific sex-stratified drivers.
At present, Prof Bill McEvoy, the lead author of the 2024 ESC Guidelines, will act as my supervisor, with co-supervision from Dr Stephen Brennan for statistical expertise. Once the UK BioBank data is available, Dr Brennan and I will proceed to finalise the data analysis & modelling plan in accordance with the available data. Such biobank-scale trajectory modelling has recent precedent, with Ko et al. (2) performing such an analysis to identify longitudinal traits using the electronic health record at a large scale.
1.) Ko, S. et al. (2022). GWAS of longitudinal trajectories at biobank scale. American journal of human genetics, 109(3), 433-445. https://doi.org/10.1016/j.ajhg.2022.01.018
2.) McEvoy, J. W. et al. (2024). 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. European heart journal, 45(38), 3912-4018. https://doi.org/10.1093/eurheartj/ehae178