Environment-Wide Association Study of Blood Pressure in the National Health and Nutrition Examination Survey (1999-2012)

Abstract

Identifying environmental exposures associated with blood pressure is a priority. Recently, we proposed the environment-wide association study to search for and replicate environmental factors associated with phenotypes. We conducted the environment-wide association study (EWAS) using the National Health and Nutrition Examination Surveys (1999-2012) which evaluated a total of 71,916 participants to prioritize environmental factors associated with systolic and diastolic blood pressure. We searched for factors on participants from survey years 1999-2006 and tentatively replicated findings in participants from years 2007-2012. Finally, we estimated the overall association and performed a second meta-analysis using all survey years (1999-2012). For systolic blood pressure, self-reported alcohol consumption emerged as our top finding (a 0.04 increase in mmHg of systolic blood pressure for 1 standard deviation increase in self-reported alcohol), though the effect size is small. For diastolic blood pressure, urinary cesium was tentatively replicated; however, this factor demonstrated high heterogeneity between populations (I2 = 51%). The lack of associations across this wide of an analysis raises the call for a broader search for environmental factors in blood pressure.