Targeted sequencing identifies a missense variant in the BEST3 gene associated with antihypertensive response to hydrochlorothiazide

Pharmacogenet Genomics. 2018 Nov;28(11):251-255. doi: 10.1097/FPC.0000000000000353.

Abstract

Chromosome 12q15 was identified in Genetic Epidemiology of Response Assessment (GERA) and replicated in Pharmacogenomic Evaluation of Antihypertensive Responses (PEAR) for its association with blood pressure (BP) response to hydrochlorothiazide (HCTZ). However, the functional variant is unknown and we aimed to identify the likely functional variants through targeted sequencing. The chromosome 12q15 region was sequenced in 397 best and worst responders to HCTZ in PEAR (N=199) and GERA (N=198) hypertensive study participants. Logistic regression was used for the association analysis adjusting for age, sex, race, and principal components 1 and 2. For validation, the significant single nucleotide polymorphism was tested for association with the change in systolic (ΔSBP) and diastolic BP (ΔDBP) post-treatment in the entire PEAR (N=370) and GERA (N=570) cohorts. A novel missense polymorphism (G>A, Pro383Leu) in BEST3, rs61747221, was significantly associated with better HCTZ response (P=0.0021, odds ratio=2.05). It was validated in the entire cohort of PEAR (ΔSBP: P=0.021, β=-1.60, ΔDBP: P=0.023, β=-1.08) and GERA (ΔSBP: P=0.028, β=-1.95, ΔDBP: P=0.032, β=-1.28). BEST3 encodes the calcium sensitive chloride channel in the vascular smooth muscle implicated in the regulation of BP, especially in response to vasoconstrictors like angiotensin II. These results suggest that BEST3 is involved in the chronic BP lowering mechanism of thiazides and highlight its importance as a genetic predictor of the BP response to thiazide diuretics.

MeSH terms

  • Adult
  • Angiotensin II / administration & dosage
  • Angiotensin II / genetics
  • Antihypertensive Agents / administration & dosage
  • Antihypertensive Agents / adverse effects
  • Atenolol / administration & dosage
  • Bestrophins / genetics*
  • Blood Pressure / drug effects
  • Blood Pressure / genetics
  • Female
  • Genetic Association Studies*
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / genetics
  • Hypertension / pathology
  • Male
  • Middle Aged
  • Muscle Proteins / genetics*
  • Polymorphism, Single Nucleotide / genetics
  • Sodium Chloride Symporter Inhibitors / administration & dosage*
  • Sodium Chloride Symporter Inhibitors / adverse effects

Substances

  • Antihypertensive Agents
  • BEST3 protein, human
  • Bestrophins
  • Muscle Proteins
  • Sodium Chloride Symporter Inhibitors
  • Angiotensin II
  • Atenolol