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Thiazide diuretics, commonly used antihypertensives, may cause QT interval (QT) prolongation, a risk factor for highly fatal and difficult to predict ventricular arrhythmias. We examined whether common single-nucleotide polymorphisms (SNPs) modified the association between thiazide use and QT or its component parts (QRS interval, JT interval) by performing ancestry-specific, trans-ethnic and cross-phenotype genome-wide analyses of European (66%), African American (15%) and Hispanic (19%) populations (N=78 199), leveraging longitudinal data, incorporating corrected standard errors to account for underestimation of interaction estimate variances and evaluating evidence for pathway enrichment. Although no loci achieved genome-wide significance (P<5 × 10-8), we found suggestive evidence (P<5 × 10-6) for SNPs modifying the thiazide-QT association at 22 loci, including ion transport loci (for example, NELL1, KCNQ3). The biologic plausibility of our suggestive results and simulations demonstrating modest power to detect interaction effects at genome-wide significant levels indicate that larger studies and innovative statistical methods are warranted in future efforts evaluating thiazide-SNP interactions.

Original publication

DOI

10.1038/tpj.2017.10

Type

Journal article

Journal

Pharmacogenomics J

Publication Date

04/2018

Volume

18

Pages

215 - 226

Keywords

Adult, Aged, Aged, 80 and over, Aging, Cohort Studies, Electrocardiography, Ethnic Groups, Female, Genomics, Heart Rate, Humans, Longitudinal Studies, Male, Middle Aged, Pharmacogenetics, Polymorphism, Single Nucleotide, Sodium Chloride Symporter Inhibitors