African ancestry genome-wide association study of blood pressure and hypertension identifies 25 novel loci through predicted gene expression

Abstract African Americans (AAs) experience a high burden of hypertension but have been underrepresented in genetic studies of blood pressure. We performed common and rare variant genome-wide association studies (GWAS) of systolic (SBP) and diastolic (DBP) blood pressure, pulse pressure and hypertension in 95,457 AAs from the Million Veteran Program and Continental Origins and Genetic Epidemiology Network (COGENT) consortium with replication in up to 41,014 African-ancestry participants. GWAS meta-analysis confirmed 26 previously reported loci including 15 with SBP, four with DBP, 10 with pulse pressure and five with hypertension. Predicted gene expression analysis identified 25 genes newly associated with blood pressure. We provide validated African-ancestry polygenic scores for SBP and DBP that are strongly associated with hypertension. This work provides evidence for similar genetic architectures of hypertension and blood pressure across racial/ethnic groups and demonstrates the utility of predicted expression analysis in identifying novel genes beyond GWAS alone.