The genetics of blood pressure regulation and its target organs from association studies in 342,415 individuals

Open

Georg B. Ehret, Teresa Ferreira, Daniel I. Chasman, Anne U. Jackson, Ellen M. Schmidt, Toby Johnson, Gudmar Thorleifsson, Jian'An Luan, Louise A. Donnelly, Stavroula Kanoni, Ann-Kristin Petersen, Vasyl Pihur, Rona J. Strawbridge, Dmitry Shungin, Maria F. Hughes, Osorio Meirelles, Marika Kaakinen, Nabila Bouatia-Naji, Kati Kristiansson, Sonia Shah, Marcus E. Kleber, Xiuqing Guo, Leo-Pekka Lyytikäinen, Cristiano Fava, Niclas Eriksson, Ilja M. Nolte, Patrik K. Magnusson, Elias L. Salfati, Loukianos S. Rallidis, Elizabeth Theusch, Andrew J. P. Smith, Lasse Folkersen, Kate Witkowska, Tune H. Pers, Roby Joehanes, Stuart K. Kim, Lazaros Lataniotis, Rick Jansen, Andrew D. Johnson, Helen Warren, Young Jin Kim, Wei Zhao, Ying Wu, Bamidele O. Tayo, Murielle Bochud, Devin Absher, Linda S. Adair, Najaf Amin, Dan E. Arking, Tomas Axelsson, Damiano Baldassarre, Beverley Balkau, Stefania Bandinelli, Michael R. Barnes, Inês Barroso, Stephen Bevan, Joshua C. Bis, Gyda Bjornsdottir, Michael Boehnke, Eric Boerwinkle, Lori L. Bonnycastle, Dorret I. Boomsma, Stefan R. Bornstein, Morris J. Brown, Michel Burnier, Claudia P. Cabrera, John C. Chambers, I-Shou Chang, Ching-Yu Cheng, Peter S. Chines, Ren-Hua Chung, Francis S. Collins, John M. Connell, Angela Döring, Jean Dallongeville, John Danesh, Ulf De Faire, Graciela Delgado, Anna F. Dominiczak, Alex S. F. Doney, Fotios Drenos, Sarah Edkins, John D. Eicher, Roberto Elosua, Stefan Enroth, Jeanette Erdmann, Per Eriksson, Tonu Esko, Evangelos Evangelou, Alun Evans, Tove Fall, Martin Farrall, Janine F. Felix, Jean Ferrières, Luigi Ferrucci, Myriam Fornage, Terrence Forrester, Nora Franceschini, Oscar H. Franco, Anders Franco-Cereceda, Ross M. Fraser, Santhi K. Ganesh, He Gao, Karl Gertow, Francesco Gianfagna, Bruna Gigante, Franco Giulianini, Anuj Goel, Alison H. Goodall, Mark O. Goodarzi, Mathias Gorski, Jürgen Gräßler, Christopher J. Groves, Vilmundur Gudnason, Ulf Gyllensten, Göran Hallmans, Anna-Liisa Hartikainen, Maija Hassinen, Aki S. Havulinna, Caroline Hayward, Serge Hercberg, Karl-Heinz Herzig, Andrew A. Hicks, Aroon D. Hingorani, Joel N. Hirschhorn, Albert Hofman, Jostein Holmen, Oddgeir Lingaas Holmen, Jouke-Jan Hottenga, Phil Howard, Chao A. Hsiung, Steven C. Hunt, M Arfan Ikram, Thomas Illig, Carlos Iribarren, Richard A. Jensen, Mika Kähönen, Hyun Min Kang, Sekar Kathiresan, Brendan J. Keating, Kay-Tee Khaw, Yun Kyoung Kim, Eric Kim, Mika Kivimaki, Norman Klopp, Genovefa Kolovou, Pirjo Komulainen, Jaspal S. Kooner, Gulum Kosova, Ronald M. Krauss, Diana Kuh, Zoltan Kutalik, Johanna Kuusisto, Kirsti Kvaløy, Timo A. Lakka, Nanette R. Lee, I-Te Lee, Wen-Jane Lee, Daniel Levy, Xiaohui Li, Kae-Woei Liang, Honghuang Lin, Li Lin, Jaana Lindström, Stéphane Lobbens, Satu Männistö, Gabriele Müller, Martina Müller-Nurasyid, François Mach, Hugh S. Markus, Eirini Marouli, Mark I. McCarthy, Colin A. McKenzie, Pierre Meneton, Cristina Menni, Andres Metspalu, Vladan Mijatovic, Leena Moilanen, May E. Montasser, Andrew D. Morris, Alanna C. Morrison, Antonella Mulas, Ramaiah Nagaraja, Narisu Narisu, Kjell Nikus, Christopher J. O'Donnell, Paul F. O'Reilly, Ken K. Ong, Fred Paccaud, Cameron D. Palmer, Afshin Parsa, Nancy L. Pedersen, Brenda W. Penninx, Markus Perola, Annette Peters, Neil Poulter, Peter P. Pramstaller, Bruce M. Psaty, Thomas Quertermous, Dabeeru C. Rao, Asif Rasheed, N William Rayner, Frida Renström, Rainer Rettig, Kenneth M. Rice, Robert Roberts, Lynda M. Rose, Jacques Rossouw, Nilesh J. Samani, Serena Sanna, Jouko Saramies, Heribert Schunkert, Sylvain Sebert, Wayne H.-H. Sheu, Young-Ah Shin, Xueling Sim, Johannes H. Smit, Albert V. Smith, Maria X. Sosa, Tim D. Spector, Alena Stančáková, Alice V. Stanton, Kathleen E. Stirrups, Heather M. Stringham, Johan Sundstrom, Amy J. Swift, Ann-Christine Syvänen, E-Shyong Tai, Toshiko Tanaka, Kirill V. Tarasov, Alexander Teumer, Unnur Thorsteinsdottir, Martin D. Tobin, Elena Tremoli, Andre G. Uitterlinden, Matti Uusitupa, Ahmad Vaez, Dhananjay Vaidya, Cornelia M. Van Duijn, Erik P. A. Van Iperen, Ramachandran S. Vasan, Germaine C. Verwoert, Jarmo Virtamo, Veronique Vitart, Benjamin F. Voight, Peter Vollenweider, Aline Wagner, Louise V. Wain, Nicholas J. Wareham, Hugh Watkins, Alan B. Weder, Harm-Jan Westra, Rainford Wilks, Tom Wilsgaard, James F. Wilson, Tien Y. Wong, Tsun-Po Yang, Jie Yao, Loic Yengo, Weihua Zhang, Jing Hua Zhao, Xiaofeng Zhu, Pascal Bovet, Richard S. Cooper, Karen L. Mohlke, Danish Saleheen, Jong-Young Lee, Paul Elliott, Hinco J. Gierman, Cristen J. Willer, Lude Franke, G. Kees Hovingh, Kent D. Taylor, George Dedoussis, Peter Sever, Andrew Wong, Lars Lind, Themistocles L. Assimes, Inger Njølstad, Peter E. H. Schwarz, Claudia Langenberg, Harold Snieder, Mark J. Caulfield, Olle Melander, Markku Laakso, Juha Saltevo, Rainer Rauramaa, Jaakko Tuomilehto, Erik Ingelsson, Terho Lehtimäki, Kristian Hveem, Walter Palmas, Winfried März, Meena Kumari, Veikko Salomaa, Yii-Der I. Chen, Jerome I. Rotter, Philippe Froguel, Marjo-Riitta Jarvelin, Edward G. Lakatta, Kari Kuulasmaa, Paul W. Franks, Anders Hamsten, H-Erich Wichmann, Colin N. A. Palmer, Kari Stefansson, Paul M. Ridker, Ruth J. F. Loos, Aravinda Chakravarti, Panos Deloukas, Andrew P. Morris, Christopher Newton-Cheh, Patricia B. Munroe

2016 Nature Genetics Vol. 48 Issue 10 Article Cited by 355 Quartile

Abstract

To dissect the genetic architecture of blood pressure and assess effects on target organ damage, we analyzed 128,272 SNPs from targeted and genome-wide arrays in 201,529 individuals of European ancestry, and genotypes from an additional 140,886 individuals were used for validation. We identified 66 blood pressure-associated loci, of which 17 were new; 15 harbored multiple distinct association signals. The 66 index SNPs were enriched for cis-regulatory elements, particularly in vascular endothelial cells, consistent with a primary role in blood pressure control through modulation of vascular tone across multiple tissues. The 66 index SNPs combined in a risk score showed comparable effects in 64,421 individuals of non-European descent. The 66-SNP blood pressure risk score was significantly associated with target organ damage in multiple tissues but with minor effects in the kidney. Our findings expand current knowledge of blood pressure-related pathways and highlight tissues beyond the classical renal system in blood pressure regulation. © 2016 Nature America, Inc. All rights reserved.

Affiliations

Center for Complex Disease Genomics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD, United States; Cardiology, Department of Medicine, Geneva University Hospital, Geneva, Switzerland; Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States; Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States; Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, United States; Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States; Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; GlaxoSmithKline, Stevenage, United Kingdom; DeCODE Genetics/Amgen, Inc, Reykjavik, Iceland; MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom; Medical Research Institute, University of Dundee, Ninewells Hospital, Medical School, Dundee, United Kingdom; William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom; Institute of Genetic Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Cardiovascular Research Unit, Center for Molecular Medicine, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Center for Molecular Medicine, Karolinska University Hospital Solna, Stockholm, Sweden; Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden; Department of Clinical Sciences, Genetic and Molecular Epidemiology Unit, Lund University, Malmö, Sweden; Department of Odontology, Umeå University, Umeå, Sweden; Centre of Excellence for Public Health, Queens University Belfast, Belfast, United Kingdom; Laboratory of Genetics, Intramural Research Program, National Institute on Aging, US National Institutes of Health, Baltimore, MD, United States; Department of Genomics of Common Disease, School of Public Health, Imperial College London, Hammersmith Hospital, London, United Kingdom; INSERM UMR 970, Paris Cardiovascular Research Center (PARCC), Paris, France; University Paris-Descartes, Sorbonne Paris Cité, Paris, France; National Institute for Health and Welfare, Helsinki, Finland; Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland; Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, London, United Kingdom; Vth Department of Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute, Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, United States; Department of Clinical Chemistry, Fimlab Laboratories, Tampere, Finland; Department of Clinical Chemistry, University of Tampere, School of Medicine, Tampere, Finland; Department of Internal Medicine, University of Lund, Malmö, Sweden; Department of Medicine, University of Verona, Verona, Italy; Uppsala University, Uppsala Clinical Research Center, Uppsala, Sweden; Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Medicine, Stanford University, School of Medicine, Stanford, CA, United States; Second Department of Cardiology, Attikon Hospital, School of Medicine, University of Athens, Athens, Greece; Children's Hospital, Oakland Research Institute, Oakland, CA, United States; Centre for Cardiovascular Genetics, Institute of Cardiovascular Science, University College London, London, United Kingdom; NIHR Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London, United Kingdom; Division of Endocrinology, Boston Children's Hospital, Boston, MA, United States; Center for Basic and Translational Obesity Research, Boston Children's Hospital, Boston, MA, United States; Program in Medical and Population Genetics, Broad Institute of mit and Harvard, Cambridge, MA, United States; Novo Nordisk Foundation, Centre for Basic Metabolic Research, Section of Metabolic, Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, United States; Department of Developmental Biology and Genetics, Stanford University Medical Center, Stanford, CA, United States; Department of Psychiatry, VU University Medical Center, Amsterdam, Netherlands; National Heart, Lung, and Blood Institute, Cardiovascular Epidemiology and Human Genomics Branch, Bethesda, MD, United States; Center for Genome Science, National Institute of Health, Osong Health Technology Administration Complex, Chungcheongbuk-do, South Korea; Division of Translational Medicine and Human Genetics, Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Department of Public Health Sciences, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, United States; Institute of Social and Preventive Medicine (IUMSP), Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland; HudsonAlpha Institute for Biotechnology, Huntsville, AL, United States; Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands; Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy; Centro Cardiologico Monzino, IRCCS, Milan, Italy; INSERM U1018, Centre for Research in Epidemiology and Population Health, University Paris-Sud, URMS 1018, Villejuif, France; Geriatric Unit, Azienda Sanitaria Firenze (ASF), Florence, Italy; Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, United Kingdom; University of Cambridge, Metabolic Research Laboratories, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom; NIHR Cambridge Biomedical Research Centre, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom; School of Life Science, University of Lincoln, Joseph Banks Laboratories, Lincoln, United Kingdom; Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, United States; Human Genetics Center, School of Public Health, University of Texas, Health Science Center at Houston, Houston, TX, United States; Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, US National Institutes of Health, Bethesda, MD, United States; Department of Biological Psychology, VU University, Amsterdam, Netherlands; Department of Medicine III, University of Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany; Barts Heart Centre, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; Nephrology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Cardiology, Ealing Hospital, NHS Trust, Southall, United Kingdom; Imperial College Healthcare NHS Trust, London, United Kingdom; National Institute of Cancer Research, National Health Research Institutes, Zhunan Town, Taiwan; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore; Duke-NUS Graduate Medical School Singapore, Singapore, Singapore; Department of Ophthalmology, National University of Singapore, National University Health System, Singapore, Singapore; Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Zhunan Town, Taiwan; University of Dundee, Ninewells Hospital, Medical School, Dundee, United Kingdom; Institute of Epidemiology i, Helmholtz Zentrum München, Neuherberg, Germany; Institute of Epidemiology II, Helmholtz Zentrum München, Neuherberg, Germany; INSERM UMR 1167, Lille 2 University, Institut Pasteur Lille, Lille, France; Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; NIHR Blood and Transplant Research Unit in Donor Health and Genomics, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom; Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom; Medical Research Council, Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom; Cardiovascular Epidemiology and Genetics, Institut Hospital Del Mar D'Investigacions Mèdiques (IMIM), Barcelona, Spain; Department of Immunology, Genetics and Pathology, University of Uppsala, Biomedical Center, Uppsala, Sweden; Science for Life Laboratory, University of Uppsala, Biomedical Center, Uppsala, Sweden; Institut für Integrative und Experimentelle Genomik, Universiät zu Lübeck, Lübeck, Germany; Deutsches Zentrum für Herz Kreislauf Forschung (DZHK), Partner Site Hamburg, Lübeck, Kiel, Germany; Estonian Genome Center, University of Tartu, Tartu, Estonia; Broad Institute of mit and Harvard, Cambridge, MA, United States; Department of Hygiene and Epidemiology, University of Ioannina, Medical School, Ioannina, Greece; Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden; Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands; Toulouse University, School of Medicine, Rangueil University Hospital, INSERM UMR 1027, Toulouse, France; Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, United States; Institute of Molecular Medicine, University of Texas, Health Science Center at Houston, Houston, TX, United States; Tropical Metabolism Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Cardiothoracic Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom; Synpromics, Ltd, Edinburgh, United Kingdom; Department of Cardiology, University of Michigan, Medical School, Ann Arbor, MI, United States; Epidemiology and Preventive Medicine (EPIMED) Research Centre, Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy; Department of Epidemiology and Prevention, IRCCS, Istituto Neurologico Mediterraneo (NEUROMED), Pozzilli, Italy; Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester, United Kingdom; NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, United Kingdom; Division of Endocrinology, Diabetes and Metabolism, Cedars-Sinai Medical Center, Los Angeles, CA, United States; Department of Genetic Epidemiology, Institute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany; Department of Nephrology, University Hospital Regensburg, Regensburg, Germany; Division of Pathobiochemistry, Department of Medicine III, Technische Universität Dresden, Dresden, Germany; Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom; Icelandic Heart Association, Kopavogur, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland; Institute of Clinical Medicine/Obstetrics and Gynaecology, University of Oulu, Oulu, Finland; Medical Research Center, Oulu University Hospital, Oulu, Finland; Kuopio Research Institute of Exercise Medicine, Kuopio, Finland; Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, United Kingdom; UREN, INSERM U557, INRA U1125, CNAM, SMBH, Sorbonne Paris Cité, Université Paris 13, Bobigny, France; Institute of Biomedicine, University of Oulu, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland; Biocenter Oulu, University of Oulu, Oulu, Finland; Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, Poznan, Poland; Center for Biomedicine, European Academy Bozen/Bolzano (EURAC), Bolzano, Italy; Department of Genetics, Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; HUNT Research Centre, Department of Public Health and General Practice, Norwegian University of Science and Technology, Levanger, Norway; St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway; Cardiovascular Genetics Division, University of Utah, School of Medicine, Salt Lake City, UT, United States; Department of Genetic Medicine, Weill Cornell Medical College Qatar, Doha, Qatar; Department of Radiology, Erasmus MC, Rotterdam, Netherlands; Department of Neurology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands; Research Unit of Molecular Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Hannover Unified Biobank, Hannover Medical School, Hannover, Germany; Hannover Medical School, Institute for Human Genetics, Hannover, Germany; Division of Research, Kaiser Permanente, Oakland, CA, United States; Department of Medicine, University of Washington, Seattle, WA, United States; Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland; Department of Clinical Physiology, University of Tampere, School of Medicine, Tampere, Finland; Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, United States; Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, United States; Department of Medicine, Harvard Medical School, Boston, MA, United States; Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States; Division of Transplantation, Department of Surgery, University of Pennsylvania, Philadelphia, PA, United States; Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, United States; Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom; 1st Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece; National Heart and Lung Institute, Imperial College London, Hammersmith Hospital Campus, London, United Kingdom; Department of Medicine, Children's Hospital, Oakland Research Institute, Oakland, CA, United States; MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom; Department of Medical Genetics, University of Lausanne, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; Department of Medicine, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland; Institute of Biomedicine/Physiology, University of Eastern Finland, Kuopio, Finland; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland; Office of Population Studies Foundation, Inc., Talamban, Cebu City, Philippines; Department of Anthropology, Sociology and History, University of San Carlos, Talamban, Cebu City, Philippines; Division of Endocrine and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan; Population Sciences Branch, National Heart, Lung, and Blood Institute, US National Institutes of Health, Bethesda, MD, United States; Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan; Section of Computational Biomedicine, Department of Medicine, Boston University, School of Medicine, Boston, MA, United States; European Genomic Institute for Diabetes (EGID), Lille, France; CNRS UMR 8199, Lille Pasteur Institute, Lille, France; Lille 2 University, Lille, France; Center for Evidence-Based Healthcare, University of Dresden, Medical Faculty Carl Gustav Carus, Dresden, Germany; Department of Medicine i, University Hospital Großhadern, Ludwig Maximilians University, Munich, Germany; Institute of Medical Informatics, Biometry and Epidemiology, Ludwig Maximilians Universität, Munich, Germany; Neurology Unit, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom; Department of Dietetics-Nutrition, Harokopio University, Athens, Greece; INSERM U1142, LIMICS, UMRS 1142, Sorbonne Universités, UPMC Université Paris 06, Université Paris 13, Paris, France; Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom; Department of Life and Reproduction Sciences, University of Verona, Verona, Italy; Department of Medicine, Kuopio University Hospital, Kuopio, Finland; Unit of General Practice, Oulu University Hospital, Oulu, Finland; Department of Medicine, Program for Personalized and Genomic Medicine, University of Maryland, School of Medicine, Baltimore, MD, United States; Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas, Health Science Center at Houston, Houston, TX, United States; Istituto di Ricerca Genetica e Biomedica (IRGB), Consiglio Nazionale Delle Ricerche, Cittadella Universitaria di Monseratto, Monserrato, Cagliari, Italy; Department of Cardiology, Heart Center, Tampere University Hospital, Tampere, Finland; Department of Cardiology, University of Tampere, School of Medicine, Tampere, Finland; National Heart, Lung, and Blood Institute, Division of Cardiovascular Sciences, Bethesda, MD, United States; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Genetics and Program in Genomics, Children's Hospital Boston, Boston, MA, United States; Department of Psychiatry, EMGO Institute, Neuroscience Campus, VU University Medical Centre, Amsterdam, Netherlands; Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Psychiatry, Leiden University Medical Centre, Leiden, Netherlands; International Centre for Circulatory Health, Imperial College London, London, United Kingdom; Department of Neurology, General Central Hospital, Bolzano, Italy; Department of Neurology, University of Lübeck, Lübeck, Germany; Department of Epidemiology, University of Washington, Seattle, WA, United States; Department of Health Services, University of Washington, Seattle, WA, United States; Group Health Research Institute, Group Health Cooperative, Seattle, WA, United States; Division of Biostatistics, Washington University, School of Medicine, St. Louis, MO, United States; Center for Non-Communicable Diseases, Karachi, Pakistan; Department of Biobank Research, Umeå University, Umeå, Sweden; Institute of Physiology, University Medicine Greifswald, Greifswald, Germany; Department of Biostatistics, University of Washington, Seattle, WA, United States; University of Ottawa Heart Institute, Cardiovascular Research Methods Centre Ontario, Ottawa, ON, Canada; Ruddy Canadian Cardiovascular Genetics Centre, Ottawa, ON, Canada; South Karelia Central Hospital, Lappeenranta, Finland; Deutsches Herzzentrum München, Munich, Germany; Technische Universität München, Munich, Germany; Deutsches Zentrum für Herz Kreislauf Forschung (DZHK), Munich, Germany; Munich Heart Alliance, Munich, Germany; Center for Lifecourse Health Research, University of Oulu, Oulu, Finland; College of Medicine, National Defense Medical Center, Taipei, Taiwan; Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore, Singapore; University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland; Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland; Department of Haematology, University of Cambridge, Cambridge, United Kingdom; Department of Medicine, National University of Singapore, National University Health System, Singapore, Singapore; Laboratory of Cardiovascular Science, Intramural Research Program, National Institute on Aging, US National Institutes of Health, Baltimore, MD, United States; Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; Department of Health Sciences, University of Leicester, Leicester, United Kingdom; Department of Internal Medicine, Erasmus MC, Rotterdam, Netherlands; Department of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Research Unit, Kuopio University Hospital, Kuopio, Finland; Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran; Johns Hopkins Medical Institutions, Baltimore, MD, United States; Centre of Medical Systems Biology (CMSB 1-2), NGI Erasmus Medical Center, Rotterdam, Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, Amsterdam, Netherlands; Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, Netherlands; Section of Preventive Medicine, Department of Medicine, Boston University, School of Medicine, Boston, MA, United States; Cardiology, Department of Medicine, Boston University, School of Medicine, Boston, MA, United States; Department of Systems Pharmacology and Translational Therapeutics, Department of Genetics, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, United States; Department of Internal Medicine, University Hospital Lausanne, Lausanne, Switzerland; Department of Epidemiology and Public Health, EA3430, University of Strasbourg, Strasbourg, France; Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, Medical School, Ann Arbor, MI, United States; University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Epidemiology Research Unit, Tropical Medicine Research Institute, University of the West Indies, Mona, Kingston, Jamaica; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway; Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway; MRC Cancer Unit, University of Cambridge, Cambridge, United Kingdom; Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, United States; Ministry of Health, Victoria, Seychelles; Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, United States; MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom; Enterprise Informatics, Illumina, Inc., Santa Clara, CA, United States; Department of Human Genetics, University of Michigan, Ann Arbor, MI, United States; Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Department of Vascular Medicine, Academic Medical Center, Amsterdam, Netherlands; Paul Langerhans Institute Dresden, Helmholtz Center Munich, University Hospital, Faculty of Medicine, TU Dresden, Dresden, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany; Department of Medicine, Central Finland Health Care District, Jyväskylä, Finland; Dasman Diabetes Institute, Dasman, Kuwait; Saudi Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia; Centre for Vascular Prevention, Danube University Krems, Krems, Austria; Department of Medicine, Columbia University, New York, NY, United States; Synlab Academy, Synlab Services, Mannheim, Germany; Clinical Institute of Medical, Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria; Unit of Primary Care, Oulu University Hospital, Oulu, Finland; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Institute of Medical Statistics and Epidemiology, Technical University Munich, Munich, Germany; Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Mindich Child Health Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States; Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders (PACER-HD), King Abdulaziz University, Jeddah, Saudi Arabia; Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom; University of Lübeck, Lübeck, Germany