Association analysis between an epigenetic alcohol risk score and blood pressure.

Epigenome-wide association studies have revealed multiple DNA methylation sites (CpGs) associated with alcohol consumption, an important lifestyle risk factor for cardiovascular diseases. We generated an alcohol consumption epigenetic risk score (ERS) based on previously reported 144 alcohol-associated CpGs and examined the association of the ERS with systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension (HTN) in 3,898 Framingham Heart Study (FHS) participants. We found an association of alcohol intake with the ERS in the meta-analysis with 0.09 units higher ERS per drink consumed per day (p<0.0001). Cross-sectional analyses in FHS revealed that a one-unit increment of the ERS was associated with 1.93 mm Hg higher SBP (p=4.64E-07), 0.68 mm Hg higher DBP (p=0.006), and an odds ratio of 1.78 for HTN (p<2E-16). Meta-analysis of the cross-sectional association of the ERS with BP traits in eight independent external cohorts (n=11,544) showed similar relationships with blood pressure levels, i.e., a one-unit increase in ERS was associated with 0.74 (p=0.002) and 0.50 (p=0.0006) mm Hg higher SBP and DBP, but could not confirm the association with hypertension. Longitudinal analyses in FHS (n=3,260) and five independent external cohorts (n=4,021) showed that the baseline ERS was not associated with a change in blood pressure over time or with incident HTN. Our findings provide proof-of-concept that utilizing an ERS is a useful approach to capture the recent health consequences of lifestyle behaviors such as alcohol consumption.