Type 2 Diabetes and Hypertension: A Study on Bidirectional Causality

Rationale: In observational studies, type 2 diabetes (T2D) has been associated with an increased risk of hypertension (HTN), and vice versa; however, the causality between these conditions remains to be determined. Objective: This population-based prospective cohort study sought to investigate the bidirectional causal relations of T2D with HTN, systolic and diastolic blood pressure (SBP and DBP) using Mendelian randomization (MR) analysis. Methods and Results: After exclusion of participants free of a history of heart failure, cardiovascular disease, cardiac procedures, and non T2D diabetes, a total of 318,664 unrelated individuals with qualified genotyping data of European descent aged 37-73 from UK Biobank were included. The genetically instrumented T2D and HTN were constructed using 134 and 233 single nucleotide polymorphisms (SNPs), respectively. Seven complementary MR methods were applied, including inverse variance weighted method (IVW), two median-based methods (simple and weighted), MR-Egger, MR-R...