Causal Relationship Between Hypertension And Vertigo: A Mendelian Randomization Study.

Introduction: Current genetic research on the relationship between hypertension and vertigo is limited, and traditional observational studies cannot establish a causal relationship due to design limitations, particularly regarding whether hypertension acts as a causal risk factor for specific vertigo subtypes, such as benign paroxysmal positional vertigo (BPPV).

Methods: This study employed a two-sample MR approach to infer causal relationships via genome- wide association study (GWAS) data, thereby addressing the limitations of traditional observational studies. In addition to analyzing the link between total vertigo and hypertension, we examined three major types of vertigo: central vertigo, benign paroxysmal positional vertigo (BPPV), and other peripheral vertigo. The study included 3834 cases of BPPV, 186 cases of central vertigo, 1293 cases of other peripheral vertigo, and 209,582 controls. Various MR methods, including the inverse variance weighted (IVW) approach, MR-Egger, weighted median, and simple mode, were employed to deduce the potential causative associations.

Results: A set of 53 genome-wide significant single-nucleotide polymorphisms (SNPs) associated with hypertension was identified as instrumental variables for subsequent MR analysis. The results indicated a significantly positive correlation between hypertension and the risk of total vertigo (OR: 1.16, 95% CI: 1.08-1.25, p <0.05), BPPV (OR: 1.12, CI: 1.01-1.24, and p =0.03), and other peripheral vertigo (OR: 1.19, 95% CI: 1.00-1.41, p =0.046), whereas no significant association was found with central vertigo (OR: 1.15, 95% CI: 0.74-1.80, p =0.53).

Discussion: This study provides genetic evidence for a positive association between hypertension and vertigo, particularly BPPV and peripheral vertigo, but not central vertigo. Hypertension may induce vestibular dysfunction via vascular changes leading to tissue hypoxia and cochlearvestibular degeneration. Limitations include small sample sizes for certain vertigo subtypes (e.g., central vertigo) and limited generalizability to non-European populations.

Conclusion: This MR analysis provides evidence supporting a potential causal relationship between hypertension and an increased risk of certain types of vertigo. These findings contribute to the understanding of risk factors and the early prediction of vertigo.