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Published in: BMC Primary Care 1/2013

Open Access 01-12-2013 | Research article

Primary care patient willingness for genetic testing for salt-sensitive hypertension: a cross sectional study

Authors: Masanobu Okayama, Taro Takeshima, Ryusuke Ae, Masanori Harada, Eiji Kajii

Published in: BMC Primary Care | Issue 1/2013

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Abstract

Background

The current research into single nucleotide polymorphisms has extended the role of genetic testing to the identification of increased risk for common medical conditions. Advances in genetic research may soon necessitate preparation for the role of genetic testing in primary care medicine. This study attempts to determine what proportion of patients would be willing to undergo genetic testing for salt-sensitive hypertension in a primary care setting, and what factors are related to this willingness.

Methods

A cross-sectional study using a self-report questionnaire was conducted among outpatients in primary care clinics and hospitals in Japan. The main characteristics measured were education level, family medical history, personal medical history, concern about hypertension, salt preference, reducing salt intake, and willingness to undergo genetic testing for salt-sensitive hypertension.

Results

Of 1,932 potential participants, 1,457 (75%) responded to the survey. Of the respondents, 726 (50%) indicated a willingness to undergo genetic testing. Factors related to this willingness were being over 50 years old (adjusted odds ratio [ad-OR] = 1.42, 95% Confidence interval = 1.09 – 1.85), having a high level of education (ad-OR: 1.83, 1.38 – 2.42), having a family history of hypertension (ad-OR: 1.36, 1.09 – 1.71), and worrying about hypertension (ad-OR: 2.06, 1.59 – 2.68).

Conclusions

Half of the primary care outpatients surveyed in this study wanted to know their genetic risk for salt-sensitive hypertension. Those who were worried about hypertension or had a family history of hypertension were more likely to be interested in getting tested. These findings suggest that primary care physicians should provide patients with advice on genetic testing, as well as address their anxieties and concerns related to developing hypertension.
Literature
1.
go back to reference Manolio TA, Collins FS, Cox NJ, Goldstein DB, Hindorff LA, Hunter DJ, McCarthy MI, Ramos EM, Cardon LR, Chakravarti A, et al: Finding the missing heritability of complex diseases. Nature. 2009, 461 (7265): 747-753. 10.1038/nature08494.CrossRefPubMedPubMedCentral Manolio TA, Collins FS, Cox NJ, Goldstein DB, Hindorff LA, Hunter DJ, McCarthy MI, Ramos EM, Cardon LR, Chakravarti A, et al: Finding the missing heritability of complex diseases. Nature. 2009, 461 (7265): 747-753. 10.1038/nature08494.CrossRefPubMedPubMedCentral
3.
go back to reference Tuckson RV, Newcomer L, De Sa JM: Accessing genomic medicine: affordability, diffusion, and disparities. JAMA. 2013, 309 (14): 1469-1470. 10.1001/jama.2013.1468.CrossRefPubMed Tuckson RV, Newcomer L, De Sa JM: Accessing genomic medicine: affordability, diffusion, and disparities. JAMA. 2013, 309 (14): 1469-1470. 10.1001/jama.2013.1468.CrossRefPubMed
4.
go back to reference Borry P, Cornel MC, Howard HC: Where are you going, where have you been: a recent history of the direct-to-consumer genetic testing market. J Community Genet. 2010, 1 (3): 101-106. 10.1007/s12687-010-0023-z.CrossRefPubMedPubMedCentral Borry P, Cornel MC, Howard HC: Where are you going, where have you been: a recent history of the direct-to-consumer genetic testing market. J Community Genet. 2010, 1 (3): 101-106. 10.1007/s12687-010-0023-z.CrossRefPubMedPubMedCentral
5.
go back to reference Mutch DM, Wahli W, Williamson G: Nutrigenomics and nutrigenetics: the emerging faces of nutrition. FASEB J. 2005, 19 (12): 1602-1616. 10.1096/fj.05-3911rev.CrossRefPubMed Mutch DM, Wahli W, Williamson G: Nutrigenomics and nutrigenetics: the emerging faces of nutrition. FASEB J. 2005, 19 (12): 1602-1616. 10.1096/fj.05-3911rev.CrossRefPubMed
6.
go back to reference Morren M, Rijken M, Baanders AN, Bensing J: Perceived genetic knowledge, attitudes towards genetic testing, and the relationship between these among patients with a chronic disease. Patient Educ Couns. 2007, 65 (2): 197-204. 10.1016/j.pec.2006.07.005.CrossRefPubMed Morren M, Rijken M, Baanders AN, Bensing J: Perceived genetic knowledge, attitudes towards genetic testing, and the relationship between these among patients with a chronic disease. Patient Educ Couns. 2007, 65 (2): 197-204. 10.1016/j.pec.2006.07.005.CrossRefPubMed
7.
8.
go back to reference Scheuner MT, Wang SJ, Raffel LJ, Larabell SK, Rotter JI: Family history: a comprehensive genetic risk assessment method for the chronic conditions of adulthood. Am J Med Genet. 1997, 71 (3): 315-324. 10.1002/(SICI)1096-8628(19970822)71:3<315::AID-AJMG12>3.0.CO;2-N.CrossRefPubMed Scheuner MT, Wang SJ, Raffel LJ, Larabell SK, Rotter JI: Family history: a comprehensive genetic risk assessment method for the chronic conditions of adulthood. Am J Med Genet. 1997, 71 (3): 315-324. 10.1002/(SICI)1096-8628(19970822)71:3<315::AID-AJMG12>3.0.CO;2-N.CrossRefPubMed
9.
go back to reference O’Neill SC, Brewer NT, Lillie SE, Morrill EF, Dees EC, Carey LA, Rimer BK: Women’s interest in gene expression analysis for breast cancer recurrence risk. J Clin Oncol. 2007, 25 (29): 4628-4634. 10.1200/JCO.2006.09.6255.CrossRefPubMed O’Neill SC, Brewer NT, Lillie SE, Morrill EF, Dees EC, Carey LA, Rimer BK: Women’s interest in gene expression analysis for breast cancer recurrence risk. J Clin Oncol. 2007, 25 (29): 4628-4634. 10.1200/JCO.2006.09.6255.CrossRefPubMed
10.
go back to reference Esplen MJ, Madlensky L, Aronson M, Rothenmund H, Gallinger S, Butler K, Toner B, Wong J, Manno M, McLaughlin J: Colorectal cancer survivors undergoing genetic testing for hereditary non-polyposis colorectal cancer: motivational factors and psychosocial functioning. Clin Genet. 2007, 72 (5): 394-401. 10.1111/j.1399-0004.2007.00893.x.CrossRefPubMed Esplen MJ, Madlensky L, Aronson M, Rothenmund H, Gallinger S, Butler K, Toner B, Wong J, Manno M, McLaughlin J: Colorectal cancer survivors undergoing genetic testing for hereditary non-polyposis colorectal cancer: motivational factors and psychosocial functioning. Clin Genet. 2007, 72 (5): 394-401. 10.1111/j.1399-0004.2007.00893.x.CrossRefPubMed
11.
go back to reference Metcalfe KA, Fan I, McLaughlin J, Risch HA, Rosen B, Murphy J, Bradley L, Armel S, Sun P, Narod SA: Uptake of clinical genetic testing for ovarian cancer in Ontario: a population-based study. Gynecol Oncol. 2009, 112 (1): 68-72. 10.1016/j.ygyno.2008.10.007.CrossRefPubMed Metcalfe KA, Fan I, McLaughlin J, Risch HA, Rosen B, Murphy J, Bradley L, Armel S, Sun P, Narod SA: Uptake of clinical genetic testing for ovarian cancer in Ontario: a population-based study. Gynecol Oncol. 2009, 112 (1): 68-72. 10.1016/j.ygyno.2008.10.007.CrossRefPubMed
12.
go back to reference Mogilner A, Otten M, Cunningham JD, Brower ST: Awareness and attitudes concerning BRCA gene testing. Ann Surg Oncol. 1998, 5 (7): 607-612. 10.1007/BF02303830.CrossRefPubMed Mogilner A, Otten M, Cunningham JD, Brower ST: Awareness and attitudes concerning BRCA gene testing. Ann Surg Oncol. 1998, 5 (7): 607-612. 10.1007/BF02303830.CrossRefPubMed
13.
go back to reference Collins V, Halliday J, Warren R, Williamson R: Cancer worries, risk perceptions and associations with interest in DNA testing and clinic satisfaction in a familial colorectal cancer clinic. Clin Genet. 2000, 58 (6): 460-468.CrossRefPubMed Collins V, Halliday J, Warren R, Williamson R: Cancer worries, risk perceptions and associations with interest in DNA testing and clinic satisfaction in a familial colorectal cancer clinic. Clin Genet. 2000, 58 (6): 460-468.CrossRefPubMed
14.
go back to reference Bruno M, Digennaro M, Tommasi S, Stea B, Danese T, Schittulli F, Paradiso A: Attitude towards genetic testing for breast cancer susceptibility: a comparison of affected and unaffected women. Eur J Cancer Care (Engl). 2010, 19 (3): 360-368. 10.1111/j.1365-2354.2009.01067.x.CrossRef Bruno M, Digennaro M, Tommasi S, Stea B, Danese T, Schittulli F, Paradiso A: Attitude towards genetic testing for breast cancer susceptibility: a comparison of affected and unaffected women. Eur J Cancer Care (Engl). 2010, 19 (3): 360-368. 10.1111/j.1365-2354.2009.01067.x.CrossRef
15.
go back to reference Bloss CS, Ornowski L, Silver E, Cargill M, Vanier V, Schork NJ, Topol EJ: Consumer perceptions of direct-to-consumer personalized genomic risk assessments. Genet Med. 2010, 12 (9): 556-566. 10.1097/GIM.0b013e3181eb51c6.CrossRefPubMed Bloss CS, Ornowski L, Silver E, Cargill M, Vanier V, Schork NJ, Topol EJ: Consumer perceptions of direct-to-consumer personalized genomic risk assessments. Genet Med. 2010, 12 (9): 556-566. 10.1097/GIM.0b013e3181eb51c6.CrossRefPubMed
16.
go back to reference Anderson RT, Press N, Tucker DC, Snively BM, Wenzel L, Ellis SD, Hall MA, Walker AP, Thomson EJ, Lewis-Jack O, et al: Patient acceptability of genotypic testing for hemochromatosis in primary care. Genet Med. 2005, 7 (8): 557-563. 10.1097/01.GIM.0000177531.53338.65.CrossRefPubMed Anderson RT, Press N, Tucker DC, Snively BM, Wenzel L, Ellis SD, Hall MA, Walker AP, Thomson EJ, Lewis-Jack O, et al: Patient acceptability of genotypic testing for hemochromatosis in primary care. Genet Med. 2005, 7 (8): 557-563. 10.1097/01.GIM.0000177531.53338.65.CrossRefPubMed
17.
go back to reference Amin TT, Al-Wadaani HA, Al-Quaimi MM, Aldairi NA, Alkhateeb JM, Al-Jaafari AA: Saudi women’s interest in breast cancer gene testing: possible influence of awareness, perceived risk and socio-demographic factors. Asian Pac J Cancer Prev. 2012, 13 (8): 3879-3887. 10.7314/APJCP.2012.13.8.3879.CrossRefPubMed Amin TT, Al-Wadaani HA, Al-Quaimi MM, Aldairi NA, Alkhateeb JM, Al-Jaafari AA: Saudi women’s interest in breast cancer gene testing: possible influence of awareness, perceived risk and socio-demographic factors. Asian Pac J Cancer Prev. 2012, 13 (8): 3879-3887. 10.7314/APJCP.2012.13.8.3879.CrossRefPubMed
18.
go back to reference Egan BM, Zhao Y, Axon RN: US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008. JAMA. 2010, 303 (20): 2043-2050. 10.1001/jama.2010.650.CrossRefPubMed Egan BM, Zhao Y, Axon RN: US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008. JAMA. 2010, 303 (20): 2043-2050. 10.1001/jama.2010.650.CrossRefPubMed
20.
go back to reference Intersalt Cooperative Research Group: Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. Intersalt Cooperative Research Group. BMJ. 1988, 297 (6644): 319-328.CrossRef Intersalt Cooperative Research Group: Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. Intersalt Cooperative Research Group. BMJ. 1988, 297 (6644): 319-328.CrossRef
21.
go back to reference Katsuya T, Ishikawa K, Sugimoto K, Rakugi H, Ogihara T: Salt sensitivity of Japanese from the viewpoint of gene polymorphism. Hypertens Res. 2003, 26 (7): 521-525. 10.1291/hypres.26.521.CrossRefPubMed Katsuya T, Ishikawa K, Sugimoto K, Rakugi H, Ogihara T: Salt sensitivity of Japanese from the viewpoint of gene polymorphism. Hypertens Res. 2003, 26 (7): 521-525. 10.1291/hypres.26.521.CrossRefPubMed
22.
go back to reference Kanazawa M, Yoshiike N, Osaka T, Numba Y, Zimmet P, Inoue S: Criteria and classification of obesity in Japan and Asia-Oceania. World Rev Nutr Diet. 2005, 94: 1-12.CrossRefPubMed Kanazawa M, Yoshiike N, Osaka T, Numba Y, Zimmet P, Inoue S: Criteria and classification of obesity in Japan and Asia-Oceania. World Rev Nutr Diet. 2005, 94: 1-12.CrossRefPubMed
23.
go back to reference Khoury MJ, McBride CM, Schully SD, Ioannidis JP, Feero WG, Janssens AC, Gwinn M, Simons-Morton DG, Bernhardt JM, Cargill M, et al: The Scientific Foundation for personal genomics: recommendations from a National Institutes of Health-Centers for Disease Control and Prevention multidisciplinary workshop. Genet Med. 2009, 11 (8): 559-567. 10.1097/GIM.0b013e3181b13a6c.CrossRefPubMedPubMedCentral Khoury MJ, McBride CM, Schully SD, Ioannidis JP, Feero WG, Janssens AC, Gwinn M, Simons-Morton DG, Bernhardt JM, Cargill M, et al: The Scientific Foundation for personal genomics: recommendations from a National Institutes of Health-Centers for Disease Control and Prevention multidisciplinary workshop. Genet Med. 2009, 11 (8): 559-567. 10.1097/GIM.0b013e3181b13a6c.CrossRefPubMedPubMedCentral
24.
go back to reference Bagos PG, Elefsinioti AL, Nikolopoulos GK, Hamodrakas SJ: The GNB3 C825T polymorphism and essential hypertension: a meta-analysis of 34 studies including 14,094 cases and 17,760 controls. J Hypertens. 2007, 25 (3): 487-500. 10.1097/HJH.0b013e328011db24.CrossRefPubMed Bagos PG, Elefsinioti AL, Nikolopoulos GK, Hamodrakas SJ: The GNB3 C825T polymorphism and essential hypertension: a meta-analysis of 34 studies including 14,094 cases and 17,760 controls. J Hypertens. 2007, 25 (3): 487-500. 10.1097/HJH.0b013e328011db24.CrossRefPubMed
25.
go back to reference Pereira TV, Nunes AC, Rudnicki M, Yamada Y, Pereira AC, Krieger JE: Meta-analysis of the association of 4 angiotensinogen polymorphisms with essential hypertension: a role beyond M235T?. Hypertension. 2008, 51 (3): 778-783. 10.1161/HYPERTENSIONAHA.107.100370.CrossRefPubMed Pereira TV, Nunes AC, Rudnicki M, Yamada Y, Pereira AC, Krieger JE: Meta-analysis of the association of 4 angiotensinogen polymorphisms with essential hypertension: a role beyond M235T?. Hypertension. 2008, 51 (3): 778-783. 10.1161/HYPERTENSIONAHA.107.100370.CrossRefPubMed
26.
go back to reference Phillips CM: Nutrigenetics and metabolic disease: current status and implications for personalised nutrition. Nutrients. 2013, 5 (1): 32-57. 10.3390/nu5010032.CrossRefPubMedPubMedCentral Phillips CM: Nutrigenetics and metabolic disease: current status and implications for personalised nutrition. Nutrients. 2013, 5 (1): 32-57. 10.3390/nu5010032.CrossRefPubMedPubMedCentral
27.
go back to reference Hutson SP: Attitudes and psychological impact of genetic testing, genetic counseling, and breast cancer risk assessment among women at increased risk. Oncol Nurs Forum. 2003, 30 (2): 241-246. 10.1188/03.ONF.241-246.CrossRefPubMed Hutson SP: Attitudes and psychological impact of genetic testing, genetic counseling, and breast cancer risk assessment among women at increased risk. Oncol Nurs Forum. 2003, 30 (2): 241-246. 10.1188/03.ONF.241-246.CrossRefPubMed
28.
go back to reference Scheuner MT, Sieverding P, Shekelle PG: Delivery of genomic medicine for common chronic adult diseases: a systematic review. JAMA. 2008, 299 (11): 1320-1334. 10.1001/jama.299.11.1320.CrossRefPubMed Scheuner MT, Sieverding P, Shekelle PG: Delivery of genomic medicine for common chronic adult diseases: a systematic review. JAMA. 2008, 299 (11): 1320-1334. 10.1001/jama.299.11.1320.CrossRefPubMed
29.
go back to reference Cyr A, Dunnagan TA, Haynes G: Efficacy of the health belief model for predicting intention to pursue genetic testing for colorectal cancer. J Genet Couns. 2010, 19 (2): 174-186. 10.1007/s10897-009-9271-7.CrossRefPubMed Cyr A, Dunnagan TA, Haynes G: Efficacy of the health belief model for predicting intention to pursue genetic testing for colorectal cancer. J Genet Couns. 2010, 19 (2): 174-186. 10.1007/s10897-009-9271-7.CrossRefPubMed
30.
go back to reference Jones DL, Clayton EW: The role of distress in uptake and response to predisposition genetic testing: the BMPR2 experience. Genet Test Mol Biomarkers. 2012, 16 (3): 203-209. 10.1089/gtmb.2011.0059.CrossRefPubMedPubMedCentral Jones DL, Clayton EW: The role of distress in uptake and response to predisposition genetic testing: the BMPR2 experience. Genet Test Mol Biomarkers. 2012, 16 (3): 203-209. 10.1089/gtmb.2011.0059.CrossRefPubMedPubMedCentral
31.
go back to reference Bloss CS, Schork NJ, Topol EJ: Effect of direct-to-consumer genomewide profiling to assess disease risk. N Engl J Med. 2011, 364 (6): 524-534. 10.1056/NEJMoa1011893.CrossRefPubMedPubMedCentral Bloss CS, Schork NJ, Topol EJ: Effect of direct-to-consumer genomewide profiling to assess disease risk. N Engl J Med. 2011, 364 (6): 524-534. 10.1056/NEJMoa1011893.CrossRefPubMedPubMedCentral
32.
go back to reference James KM, Cowl CT, Tilburt JC, Sinicrope PS, Robinson ME, Frimannsdottir KR, Tiedje K, Koenig BA: Impact of direct-to-consumer predictive genomic testing on risk perception and worry among patients receiving routine care in a preventive health clinic. Mayo Clin Proc. 2011, 86 (10): 933-940. 10.4065/mcp.2011.0190.CrossRefPubMedPubMedCentral James KM, Cowl CT, Tilburt JC, Sinicrope PS, Robinson ME, Frimannsdottir KR, Tiedje K, Koenig BA: Impact of direct-to-consumer predictive genomic testing on risk perception and worry among patients receiving routine care in a preventive health clinic. Mayo Clin Proc. 2011, 86 (10): 933-940. 10.4065/mcp.2011.0190.CrossRefPubMedPubMedCentral
33.
go back to reference Bredart A, Kop JL, Depauw A, Caron O, Sultan S, Leblond D, Fajac A, Buecher B, Gauthier-Villars M, Nogues C, et al: Short-term psychological impact of the BRCA1/2 test result in women with breast cancer according to their perceived probability of genetic predisposition to cancer. Br J Cancer. 2013, 108 (5): 1012-1020. 10.1038/bjc.2012.599.CrossRefPubMedPubMedCentral Bredart A, Kop JL, Depauw A, Caron O, Sultan S, Leblond D, Fajac A, Buecher B, Gauthier-Villars M, Nogues C, et al: Short-term psychological impact of the BRCA1/2 test result in women with breast cancer according to their perceived probability of genetic predisposition to cancer. Br J Cancer. 2013, 108 (5): 1012-1020. 10.1038/bjc.2012.599.CrossRefPubMedPubMedCentral
34.
go back to reference Offit K: Genomic profiles for disease risk: predictive or premature?. JAMA. 2008, 299 (11): 1353-1355. 10.1001/jama.299.11.1353.CrossRefPubMed Offit K: Genomic profiles for disease risk: predictive or premature?. JAMA. 2008, 299 (11): 1353-1355. 10.1001/jama.299.11.1353.CrossRefPubMed
35.
go back to reference Hashimoto T, Yagami F, Owada M, Sugawara T, Kawamura M: Salt preference according to a questionnaire vs. dietary salt intake estimated by a spot urine method in participants at a health check-up center. Intern Med. 2008, 47 (5): 399-403. 10.2169/internalmedicine.47.0622.CrossRefPubMed Hashimoto T, Yagami F, Owada M, Sugawara T, Kawamura M: Salt preference according to a questionnaire vs. dietary salt intake estimated by a spot urine method in participants at a health check-up center. Intern Med. 2008, 47 (5): 399-403. 10.2169/internalmedicine.47.0622.CrossRefPubMed
Metadata
Title
Primary care patient willingness for genetic testing for salt-sensitive hypertension: a cross sectional study
Authors
Masanobu Okayama
Taro Takeshima
Ryusuke Ae
Masanori Harada
Eiji Kajii
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2013
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-14-149

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