title: Does a medical history of hypertension influence disclosing genetic testing results of the risk for salt-sensitive hypertension, in primary care?
abstract: OBJECTIVE
  Disclosing genetic testing results may contribute to the prevention and management of many common diseases. However, whether the presence of a disease influences these effects is unclear. This study aimed to clarify the difference in the effects of disclosing genetic testing results of the risk for developing salt-sensitive hypertension on the behavioral modifications with respect to salt intake in hypertensive and nonhypertensive patients.
  
  
  METHODS
  A cross-sectional study using a self-administered questionnaire was conducted for outpatients aged >20 years (N=2,237) at six primary care clinics and hospitals in Japan. The main factors assessed were medical histories of hypertension, salt preferences, reduced salt intakes, and behavior modifications for reducing salt intake. Behavioral modifications of participants were assessed using their behavior stages before and after disclosure of the hypothetical genetic testing results.
  
  
  RESULTS
  Of the 2,237 participants, 1,644 (73.5%) responded to the survey. Of these respondents, 558 (33.9%) patients were hypertensive and 1,086 (66.1%) were nonhypertensive. After being notified of the result "If with genetic risk", the nonhypertensive participants were more likely to make positive behavioral modifications compared to the hypertensive patients among all participants and in those aged <65 years (adjusted relative ratio [ad-RR], 1.76; 95% confidence interval, 1.12-2.76 and ad-RR, 1.99; 1.11-3.57, respectively). In contrast, no difference in negative behavioral modifications between hypertensive and nonhypertensive patients was detected after being notified of the result "If without genetic risk" (ad-RR, 1.05; 95% confidence interval, 0.70-1.57).
  
  
  CONCLUSIONS
  The behavior of modifying salt intake after disclosure of the genetic testing results differed between hypertensive and nonhypertensive patients. Disclosing a genetic risk for salt-sensitive hypertension was likely to cause nonhypertensive patients, especially those aged <65 years, to improve their behavior regarding salt intake. We conclude that disclosing genetic testing results could help prevent hypertension, and that the doctor should communicate the genetic testing results to those patients with a medical history of hypertension, or those who are at risk of developing hypertension.
authors.affiliation: Division of Community Medicine and Medical Education, Kobe University Graduate School of Medicine, Kobe, Hyogo; Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Okayama
authors.affiliation: Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi.
authors.forename: Taro
authors.initials: T
authors.lastname: Takeshima
authors.affiliation: Department of Support of Rural Medicine, Yamaguchi Grand Medical Center, Hofu, Yamaguchi.
authors.forename: Masanori
authors.initials: M
authors.lastname: Harada
authors.affiliation: Division of Public Health, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Ae
authors.affiliation: Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kajii
keywords: attitude to health; genetic testing; hypertension; outpatient; sodium-restricted