Our observation of 9-10 mm Hg higher BP at age 50+ years when comparing the top vs bottom fifths of the BP GRS distribution has potential clinical and public health implications. We stratified by age due to a significant interaction of the GRS with age (P ranging between 9.96×10-11 and 1.16×10-3 for interaction with continuous BP traits, P = 0.012 for hypertension). Measuring the GRS in early life raises the possibility of adopting an early precision medicine approach to offset the genetic risk through lifestyle intervention (i.e. reduced sodium intake, increased potassium intake, maintenance of optimal weight, low adult alcohol consumption and regular exercise)58–60. Studies of non-pharmacologic approaches to BP control indicate that 10 mm Hg or more reduction in SBP is an achievable goal through lifestyle measures alone61, while recent evidence suggests that favorable lifestyle may offset the cardiovascular sequelae associated with high genetic risk62. As the above data are observational, the extent to which adherence to lifestyle recommendations amongst high genetic risk individuals might result in favorable outcomes remains uncertain; given the substantial effect of GRS on BP
