rs699

badMag 3.5

This is a variant in the AGT gene that changes a methionine to an threonine.

Key Literature Trait Associations

Hypertension Risk

Angiotensinogen (AGT) is the precursor protein that the renin-angiotensin system converts into angiotensin II, a blood-vessel constrictor and sodium balance regulator. The rs699 variant (M235T) results in higher circulating angiotensinogen levels. A meta-analysis found TT vs MM genotype OR of 1.21 (95% CI 1.11–1.32) for essential hypertension. The variant interacts with dietary sodium and potassium intake.

Allele G
OR 1.19
p
Meta-analysis
multi-ancestry
Allele G
OR
p 7.3e-10
N 17,000
Meta-analysisLarge GWAS
East Asian
Allele G
OR 1.80
p
Meta-analysis
African
Maamor NH et al. AGT, CYP11B2 & ADRB2 gene polymorphism & essential hypertension (HT): A meta-analysis. The Indian Journal of Medical Research (2024)
Allele G
OR 1.37
p 3.0e-2
Meta-analysis
South Asian

Preeclampsia

The G (Thr235) allele of rs699 is associated with increased preeclampsia risk, particularly in TT homozygotes. A 2008 meta-analysis (17 studies, 1,446 cases, 3,829 controls) found TT homozygotes 1.62× more likely to develop preeclampsia/eclampsia (95% CI 1.12–2.33; P=0.01), with stronger effects in Caucasians (OR=1.99) than East Asians. A 2012 meta-analysis of 22 studies confirmed the TT genotype elevates preeclampsia risk. However, a 2016 updated meta-analysis (n=45,547) found no significant association, highlighting ongoing uncertainty — the overall evidence remains mixed.

Allele G
OR 1.62
p 1.0e-2
N 5,275
Meta-analysis
multi-ancestry
Zhang G et al. Association Between Gene Polymorphisms on Chromosome 1 and Susceptibility to Pre-Eclampsia: An Updated Meta-Analysis. Medical Science Monitor : International Medical Journal of Experimental and Clinical Research (2016)
Allele G
OR
p 4.8e-1
N 45,547
Meta-analysis
multi-ancestry
Ni S et al. AGT M235T polymorphism contributes to risk of preeclampsia: evidence from a meta-analysis. Journal of the Renin-angiotensin-aldosterone System : Jraas (2012)
Allele G
OR
p
Meta-analysis
multi-ancestry

Systolic blood pressure

The G allele of rs699 is robustly associated with higher systolic blood pressure at genome-wide significance in large GWAS datasets. GWAS Catalog entries for rs699 show beta estimates of +0.29 to +0.33 mmHg per allele for SBP at p-values as low as 3×10⁻²⁶, replicated across multiple independent cohorts. A prospective cohort of 18,436 Caucasian women found a non-significant HR=1.04 for blood pressure progression, suggesting the SBP effect is modest per allele but robustly detectable in adequately-powered studies. The AGT M235T association with blood pressure is mechanistically supported by elevated circulating angiotensinogen levels in G allele carriers.

Allele G
OR
β 0.292
p 6.0e-26
N 19,426
Meta-analysisLarge GWAS
East Asian

Diastolic blood pressure

The G allele (Thr235) of rs699 is associated with higher diastolic blood pressure at genome-wide significance. GWAS Catalog entries show beta values of +0.02 to +0.33 SD units for DBP at p-values ranging from 7×10⁻³⁸ to 3×10⁻⁹ across multiple large studies. The AGT M235T variant's effect on diastolic BP is mechanistically mediated through elevated plasma angiotensinogen and increased angiotensin II production, a well-established RAAS mechanism. Effects are consistently replicated but small in absolute magnitude per allele.

Allele G
OR
β 0.216
p 7.0e-46
N 19,426
Meta-analysisLarge GWAS
East Asian

Chronic kidney disease

Evidence on rs699 and chronic kidney disease is mixed but leans toward the G (Thr235) allele being associated with increased CKD risk, while the A (Met235) allele may be protective. A 2019 systematic review and meta-analysis of 114 RAAS gene studies found the rs699-T (A allele on minus strand) associated with reduced CKD risk across multiple ethnicities. A 2025 case-control study (n=380) confirmed the A allele was more frequent in controls (46.9%) than CKD cases (35.3%; p=0.001). Mechanistically, higher angiotensinogen from the G allele promotes glomerular hypertension, consistent with known RAAS nephrotoxicity.

Allele G
OR
p 1.0e-3
N 380
Candidate gene study
South Asian

Plasma angiotensinogen levels

The G allele (Thr235) of rs699 is consistently associated with higher circulating angiotensinogen levels — the molecular mechanism underlying its blood pressure effects. The landmark 2003 meta-analysis of 127 studies quantified a stepwise increase: ~5% higher plasma AGT in heterozygotes and ~11% higher in TT homozygotes (vs MM). GWAS Catalog associations for rs699 with 'blood protein amount' (beta=0.182, p=3×10⁻⁸) corroborate this at a proteomic level. This functional molecular phenotype is one of the best-characterized genotype-to-phenotype mechanisms for any common blood pressure variant.

Allele G
OR
p
Meta-analysis
multi-ancestry

GWAS Catalog Trait Associations (6)

Genome-wide significant associations (p < 5×10⁻⁸) from the NHGRI-EBI GWAS Catalog.

ClinVar annotation

Benign★★★
11 submitters12 publications

Hypertension, essential, susceptibility to; not specified; Renal tubular dysgenesis; not provided; Hypertensive disorder

View on ClinVar →

Research that mentions this SNP (9)

Genetic variation of FTO: rs1421085 T&gt;C, rs8057044 G&gt;A, rs9939609 T&gt;A, and copy number (CNV) in Mexican Mayan school‐aged children with obesity/overweight and with normal weight
ReviewLizbeth González‐Herrera et al.(2019)· American Journal of Human Biology

A literature review of 70 studies examining single nucleotide polymorphisms (SNPs) associated with obesity in Mexican populations published 2011-2021. The authors identified SNPs with differential behavior in Mexican compared to Caucasian populations, including rs17782313 (MC4R), rs6548238 (TMEM18), rs6265 (BDNF), rs7498665 (SH2B1), and notably rs6232 (PCSK1) associated with early-onset obesity in Mexican youth. The review emphasizes ethnicity-dependent genetic effects on BMI heritability (40-70%) and highlights genes involved in cholesterol metabolism and adipokine signaling pathways.

Traits studied:AdiposityBlood pressureBody mass index (BMI)Cardiovascular risk factorsDyslipidemiaInsulin resistanceMetabolic syndromeObesityOverweightType 2 diabetes
Genetic variants conferring susceptibility to gastroschisis: a phenomenon restricted to the interaction with the environment?
Meta-analysisN=434Victor M. Salinas-Torres et al.(2018)· Pediatric Surgery International

This systematic review analyzed genetic associations with gastroschisis from 1980-2017, identifying 14 SNPs from 10 genes associated with crude risk and 30 SNPs from 14 genes with stratified risk. Four SNPs showed significant associations: rs4961 (ADD1, p=0.023), rs5443 (GNB3, p=0.002), rs1042713 (ADRB2, p=0.007), and rs1042714 (ADRB2, p=0.006). The findings suggest genetic susceptibility in gastroschisis is not restricted to gene-environment interactions, with blood pressure regulation genes playing a significant role in vascular disruption pathogenesis.

Traits studied:Gastroschisis
Human loci involved in drug biotransformation: worldwide genetic variation, population structure, and pharmacogenetic implications
ReviewPierpaolo Maisano Delser et al.(2013)· Human Genetics

This population genetic analysis examined 1,001 pharmacogenetic SNPs across 52 populations from the Human Genome Diversity Cell-Line Panel using discriminant analysis to characterize global genetic variation in drug-metabolizing loci. The study identified six geographic genetic clusters and found that cytochrome P450 genes show significantly higher genetic diversity between populations compared to other gene categories. Key variants rs1403527 (NR1I2) and rs699 (AGT) were identified as substantially contributing to population differentiation, with genetic variation patterns reflecting human demographic history.

Traits studied:Drug responsePharmacogenetic traits
Patatin-like phospholipase domain-containing 3 I148M affects liver steatosis in patients with chronic hepatitis B
ReviewMauro Viganò et al.(2013)· Hepatology

This comprehensive review examines the genetic background of nonalcoholic fatty liver disease (NAFLD), focusing on variants identified by genome-wide association studies (GWAS) and candidate gene studies. The most significant GWAS-identified variants are PNPLA3 rs738409 (I148M), which strongly associates with increased liver steatosis, fibrosis severity, and HCC risk (12-fold increased risk for homozygous carriers), and TM6SF2 rs58542926 (E167K), which increases NASH progression but reduces cardiovascular risk. The review also discusses numerous candidate genes involved in lipid and glucose metabolism and liver injury mechanisms.

Traits studied:Cardiovascular diseaseChronic kidney diseaseCirrhosisHepatic injuryHepatic steatosisHepatocellular carcinomaInsulin resistanceLipid metabolismLiver fibrosisMetabolic syndromeNecroinflammationNonalcoholic fatty liver disease (NAFLD)Nonalcoholic steatohepatitis (NASH)ObesityType 2 diabetes
Associations of polymorphisms in the genes of FGFR2, FGF1, and RBFOX2 with breast cancer risk by estrogen/progesterone receptor status
AssociationN=2,416Yu‐Ling Cen et al.(2013)· Molecular Carcinogenesis

A hospital-based case-control study in rural and urban India (1,204 cases; 1,212 controls) examined genetic and lifestyle risk factors for breast cancer. Four SNPs in FGFR2 (rs1219648, rs2420946, rs2981575, rs2981582) showed positive associations with breast cancer (ORs 1.32-1.47). Additional SNPs in obesity and metabolic genes (rs374748 in FBN2, rs2922763 in HNF4G, rs2116830 in KCNMA1, rs11121832 in MTHFR, rs16886165 in MAP3K1, rs11594610 in TCF7L2, rs2274459 in MLN) were associated with increased breast cancer risk. Waist-to-hip ratio ≥0.95 showed strong association (OR 3.78; 95% CI 2.92-4.89), and women living first 20 years in rural areas showed protective effect (OR 0.77).

Traits studied:Breast cancerBreast cancer riskER+/PR+ breast cancerER/PR negative breast cancerTriple negative breast cancer
Genome‐wide association studies of cerebral white matter lesion burden
Meta-analysisN=12,385Fornage M. et al.(2011)· Annals of Neurology

Genome-wide meta-analysis of 9,361 Europeans identified six genome-wide significant SNPs on chromosome 17q25 associated with white matter hyperintensity (WMH) burden. The most significant SNP, rs3744028 (P = 4.0×10⁻⁹ discovery, P = 1.3×10⁻⁷ replication, P = 4.0×10⁻¹⁵ combined), and rs1055129 were replicated in 3,024 additional individuals. Risk alleles increased WMH burden by 4-8% of mean burden.

Traits studied:Cerebral white matter lesionsWhite matter hyperintensities (WMH) burden
Dissociation betweenAPOC3variants, hepatic triglyceride content and insulin resistance
ReviewJulia Kozlitina et al.(2011)· Hepatology

Comprehensive review of genetic background in nonalcoholic fatty liver disease (NAFLD). The PNPLA3 I148M variant (rs738409 C>G) is identified as a major genetic player strongly associated with increased liver fat content, NASH development, fibrosis severity, and HCC risk. The TM6SF2 E167K variant (rs58542926) emerges as another key contributor to NAFLD pathogenesis and disease progression. Multiple additional GWAS-identified variants and candidate genes are reviewed for their roles in NAFLD susceptibility and progression.

Traits studied:Alcoholic liver diseaseCardiovascular diseaseChronic kidney diseaseHCCHepatic steatosisHepatic triglyceridesHepatitis B steatosisHepatitis C progressionHepatocellular carcinomaInsulin resistanceLipid metabolismLiver fat contentLiver fibrosisNAFLDNASHNecroinflammationNonalcoholic fatty liver diseaseNonalcoholic steatohepatitisType 2 diabetes
Male–female differences in the genetic regulation of t-PA and PAI-1 levels in a Ghanaian population
AssociationN=992Schoenhard JA et al.(2008)· Human Genetics

This population-based study of 992 Ghanaian residents examined genetic and non-genetic determinants of tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) levels, factors associated with thromboembolic disease risk. The PAI-1 4G/5G (rs1799768) polymorphism predicted PAI-1 levels in females, while the t-PA I/D (rs4646972), and renin polymorphisms (rs3730103, rs1464816) showed gender-specific associations with t-PA and PAI-1. Both traditional cardiovascular risk factors (BMI, blood pressure, glucose, lipids) and genetic variants contributed to t-PA and PAI-1 variation, with genetic factors differing significantly between males and females.

Traits studied:Cardiovascular disease riskPAI-1 (plasminogen activator inhibitor-1) levelsThromboembolic diseaset-PA (tissue-type plasminogen activator) levels
Diuretic Therapy, the α-Adducin Gene Variant, and the Risk of Myocardial Infarction or Stroke in Persons With Treated Hypertension
MethodsN=5,126Psaty BM et al.(2002)· JAMA

This is a study design and baseline characteristics paper for a nested case-control pharmacogenetic study of antihypertensive drug treatment. The study recruited 5,126 participants (794 myocardial infarction cases, 4,997 controls) through Dutch community pharmacies to assess whether specific genetic polymorphisms in renin-angiotensin system genes (AGT, ACE, AGTR1), alpha-adducin (ADD1), and other cardiovascular-related genes (GNB3, NOS3) modify the effect of antihypertensive drugs on myocardial infarction risk. The paper presents recruitment methodology, participant baseline characteristics, and selected genetic polymorphisms for analysis rather than association results.

Traits studied:Blood pressure response to antihypertensive drugsHypertensionMyocardial infarction

Gene information from NCBI Gene. Variant classifications from ClinVar.

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