supplementary materials provide complete methods and include the following sections : study recruitment and phenotyping , adjustment for antihypertensive medications , genotyping , data quality control , genotype imputation , within - cohort association analyses , meta - analyses of discovery and validation stages , stratified analyses by sex and bmi , identification of esnps and nssnps , metabolomic and lipidomic analyses , cnv analyses , pathway analyses , analyses for non - european ancestries , association of a risk score with hypertension and cardiovascular disease , estimation of numbers of undiscovered variants , measurement of natriuretic peptides , and brief literature reviews and gwas database lookups of all validated bp loci .
blood pressure ( bp ) is a heritable trait1 influenced by multiple biological pathways and is responsive to environmental stimuli . 
 over one billion people worldwide have hypertension ( bp 140 mm hg systolic [ sbp ] or 90 mm hg diastolic [ dbp])2 . even small increments in bp are associated with increased risk of cardiovascular events3 . 
 this genome - wide association study of sbp and dbp , which used a multi - stage design in 200,000 individuals of european descent , identified 16 novel loci : six of these loci contain genes previously known or suspected to regulate bp ( gucy1a3-gucy1b3 ; npr3-c5orf23 ; adm ; furin - fes ; gosr2 ; gnas - edn3 ) ; the other 10 provide new clues to bp physiology . a genetic risk score based on 29 genome - wide significant variants 
 was associated with hypertension , left ventricular wall thickness , stroke , and coronary artery disease , but not kidney disease or kidney function . 
 we also observed associations with bp in east asian , south asian , and african ancestry individuals . 
 our findings provide new insights into the genetics and biology of bp , and suggest novel potential therapeutic pathways for cardiovascular disease prevention .