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Does hypertension have a strong genetic component?

57 yr old, Female
57 yr old, Female
asked Sep 16, 2009 at 05:09PM in Other
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  • 1
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    answered Sep 16, 2009 at 07:34PM
    A person’s family health history of having hypertension will put you in a higher risk category for developing hypertension. Genetic factors can contribute to about a thirty percent of cases of essential hypertension (high blood pressure of unknown cause).
    But remember lifestyle choices, i.e., smoking, sedentary lifestyle, over eating, etc. also play a major role in this disease more so than genetics.
  • 2
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    answered Sep 17, 2009 at 11:19AM
    Yes, most hypertension does have a strong genetic component to some extent. In general, hypertension is divided into two sections based on whether the exact underlying mechanism is known or not. Secondary hypertension is relatively rare as far as a cause for elevated blood pressure and can be the result of an underlying hormonal condition (many different hormones can affect blood pressure--cortisol, epinephrine, aldosterone, renin, etc.). Narrowing of particular major arteries such as those that lead to the kidney can also raise blood pressure. These secondary causes for hypertension are usually not considered to have a strong genetic component, but are important to consider as underlying causes because of the potential for "cure".
    The other category is primary or "essential" hypertension, which comprises over 90% of patients. The underlying reasons are less well characterized/understood and probably represent the end result of both genetic and environmental interactions. The genetic component is comparitvely weak in the traditional sense suggesting that it might actually be a combination of genes that together contribute to the net effect of raising blood pressure. However, it is also fairly well recognized that our environmental factors (sedentary lifestyle, obesity, salt, diet, etc) can also contribute to either minimize or amplify an underlying genetic risk.
    In most cases, we define 'genetic risk' as having a first-degree relative who developed high blood pressure before the age of 55 years (the actual age cut-off is variable). In those cases, most people develop essential hypertension in their 30's-40's, again depending on the environmental components, which can either delay or accelerate onset.
  • 1
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    answered Oct 15, 2009 at 06:43PM
    Its a long answer but lately there is a strong genetic link coming along. Especially in the african americans, there seems to be this MYPH9 gene that might be involved in majority of the reasons why that group is more prone to high blood pressure and Kidney diseases. There is great amount of research happening in this field especially in Wake Forrest University under the department of Nephrology
  • 0
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    answered Mar 02, 2010 at 09:56PM
    Very interesting, Kenar. It's tricky to separate the genes from the epigenetics, especially the catalyst of a dietary surplus or deficiency. And I know it's much more interesting for scientists to crunch gene, but we already know quite a bit about causative factors that have ready (and cheap) solutions.

    For example, African Americans might have an even greater magnesium deficiency than the average American is estimated to have. Here are a few citations from a quick search:

    http://jn.nutrition.org/cgi/content/abstract/133/9/2879
    http://www.jfponline.com/Pages.asp?AID=2678&issue=August%201999&UID=

    And this:

    "Low levels of the mineral nutrient, magnesium, may lead to a “cascade” of harmful inflammation-promoting events, according to Dr. Jay H. Kramer of George Washington University and colleagues. This may lead to disease of the heart muscle (cardiomyopathy), increasing vulnerability to injury from other forms of stress. Especially with the high rate of magnesium deficiency in the population, antioxidants and other medications - in addition to magnesium supplements - might help in reducing cardiovascular disease.

    "Patients with heart failure - especially African Americans - are prone to an imbalance of several nutrients, according to a presentation by Dr. German Kamalov and colleagues. The imbalance is accompanied by activation of certain hormones, leading to inflammation and wasting of soft tissues and bone. The authors discuss approaches to recognizing this nutritional imbalance, and suggest that a “polynutrient supplement” including calcium, magnesium, zinc, selenium, and vitamins D, B12, and B1 might play a role in heart failure management."

    Let's hear it for basic healthcare. :-)

    http://ihealthbulletin.com/blog/2009/07/12/vitamin-d-magnesium-deficiency-heart-disease/
    .
  • 0
    Votes
    answered Mar 03, 2010 at 06:34AM
    Understanding the genetic basis for clearly heritable complex diseases such has high blood pressure is a way of chipping away at the underlying pathology. The low-hanging fruit of developing treatment options has been "plucked" and the result is a diverse array of treatment options that provide fair results when whole populations are studied, but very, very unpredictable responses when applied to the individual. The result is, I have no way of knowing which BP medication is going to work in which patient and whether it is going to actually benefit them at all. Hence, when one doesn't work, we add another, when that doesn't work we add a third and so on.
    Deciphering the genetic basis provides direction to specific targets and allows us to screen the individual---tailored medicine or pharmacogenetics. That's the future of medicine. Oncology is already doing it, now the rest of medicine is trying to catch up.
    • Excellent point, Jonathan. Pharmacogenetics is definitely the last frontier and will aid tremendously in aiding individual patients. Yet, that does not met we must ditch basic health measures while we wait. "The best is enemy of the good" and all that. ;-)
      Gina Pera commented Mar 03, 2010 at 08:20AM
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