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25 - Genetics of hypertension

Published online by Cambridge University Press:  17 August 2009

By
B. Keavney  and
M. Lathrop
Edited by
Alan Wright  and
Nicholas Hastie
Alan Wright
Affiliation:
MRC Human Genetics Unit, Edinburgh
Nicholas Hastie
Affiliation:
MRC Human Genetics Unit, Edinburgh
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Summary

Introduction

Higher levels of blood pressure are a major risk factor for coronary heart disease (CHD), stroke, cardiac failure and renal failure. Meta-analysis of individual participant data from over 1 million people in prospective cohort studies has shown that the log risk of coronary heart disease and stroke are linearly related to the level of blood pressure throughout a range which extends well into that usually regarded as “normal,” with no evidence of a threshold below which blood pressure no longer influences risk (Lewington et al., 2002). Studies involving participants from many different countries show that high blood pressure is a risk for these conditions throughout the world, with the expected impact of high blood pressure set to increase as developing countries industrialise (Yusuf et al., 2004). Blood pressure is distributed approximately log-normally in all populations studied to date; within this distribution, cut-off criteria for levels of blood pressure which confer a level of risk requiring treatment (and thus define conventional hypertension) have changed over time, in general being revised downward as the importance of even relatively small elevations in blood pressure has been more widely appreciated. Currently, the European Hypertension Society guidelines define Grade I hypertension as a systolic pressure of 140–159 mmHg and/or a diastolic pressure of 90–99 mmHg; such a definition would result in some 40% of males and 33% of females in the UK carrying a diagnosis of hypertension (European Society of Hypertension/European Society of Cardiology Guidelines Committee, 2003).

Type
Chapter
Information
Genes and Common Diseases
Genetics in Modern Medicine
 , pp. 377 - 390
Publisher: Cambridge University Press
Print publication year: 2007

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References

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