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Hypertension is a highly heritable disease.

deCODEme analyzes your DNA and provides you with a personalized interpretation of your genetic risk of hypertension.

Knowing your genetic risk can help you take control of the environmental risk factors for hypertension.

Genetics and lifestyle contribute evenly to hypertension – knowing your genetic risk of hypertension can put you on a path to preventing high blood pressure

Blood pressure is the force of blood against the walls of arteries

Blood pressure is the force of blood pushing against the walls of the arteries. It is measured in mmHg (millimeters of mercury) and recorded as two numbers:

• Systolic pressure is the higher number, representing the pressure in the arteries as the heart contracts and pumps blood into the system.
• Diastolic pressure is the lower number, representing the pressure in the arteries when the heart relaxes between beats.

These two numbers combined provide doctors with information about how forcefully the heart pumps blood around the body and to some extent, how much resistance there is in the arteries. High systolic or diastolic pressure can be an indication of a disease called hypertension or high blood pressure.

Normal blood pressure in adults is 120/80 mmHg or less

Normal blood pressure in adults is less than 120 mmHg systolic and less than 80 mmHg diastolic (written as 120/80 mmHg or 120 over 80). Although normal blood pressure for an individual can vary somewhat with height, weight, fitness level, age, and general health, the American Heart Association has, on the basis of extensive research, defined blood pressure categories according to how much risk they entail for developing other diseases associated with the wear and tear of prolonged elevated blood pressure.

The chart below shows the blood pressure categories defined by the American Heart Association, listed by order of increasing risk:

Blood Pressure Category	Systolic (higher number)		Diastolic (lower number)
Normal	< 120 mmHg	and	< 80 mmHg
Pre- hypertension	120 – 139 mmHg	or	80 – 89 mmHg
Hypertension Stage1	140 – 159 mmHg	or	90 – 99 mmHg
Hypertension Stage2	> 160 mmHg	or	> 100 mmHg
Hypertensive crisis	> 180 mmHg	or	> 110 mmHg

Hypertension often has no warning signs or symptoms

Hypertension is defined as blood pressure of 140/90 mmHg or above on three consecutive measurements at least six hours apart. Blood pressure this high is a risk factor for many diseases. Over time, the increased workload on the heart weakens it and contributes to atherosclerosis (the thickening of the arteries due to fat and cholesterol depositions), thereby increasing the risk of coronary heart disease and stroke, which are among the leading causes of death in the United States. High blood pressure can also lead to other conditions, such as heart failure, kidney disease, and blindness. High blood pressure is especially dangerous because it often has no obvious warning signs or symptoms and can therefore remain undiagnosed and untreated long enough to cause damage.

High blood pressure is common, but too often goes undetected

An estimated 1 billion people worldwide have hypertension, and this number is expected to increase to 1.56 billion people by the year 2025. This translates to about 1 in 4 adults being afflicted with hypertension worldwide. Currently, about 1 in 3 Americans are thought to have hypertension, and a third of them probably do not know it.

In most cases the cause of hypertension is unknown

Hypertension is generally classified as primary and secondary hypertension. Secondary hypertension is defined as a side-effect of some other identified medical condition, such as kidney disease, Cushing’s syndrome, pregnancy, oral contraceptive use, chronic alcohol abuse, or the use of certain medications. However, only 5% of people with hypertension fall into this category. The remaining 95% have primary or essential hypertension that is not attributable to some other known medical condition. While the specific causes of primary hypertension are not known, genetic factors and certain lifestyle factors, such as body weight and salt intake are thought to contribute.

People with a family history of hypertension are at increased risk

Those at greatest risk for developing hypertension are people who are overweight, with a family history of high blood pressure, and those with higher than normal blood pressure (i.e. pre-hypertension). Hypertension is more common in males than in females and African Americans tend to develop high blood pressure earlier in life and more often than individuals of European descent. Blood pressure tends to increase with age in most people, but hypertension should not be considered a part of healthy aging. Although primary hypertension cannot be cured, it is easily detected and in most cases preventable and controllable with medication and lifestyle changes.

Genetics and high blood pressure

It is generally accepted that genetics and the environment contribute evenly to hypertension. However, estimates regarding the importance of genetic factors in hypertension (heritability estimates) vary considerably among populations, from as low as 15% to as high as 70%. This variation reflects both genetic differences among populations (for example African-American vs. Europeans) and differences in lifestyle that interact with genes to cause hypertension.

Currently, more than 30 genes are being investigated as potential candidates for affecting differential risk of hypertension. Due to the complexity of blood pressure regulation and the multiple coordinated systems affected in individuals with hypertension, it may take years for scientists to find every gene that is involved.

Recently, scientists have discovered five common genetic variants that are significantly associated with individual differences in systolic or diastolic blood pressure and hypertension. These are located on chromosomes 1, 10, 12 and 15.

deCODEme calculates your genetic risk of hypertension

The deCODEme Complete Scan identifies the variants referred to above and uses them to provide customers of European descent with a personalized interpretation of their genetic risk for developing hypertension.

At present, the necessary scientific information to interpret the genetic risk for individuals of other ethnicities is not available. This information will be added as soon as it becomes available and we are assured of its quality.

This content was last reviewed on February 22, 2011.

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