(Circulation. 2000;102:IV-40.)
© 2000 American Heart Association, Inc.
Special Anniversary Issue |
Genetics of Hypertension, Target-Organ Complications, and Response to Therapy
From the Division of Hypertension, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minn (S.T.T.), and the Human Genetics Center and Institute of Molecular Medicine, University of Texas–Houston Health Science Center (E.B.).
Correspondence to Stephen T. Turner, MD, Division of Hypertension, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. E-mail turner.stephen@mayo.edu
Key Words: blood pressure • cardiovascular diseases • drugs • genetics • hypertension
This issue of
Circulation honors extraordinary achievements in
cardiovascular disease research during the past half century and their
impact on the prevention, evaluation, and treatment of cardiovascular
disorders. One area of particularly noteworthy advancement has been
that of hypertension, the most prevalent risk factor for diseases of
the heart, brain, and kidneys and one of the most common indications
for prescription medications. Because essential hypertension, defined
by systolic blood pressure levels 
140 mm Hg or diastolic blood
pressure levels 90 mm Hg, was the subject of a comprehensive 2-part
review recently published in
Circulation,1 2
this article will focus on 3 frontiers of hypertension research that
are undergoing particularly rapid advancement and are poised to
experience further profound developments with completion of the Human
Genome Project.3
These areas include new understanding of the genetic causes of
hypertension, the genetic susceptibility to target-organ complications,
and the pharmacogenetics of antihypertensive therapy. In each of these
areas, our objectives are to review present knowledge by highlighting
salient findings and to suggest where future advancements are likely to
improve the prevention, evaluation, and treatment of
hypertension.
Genetic Causes of Hypertension
Previous studies have yielded consistent and
significant estimates of the genetic contribution to interindividual
differences in both systolic and diastolic blood pressure levels. For
example, in a sample of 1266 individuals in 278 non-Hispanic white
pedigrees, the heritability of systolic blood pressure level (that is,
the proportion of interindividual variation attributable to genetic
differences among individuals) was estimated to be
0.37.4 Similar values
have been reported for diastolic