Understanding Familial Hypertension: Is High Blood Pressure Genetic?

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High blood pressure, or hypertension, occurs when the force of blood flowing through your arteries is greater than it should be. If not properly managed, it can damage your blood vessels and lead to other health problems.

Hypertension is often associated with a sedentary lifestyle or aging, but it can also have a genetic basis, affecting individuals who are otherwise fit and healthy.

A parent with high blood pressure can pass on genes that increase the likelihood of their child developing hypertension. Familial hypertension may also arise from shared family habits that increase the risk of high blood pressure, such as smoking or an unhealthy diet.

What is Hypertension?

Blood pressure is the force of circulating blood against the inner walls of your arteries. It is measured in millimeters of mercury (mm Hg) and is represented by two numbers:

  • The first (top) number is the systolic pressure, indicating the pressure inside the artery walls during a heartbeat.
  • The second (bottom) number is the diastolic pressure, indicating the pressure when the heart is at rest.

According to the American Heart Association, a healthy blood pressure reading is a systolic pressure of less than 120 mm Hg and a diastolic pressure of less than 80 mm Hg, or less than 120/80 mm Hg.

Risk Factors for High Blood Pressure

Risk factors for high blood pressure include a family history of hypertension and the following:

  • Excessive alcohol consumption
  • High sodium diet
  • Little or no physical activity
  • Obesity
  • Smoking
  • Stress
  • Insufficient sleep

What makes high blood pressure particularly dangerous is that it can persist for a long time without presenting any obvious symptoms. Measuring your blood pressure is the only reliable way to determine if you have hypertension.

In extreme cases, when blood pressure exceeds 180/120 mm Hg, you may experience a medical emergency known as a hypertensive crisis. Symptoms can include:

  • Severe headache
  • Chest pain
  • Nausea
  • Shortness of breath
  • Fainting or unresponsiveness

What Causes Familial Hypertension?

Research from 2017 suggests that high blood pressure results from a combination of genetic, environmental, and behavioral factors.

Unlike some diseases that are linked to one or a few genes, familial hypertension involves variations in hundreds of different genes, as indicated by a 2019 study of more than 750,000 individuals. This complexity makes it difficult to pinpoint specific genes that could serve as treatment targets.

The Centers for Disease Control and Prevention (CDC) also notes that family environments can influence an individual’s risk of developing hypertension. Factors such as exposure to smoking or secondhand smoke, a diet high in sodium and saturated fat, and a lack of physical activity and good sleeping habits can all contribute to elevated blood pressure.

What is Monogenic Hypertension?

Monogenic hypertension refers to high blood pressure caused by a single genetic variant inherited from a parent. This type of hypertension accounts for approximately 30% of hypertension cases. Many of these cases are associated with electrolyte imbalances, such as those involving potassium.

There are several types of monogenic hypertension syndromes, each with its own unique origins and symptoms, including:

  • Hyperaldosteronism
  • Gordon syndrome
  • Liddle syndrome
  • Geller syndrome
  • Hypertension and brachydactyly syndrome (HTNB)
  • Mineralocorticoid hypertension
  • Congenital adrenal hyperplasia

What Can I Do if I Have a Family History of High Blood Pressure?

Knowing your family medical history is important for many reasons. For example, a history of certain cancers may determine when you should get screened. If high blood pressure runs in your family, it’s crucial to share this information with your doctor and regularly monitor your blood pressure.

One tool that can help you organize information about your family health history is My Family Health Portrait, an online resource created by the National Institutes of Health. It allows you to gather your family’s medical history, share it with relatives, and learn about your risk levels for various conditions that tend to run in families.

Lifestyle Changes

If your blood pressure is currently at a healthy level, making a few key lifestyle adjustments can help lower the odds of it rising too much. If your blood pressure is higher than usual, these steps, along with medications, may help you bring it back down to a healthy range:

  • Maintaining a moderate weight
  • Limiting alcohol consumption
  • Staying physically active
  • Avoiding smoking

Dietary Changes

The National Heart, Lung, and Blood Institute developed the Dietary Approaches to Stop Hypertension (DASH) eating plan as a heart-healthy dietary strategy.

This plan focuses on managing blood pressure by emphasizing the consumption of fruits, vegetables, whole grains, lean proteins, and reducing sodium intake. It is also flexible enough to allow people to enjoy many of their favorite foods.

Better Sleep

Sufficient sleep is essential for overall health, particularly for brain and heart function. Blood pressure is especially susceptible to the effects of poor sleep.

A 2022 study suggests that frequent sleep disturbances and short sleep—defined as less than 5, 6, or 7 hours per night—can contribute to hypertension.

Taking steps to improve both the duration and quality of your sleep can enhance not only your cardiovascular health but also your mood, concentration, energy levels, metabolism, and more.

Takeaway

Hypertension is a major risk factor for cardiovascular disease, the leading cause of death in the United States. High blood pressure is also a leading cause of stroke and a risk factor for chronic kidney disease and other health issues.

If your family medical history includes high blood pressure, start taking proactive steps to lower your risk through heart-healthy behaviors. Even if you don’t know your family history or lack a close relative with hypertension, it’s still crucial to take measures to keep your blood pressure under control.

There are various anti-hypertensive medications available that can help, but these medications should not replace a healthy diet, regular exercise, and sufficient sleep in maintaining healthy blood pressure.

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