ARS | Publication request: Report of the National Heart, Lung, and Blood Institute Working Group on epigenetics and hypertension

Submitted to: Hypertension
Publication Type: Review Article
Publication Acceptance Date: February 28, 2012
Publication Date: May 1, 2012
Citation: Cowley, A.W., Nadeau, J.H., Baccarelli, A., Berecek, K., Fornage, M., Gibbons, G.H., Harrison, D.G., Liang, M., Nathanielsz, P.W., O'Connor, D.T., Ordovas, J.M., Peng, W., Soares, M., Szyf, M., Tolunay, H.E., Wood, K.C., Zhao, K., Galis, Z.S. 2012. Report of the National Heart, Lung, and Blood Institute Working Group on epigenetics and hypertension. Hypertension. 59(5):899-905.

Technical Abstract: Hypertension affects greater than 1 billion people worldwide and in 2009 it cost the US healthcare system more than $73 billion. Despite the availability of many antihypertensive therapies, individual responses vary, and efficacy remains a concern. Current treatments have yielded only modest reductions in the overall disease risk even in countries where therapeutics are available and affordable. The initiating causes and the pathogenic mechanisms for disease and its comorbidities remain largely unknown, and prognostic markers for adult hypertension that could improve its diagnosis, prevention, and, ultimately, its management is not yet available. As a result, approximately 28% of the US population and a similar proportion of the adult Western European and Canadian populations experience what is known as “essential hypertension,” which is a primary component of several complex, multifactorial, multigenic conditions that are commonly associated with high levels of morbidity and mortality from diabetes mellitus, cardiovascular disease, and renal disease. The causes of essential hypertension remain poorly understood, although the complex mechanisms for blood pressure (BP) regulation have been extensively characterized in both humans and animal models. Hypertension is a highly heritable trait and recent genome-wide linkage and association studies, as well as candidate gene approaches, clearly demonstrate the multigenic complexity of essential hypertension. Sixteen functional genetic variants, associated with high BP have been identified in human populations. Six of these loci involve genes known previously or suspected to regulate BP, with the other genetic variants pointing to novel pathways that influence BP and cardiovascular disease risk.