Often, we blame genetics for our high blood pressure. How much truth is in these claims? I talked to Dr. Helen Warren of the Queens Mary University in London about genetic foundations of blood pressure. Dr. Warren is one of the lead authors of the world’s largest study ever conducted on genetic foundations of high blood pressure.
20 questions and 20 detailed, comprehensive answers. She describes what we know already (quite a lot!). She explains hypertension risk stratification, polygenic risk scores, genetic profiles. Learn how likely it is to inherit hypertension.
Citations from the interview:
The question ‘why me’ is posed very often in social media groups on high blood pressure. Can you answer it?
BP is influenced by both our genetics and our environmental / lifestyle risk factors. It is a balance. And we probably all have a slightly different ratio of whether our BP level is influenced more by our genetics, or by our lifestyle. We are all unique! If we consider any two people who have high BP, the reasons for their high BP could be very different.
One hypertensive patient could be carrying very little genetic risk, but they may be overweight, a smoker, with a poor diet. In contrast, the other hypertensive patient could be very fit and have a very healthy lifestyle, but hidden in the genes, and from family history, they could be highly susceptible to being at a high risk genetically of higher BP.
Hence, there are usually several reasons behind one’s high blood pressure?
A polygenic risk score is a combination of many different genetic variants, and essentially the score counts how many risk alleles we carry across all the BP-associated genes. So because BP is so highly polygenic, our high BP levels could be due to the combined effect of lots of small, individual risk genes all added together. So, in contrast to “monogenic diseases”, e.g. like Huntingtons that are caused only by one single gene, where you either are a carrier of that one single gene or not, then I don’t think the “why me” question is quite as straightforward for BP. All of us will carry some risk alleles for some of the BP-associated genes, it’s just a case of how many…
Then, in most cases it is a game of chance?
When genetics carries with it the 50:50 chance of which genes we inherit from our Mother, and which from our Father, it could all be seen as a game of chance.
However, instead of the “why me” question, with regards to what our level of genetic risk may be, or in other words, how high might our BP polygenic risk score be, perhaps the better question that patients could start asking is “what next”.
Read the full interview here.
