HYPERTENSION - GENES AND ENVIRONMENT

Hypertension can be classified as either Mendelian hypertension or ess ential hypertension, on the basis of the mode of inheritance. The Mend elian forms of hypertension develop as a result of a single gene defec t and as such are inherited in a simple Mendelian manner. In contrast, essential hypertension occurs as a consequence of a complex interplay of a number of genetic alterations and environmental factors, and the refore does not follow a clear pattern of inheritance, but exhibits fa miliar aggregation of cases. In this review, we discuss recent advance s in understanding the pathogenesis of both types of hypertension. We review the causal gene defects identified in several monogenic forms o f hypertension, and we discuss their possible relevance to the develop ment of essential hypertension. We describe the current approaches to identifying the genetic determinants of human essential hypertension a nd rat genetic models of hypertension, and summarise the results obtai ned to date using these methods. Finally, we discuss the significance of environmental factors, such as stress and diet, in the pathogenesis of hypertension, and we describe their interactions with specific hyp ertension susceptibility genes. (C) 1998 Lippincott-Raven Publishers.