Genetic epidemiology of essential hypertension

This review article is intended to introduce the uninitiated clinician to t he basic concepts, aims and early findings of the genetic epidemiology of h ypertension. It separates the rare monogenic 'Mendelian' hypertensive disor ders from the vast majority of patients with essential hypertension, which is a complex, polygenic, multifactorial disorder resulting from interaction of several genes with each other and with the environment. It highlights s ome clinical strategies used to enhance searches for 'candidates genes', su ch as subgrouping of populations into relatively homogenous groups or 'inte rmediate phenotypes' according to presumably heritable anthropometric, clin ical or biochemical characteristics; and some applications of genetic epide miologic techniques, such as linkage and association studies of certain gen e polymorphisms with hypertension using affected sibling pairs and large si bships or wide genomic screens comparing affected and unaffected population s. Although so far there is no genotypic variation proven to be causally re lated to essential hypertension, its intermediate phenotypes or any of its complications, it is hoped that new, more efficient methods of genetic anal ysis will yield clinically meaningful information.