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Is High Blood Pressure Genetic? Risk Factors & Ways To Deal

Written by Jim Duncan, MSW | Last updated:

High blood pressure can be catastrophic if it isn’t dealt with. If you have someone in your family with high blood pressure, it might make you ask, is high blood pressure genetic? Yes, genes can play a role in blood pressure, but there are other factors involved. Let’s explore more.

Introduction To The Genetics Of High Blood Pressure

Well, what does high blood pressure actually feel like? It feels like nothing at all, generally. There’s a reason it’s called the “silent killer.” It also has one of the few appropriately labeled medical terms, “hypertension.”

For being silent, hypertension has a huge impact on our overall health. It’s one of the main risk factors for the main preventable cause of death, heart disease.

Health issues that you can’t see or feel are more difficult to deal with to be sure. Out of sight, out of mind, but you can’t afford that, because if it gives you reason to notice, you’re in trouble already.

So, to stay out of trouble, it will benefit you to look at your DNA, and see if anything may potentially raise or lower your risks. Odds are good that your genes have something to say in this matter. How is high blood pressure genetic, and what other factors can influence your risks?

Some Facts About High Blood Pressure

The danger of high blood pressure is that it increases your chances of heart attack and stroke. In 2018, high blood pressure contributed to the death of almost 500,000 Americans [1, 2]. Over 100 million Americans either have hypertension or are managing it with medication [3].

According to the Blue Cross Blue Shield Health Index, high blood pressure has the greatest overall health impact in the U.S., with the highest concentration in the southeast [4].

That’s not all – it also has a financial impact. In a study looking at health expenditures in the U.S. between 2003 and 2014, people with hypertension had about 2.5 times the inpatient costs, twice the outpatient cost, and triple the prescription medication cost of those without hypertension [5].

It is the most expensive part of the top preventable non-communicable disease in the country, heart disease. The fact is, you are lowering your risks for an array of dangerous health conditions if you control your high blood pressure. Genetics can play a role, along with many other factors.

But when your health professional says that you have high blood pressure, what exactly do they mean?

What Is High Blood Pressure?

Your heart pumps blood to your entire body through your blood vessels. As blood circulates, it pushes against the inner walls of these blood vessels. Your blood pressure is a measurement of how hard your blood is pushing on these walls. Blood pressure increases when the blood vessels narrow or when the heart pumps harder [6].

When a doctor measures your blood pressure, they give you two numbers stated as “X over Y”. The “X” number describes the force when your heart beats (systolic blood pressure). The “Y” number describes the force between heartbeats (diastolic blood pressure) [7].

A reading between 90 over 60 mmHg and 120 over 80 mmHg is generally considered normal. High blood pressure happens when the systolic number is 130 mmHg or higher or the diastolic number is 80 mmHg or higher. Prior to 2017 guidelines, 140/90 mmHg was considered high, so it’s possible you will see some differences in health professionals’ diagnoses [8].

There are two main types of hypertension, primary and secondary. Primary or “essential” hypertension is the kind that just kind of happens over time. It gradually creeps up on you. Secondary hypertension has more direct causes from certain conditions or medications [1].

What Does High Blood Pressure Feel Like?

Perhaps the most important thing you can know about high blood pressure is that it usually doesn’t produce any symptoms. Most people don’t realize they have it until they visit their doctor for a routine checkup or something worse happens [1]!

The lack of symptoms is the big thing here. At life-threatening levels, some people can develop headaches, nosebleeds, or have shortness of breath, but that’s not everyone or even most. This is why it’s important to understand the risk factors and know which are relevant to you.

What Are The Risk Factors For High Blood Pressure?

We are concerned mostly with primary hypertension, since secondary has more specific, measurable causes, with given treatments. With primary hypertension, you are playing a long game.

There are things within your control that you can alter or mitigate to lessen your risks (others not so much). Some factors that can play a role in blood pressure include [1]:

  • Age
  • Being overweight or obese
  • Not getting enough physical activity
  • Tobacco use
  • A diet high in salt (sodium)
  • A diet low in potassium
  • Alcohol abuse
  • Stress/anxiety
  • Ethnicity (African ancestry)
  • Genetics

Some examples of things that can cause secondary hypertension include [9]:

  • Abuse of recreational drugs, such as cocaine and amphetamines
  • Some medications, such as birth control pills and painkillers
  • Conditions such as obstructive sleep apnea, kidney disease, and blood vessel defects

It is also possible to have hypertension with either systolic or diastolic pressure. What causes high diastolic or systolic blood pressure is similar to regular high blood pressure causes and should not be considered normal. It’s best to consider them just as you would regular hypertension.

Can High Blood Pressure Be Reversed?

There are things you can do to mitigate your risks for high blood pressure or get it back to normal levels after you realize you have a problem. Knowing your risk factors can be essential for you to know how to handle high blood pressure, genetics included.

Elimination of poor health choices like tobacco and excessive alcohol is always a good way to go for anybody. You don’t need genetic information to tell you that.

But when it comes to managing high blood pressure, genetics can affect how your body deals with food, exercise, and stress, and can determine your best choices going forward.

Is High Blood Pressure Genetic?

Your DNA hits about 50% of the differences in developing high blood pressure. The rest is an interplay of lifestyle and environment [10]. Genes can and do play a significant role though.

There is the physical component of the amount of blood in your system and the size of the blood vessels it traverses. Genes involved include [11, 12, 13, 14, 15, 14, 15, 16]:

There is the mental component of how you handle stress, influenced by the following genes [17, 18]:

There is also a metabolic component of how your body handles things that can boost blood pressure, like caffeine (CYP1A2) [19, 20].

Now, if you happen to have seen drug commercials, talked to someone who is taking medication, or know someone who is dealing with hypertension, then one of those gene names might ring a bell.

No? It’s the ACE gene, which is where the ACE inhibitor drugs get their name from.

Why do we want to inhibit ACE? ACE stands for Angiotensin-Converting-Enzyme. Angiotensin is a hormone produced in the liver and kidney in response to low sodium levels (only one of the things angiotensin is involved with), which is integral to the pressure and fluid balance in our bodies.

The ACE comes along and turns angiotensin 1 into angiotensin 2. It is this version that acts on our blood vessels and causes them to contract in an effort to balance sodium levels.

The ACE inhibitors keep angiotensin 2 from being made, limiting the ability of blood vessels to contract [14, 15, 21], and this keeps your blood pressure from rising.

But how is genetics involved? One of the reasons some people may be more at risk for needing an ACE inhibitor is a mutation in ACE2. This is a version of ACE that is almost the same structurally but actually has the opposite effect functionally.

ACE makes the angiotensin to constrict your blood vessels. ACE2 breaks it down. A C-variant of SNP rs4646174 decreases its effectiveness, making you more likely to develop hypertension [22].

How Can Analyzing Your DNA Help You Lower Your High Blood Pressure Risk?

Having your DNA analyzed can help you understand what risk factors are relevant to you based on your genes and what you can do to address them.

Not only are your chances of experiencing high blood pressure influenced by genetics, but your DNA can also affect how well you respond to strategies to help you manage your levels.

The SelfDecode Blood Pressure report allows you to optimize your health by uncovering what your genes are doing behind the scenes to affect your odds of struggling with high blood pressure.

SelfDecode analyzes over one million genetic variants related to high blood pressure to give you the most precise data on your personalized report.

Is high blood pressure genetic

Unlike other DNA companies, SelfDecode goes a step beyond merely highlighting your genetic risk for high blood pressure. Your report also comes with evidence-based diet, supplement, and lifestyle recommendations to help you optimize your high blood pressure.

For example, if you have the ACE2 variant we discussed above, you may want to enrich your diet with potassium-rich foods. Potassium helps balance out salt levels in your system and can relax blood vessel constriction [22].

Concluding Remarks

Our world today makes it relatively easy to develop hypertension, from sedentary lifestyles to convenience foods laden with processed sugars and fats. This doesn’t even get to the socioeconomic stressors and having to deal with little things like pandemics.

Honestly, you almost have to work at not developing high blood pressure, regardless of your genetics. The fact is however, your DNA can make a difference in how you deal with stress, metabolize foods, and some of those behind the curtain things like keeping your blood vessels relaxed.

Be proactive and start today by investigating your DNA to discover more about high blood pressure and genetics. For tailored recommendations based on your genes, you should check out SelfDecode.

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About the Author

Jim Duncan

Jim completed his M.S.W. in Social Work Administration at Portland State University. He has always been interested in analyzing social issues, and he helped fund and start a program against domestic violence. He has also conducted many public speaking sessions about violence against women, and published 3 fiction novels. Inspired by SelfDecode’s mission to make precision health a reality, he decided to use his natural writing ability to help teach the world about the power and promise of genomics. His areas of interest include science-based writing,  astronomy, and genomics.


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