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What to know about genetic high blood pressure

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GeneticsRisk factorsMedicationsPreventionSummary
Genetics may increase the chance of developing high blood pressure, but your genetic makeup alone doesn’t determine if you will have it. Other factors like an unhealthy lifestyle also play a role.
Medically reviewed by Alana Biggers, M.D., MPH
Written by Rashida Ruwa, RN
Updated on

High blood pressure, also known as hypertension, is a common medical condition affecting many people worldwide. Although lifestyle choices and certain medical conditions can lead to high blood pressure, genetics also play a significant role.

Genetic high blood pressure occurs when your genetic makeup predisposes you to high blood pressure levels. Understanding this genetic factor is important in developing an effective treatment plan to manage your blood pressure.

Genetics and hypertension 

A multigenerational family helping each other in the kitchen, representing the risk of genetic high blood pressure.
Flashpop/Getty Images

Genetics can significantly increase the risk of developing hypertension. Research has shown that having a family history of high blood pressure increases the likelihood of developing the condition. 

Some studies estimate the heritability of hypertension, which refers to the extent to which genetics contribute to its occurrence, to be around 30–50%.

Additionally, researchers have identified several genes involved in hypertension, including those that regulate blood vessel function, sodium and fluid balance, and the renin-angiotensin-aldosterone system. 

For people with a family history of hypertension, their chances of developing genetic high blood pressure may be higher. However, hypertension is a complex condition resulting from a combination of genetic and environmental factors. Therefore, genetics alone do not determine if high blood pressure will occur. 

If you have a family history of high blood pressure, consider talking with a healthcare professional who can assess your risk factors and offer guidance.

Risk factors

Several risks are associated with high blood pressure. These include:

  • a family history of hypertension
  • an older age
  • having overweight or obesity
  • a sedentary lifestyle
  • a high salt intake
  • excessive alcohol consumption
  • smoking

Certain ethnicities, including African American and Hispanic people, are also more likely to develop hypertension. However, the reasons for this could be to do with social barriers to accessing healthcare and lower health literacy in these populations.

Medications

In some cases, medication may be necessary to manage genetic high blood pressure. However, the specific medication and dosage your doctor prescribes will vary depending on your blood pressure readings and overall health. 

There are many different classes of medications that a doctor may prescribe.

Diuretics

Diuretics increase urine production, helping to reduce the volume of fluid in your blood vessels and lower blood pressure. Hydrochlorothiazide (Microzide) and chlorthalidone (Thalitone) are some common examples.

Possible side effects may include:

  • increased urination
  • dizziness
  • headaches
  • nausea and vomiting

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Beta-blockers

Beta-blockers such as atenolol (Tenormin) and metoprolol (Lopressor) block the effects of adrenaline, resulting in relaxed and widened blood vessels, ultimately reducing blood pressure. 

Possible side effects of beta-blockers may include:

  • fatigue
  • dizziness
  • low heart rate
  • sexual difficulties

ACE inhibitors

ACE inhibitors work by blocking the formation of a hormone called angiotensin II, which helps relax blood vessels and lower blood pressure. Common examples include lisinopril (Qbrelis) and enalapril (Vasotec).

Potential side effects may include:

  • dry cough
  • dizziness
  • low blood pressure
  • increased potassium levels 

Angiotensin II receptor blockers (ARBs)

ARBs block the effects of angiotensin II, leading to relaxed and widened blood vessels, and reducing blood pressure. Losartan (Cozaar) and valsartan (Diovan) are common examples.

Possible side effects can include:

  • cough
  • low blood pressure
  • high potassium levels

Calcium channel blockers (CCBs) 

Calcium channel blockers such as amlodipine (Norvasc) and diltiazem (Dilacor) work by blocking the entry of calcium into the muscle cells of the blood vessels and the heart. This relaxes and widens the blood vessels, lowering blood pressure.

Possible side effects of calcium channel blockers include:

  • headaches
  • dizziness
  • flushing
  • swollen ankles

However, individual responses to medication can vary, and not everyone may experience the same side effects.

Prevention

The prevention of genetic high blood pressure typically involves lifestyle modifications. These can also help manage hypertension.

While you cannot change genetic factors, living a healthy lifestyle can help manage and prevent genetic high blood pressure. Healthcare professionals may also recommend the following in addition to other lifestyle modifications:

  • Regular blood pressure monitoring: Regularly checking your blood pressure at home and during medical visits is important in managing high blood pressure. This allows for early detection of any changes so you can get prompt medical intervention when necessary.
  • Stress management: Chronic stress can lead to high blood pressure. It’s beneficial to include stress-management techniques such as relaxation exercises, deep breathing, and meditation in your daily routine to help you manage stress.
  • Genetic counseling: Genetic counseling can be beneficial for people with a family history of genetic high blood pressure. A genetic counselor can provide personalized information and guidance on understanding the role of genetics and associated risk factors.

Several lifestyle modifications can help manage genetic high blood pressure, including:

  • Maintaining a moderate weight: Maintaining a moderate body weight can help reduce the strain on your heart and blood vessels. Aim for a body mass index (BMI) within the optimal range.
  • Engaging in regular physical activity: Regular exercise, such as aerobic activity and strength training, can help lower blood pressure. The American Heart Association recommends at least 75 minutes of vigorous-intensity exercise or 150 minutes of moderate-intensity exercise each week.
  • Adopting a balanced diet: Adopting a healthy diet, such as the DASH diet, which focuses on vegetables, fruits, whole grains, lean proteins, and low fat dairy products, may help manage blood pressure levels.
  • Limiting alcohol consumption: The 2020–2025 Dietary Guidelines for Americans recommends up to one drink per day for women and up to two drinks per day for men. However, consider talking with a healthcare professional regarding alcohol consumption if you have high blood pressure.
  • Quitting smoking: Smoking can increase blood pressure and increase the chance of heart disease. A healthcare professional can recommend counseling or nicotine replacement therapy to help you quit smoking successfully.

Summary

Genetic high blood pressure occurs when your genetic makeup increases your chance of developing high blood pressure.

Although genetics play a role, high blood pressure is usually due to a combination of factors, including lifestyle choices and environmental factors. Therefore, genetics alone may not cause high blood pressure.

Adopting a healthy lifestyle, including maintaining a healthy weight, engaging in regular physical activity, following a balanced diet, and taking medications, can help treat and manage genetic high blood pressure.

It is also important to monitor blood pressure regularly, manage stress, and consider genetic counseling if you have a family history of high blood pressure.

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