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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several large family studies are reviewed to identify results suggesting single gene traits contributing to the occurrence of hypertension in humans. Segregation analysis in families has suggested major gene effects for several highly heritable traits associated with hypertension. These include recessively segregating high sodium-lithium countertransport (major gene H2 = 34%), additively segregating low urinary kallikrein excretion (major gene H2 = 51%), and recessively segregating hyperinsulinemia (major gene H2 = 33%). In some families, hypertension and metabolic abnormalities (dyslipidemia, hyperinsulinemia, and obesity) seem to be related to several candidate genes studied but not conclusively proven (LPL deficiency mutations, dense LDL subfractions, or NIDDM with hyperinsulinemia). More recently, DNA markers have identified genes promoting hypertension. Glucocorticoid-remediable aldosteronism (GRA) promotes a rare but unusual form of hypertension that is unresponsive to ordinary medications but very responsive to glucocorticoid medications. GRA has been found in hypertensive persons with a specific mutation of the 11 beta-hydroxylase gene on chromosome 8q21. Many persons with essential hypertension carry a common "susceptibility gene" at the angiotensinogen locus (chromosome 1q4) identified using linkage studies in siblings, association studies, and in studies of preeclampsia and hypertension in pregnant women. These first two well-established genetic loci promoting human hypertension represent two ends of a broad spectrum. The rare "determinant" gene for GRA by itself seems to produce severe hypertension and early strokes. The angiotensinogen (AGT) "susceptibility" gene is very common (30% of Utah Caucasians) and seems to predispose to hypertension but probably requires other genetic and environmental influences to be fully expressed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evidence for single gene contributions to hypertension and lipid disturbances: definition, genetics, and clinical significance. 798 84

Variance of blood pressure in the normal population is composed of environmental influences and the cumulative effects of gene structure polymorphisms. Essential hypertension results from the combined influence of these components, whose respective importance can vary considerably from individual to individual. In the rare forms of hypertension due to a single gene abnormality, the environmental component is negligible and the genetic component is represented by a major transmitted gene abnormality with major effects on the phenotype. These rare forms of monogenic hypertension offer interesting models for the study of the genes involved in essential hypertension. The angiotensinogen gene represents the first example of a strongly supported implication of a gene in essential hypertension. The success of this strategy allows the possibility of identifying other genes in essential hypertension.
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PMID:Role and identification of the genes involved in human hypertension. 799 85

Results from family studies suggest several possible single gene traits may be related to essential hypertension in humans. Results of segregation analysis are reviewed for six possibly related traits (high sodium-lithium countertransport, low urinary kallikrein excretion, high fasting plasma insulin level, a fat pattern index, dense LDL subfractions, and body mass index). Eight genetic loci (on chromosomes 1, 6, 8, 17 and 19) are possibly related to essential hypertension in humans and are also reviewed. Two of them (GRA and AGT) are well-established. Glucocorticoid remediable aldosteronism (GRA) is attributable to a well-defined mutation on chromosome 8q21 and leads to the production of high levels of abnormal adrenal steroid hormones with subsequent aldosteronism, early severe hypertension, and strokes. This form of hypertension is unresponsive to ordinary medications but very responsive to glucocorticoid hormone administration. The angiotensinogen (AGT) locus on chromosome 1q4 has been related to hypertension in sibship linkage studies, association studies, and studies of angiotensinogen levels by genotype in three different populations (Utah, France, Japan). This locus seems to be associated with more severe essential hypertension and also with preeclampsia. Genetic heterogeneity, imprecision in measuring specific phenotypes, and variability in sampling methods in populations studied may all contribute to weaknesses and inconsistencies between reported studies. However, growing evidence for several single gene traits promoting susceptibility to hypertension offers opportunities for identifying genetically profiled subsets of patients in whom specific environmental interventions or specific types of medications will achieve more focused prevention and treatment of hypertension and its complications.
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PMID:Tabulations and expectations regarding the genetics of human hypertension. 812 35

A common molecular variant of angiotensinogen (AGT), the precursor of the potent vasoactive hormone angiotensin II, has been incriminated as a marker for a genetic predisposition to essential hypertension in Caucasians (Jeunemaitre, X., F. Soubrier, Y. V. Kotelevtsev, R. P. Lifton, C. S. Williams, A. Charru, S. C. Hunt, P. N. Hopkins, R. R. Williams, J. M. Lalouel, and P. Corvol. 1992. Cell. 71:169-180). We now show that the same variant, T235, is associated with essential hypertension in Japanese patients. The observation of this association in a distinct, ethnically homogeneous population further substantiates an involvement of angiotensinogen in the pathogenesis of essential hypertension and has physiological, epidemiological, and evolutionary implications.
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PMID:Angiotensinogen as a risk factor for essential hypertension in Japan. 813 67

Experimental analysis of complex quantitative genetic traits, such as essential hypertension, should be greatly facilitated by being able to manipulate the expression of a gene in living animals without altering the nucleotide sequence, chromosomal location, or regulatory elements of the gene. To explore this possibility, we have used targeted gene disruption and duplication to generate mice that are genetically identical [(129 x C57BL6)F1] except for having one, two, or three functional copies of the gene coding for angiotensinogen. The two-copy animals have two normal copies of the angiotensinogen gene; the one-copy and three-copy animals have one normal copy with the other either disrupted or duplicated by gene targeting. The duplicated pair of genes was generated by a special form of gap-repair gene targeting that tandemly duplicates the whole of a gene together with 5' and 3' flanking regions. We find progressively and significantly higher levels of the gene product in the animals having increasing numbers of gene copies: the one-copy animals have steady-state plasma angiotensinogen levels approximately 35% of normal (P < 0.0001), and the three-copy animals have levels approximately 124% of normal (P < 0.004). Detailed information about regulatory sequences is not required for this type of experiment; nor is it necessary to have DNA clones or targeting constructs that cover the whole of the target gene. Varying gene copy numbers by targeting consequently offers a promising approach to quantitative genetics.
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PMID:Targeted gene duplication and disruption for analyzing quantitative genetic traits in mice. 817 Sep 56

Blood pressure is a quantitative multifactorial trait with both environmental and genetic determinants, with essential hypertension simply representing one extreme of the blood pressure distribution. While much is known about environmental factors that predispose to the development of hypertension, the nature of the genetic factors that increase such susceptibility remain virtually unknown. However, with advances in molecular techniques, several loci that influence blood pressure in rodents have been identified and recently in two selected sets of human hypertensives, a molecular variant at the angiotensinogen locus has been linked to the tendency to hypertension. It is likely that in the next few years several genetic determinants of blood pressure variability in humans will be identified. Such information will not only increase our understanding of the pathophysiology of hypertension and identify novel treatments but may permit preventative and therapeutic measures to be targetted more specifically than at present.
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PMID:Molecular genetics of susceptibility to the development of hypertension. 820 58

A recent cross-sectional study of HTs in Salt Lake City and Paris has reported a significant association of a T704-->C (Met235-->Thr) variant in exon 2 of the angiotensinogen gene (AGT) with essential hypertension (HT). The present study used a new, direct PCR technique to detect this variant in 92 Caucasians with severe hypertension (HT) and two HT parents and 94 normotensive (NT) controls. Although frequency of the variant in HTs (0.42) was higher than in NTs (0.39), the difference was not significant (chi 2 = 0.24; P = 0.63). Plasma angiotensinogen showed a weak, nonsignificant relationship with AGT genotype in females and no genotypic relationship was apparent for blood pressure. Thus, if the Met235-->Thr variant of AGT is involved in essential HT, then its contribution may be, at best, much weaker in other HT groups.
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PMID:Cross-sectional analysis of Met235-->Thr variant of angiotensinogen gene in severe, familial hypertension. 826 22

Blood pressure is a complex quantitative trait that is determined by multiple environmental and genetic factors. Although some simple Mendelian forms of high blood pressure have been described, essential hypertension is characterized by a complex mode of inheritance. Based on recent advances in molecular biology and statistical genetics, it has become feasible to search for chromosome regions that may contain genes contributing to the pathogenesis of hypertension in humans. For example, recent linkage and association studies have raised the possibility that a blood pressure regulatory locus may exist in or near the angiotensinogen gene on chromosome 1. Detailed genetic experiments in animal models of hypertension may help to guide further clinical studies and lead to an improved understanding of gene action in the pathogenesis of essential hypertension.
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PMID:Genetics of essential hypertension. 823 77

Pregnancy-induced hypertension (PIH) is a heterogeneous disorder which complicates 5-7% of all pregnancies and remains a leading cause of maternal, fetal and neonatal morbidity and mortality. Severe preeclampsia is the most distinctive and life-threatening form; a multi-system disorder more common in first pregnancies, it is characterized by high blood pressure and proteinuria. In a series of Caucasian women with pregnancy-induced hypertension, we have observed a significant association of preeclampsia with a molecular variant of angiotensinogen, T235, found previously to be associated with essential hypertension. This finding is corroborated in a sample ascertained in Japan. Together, these observations support a new pathophysiological interpretation of preeclampsia and of its relation to some forms of essential hypertension.
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PMID:A molecular variant of angiotensinogen associated with preeclampsia. 851 28

Genetic influences in cerebrovascular disease (CVD) may act either independently or by predisposing to, or modulating, the effect of risk factors such as hypertension. Factors involved in the pathogenesis of atherosclerosis, thrombosis and vasoconstriction are important in CVD. The angiotensinogen gene has recently been linked with essential hypertension in affected sibships and a particular polymorphism in exon 2 of the angiotensinogen gene, a threonine to methionine substitution at position 235 (M235T), has been associated with pre-eclampsia and hypertension. In this study we examined the relation of M235T polymorphism to cerebrovascular disease and carotid atheroma in 100 consecutive Caucasian patients with internal carotid artery territory ischaemia (TIA or stroke), presenting to a carotid ultrasound service. Forty five age-matched controls (mostly patients' spouses) were also studied. Hypertension was defined as current treatment with anti-hypertensive agents, or SBP > 160 mm Hg or DBP > 95 mm Hg. Twelve of 100 cases (12%) and eight of 45 controls (12%) were homozygous for the T235 allele. T:M allele ratios were 0.34:0.66 in cases and 0.34:0.66 in controls. There was no relation between the polymorphism and either internal carotid stenosis or common carotid artery intima-media thickness. In the cases, mean percentage internal carotid artery stenosis was TT 18.3 (SD 18.7)%, MT 38.0 (27.1)% and MM 36.8 (30.2)%. Mean intima-media thickness was TT 0.87 (0.18) mm, MT 0.95 (0.34) mm and MM 0.88 (0.23) mm. There was no relation between the polymorphism and hypertension (TT 11 of 100 cases, six of 45 controls).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Lack of association between angiotensinogen polymorphism (M235T) and cerebrovascular disease and carotid atheroma. 852 90


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