A positive parental history of high blood pressure

Abstract

Familial aggregation of blood pressure (BP) has been recognised for a long time and enquiry about family history, especially in parents, forms a standard part of our assessment of a hypertensive patient. To some extent, a positive response conditions our interpretation of the patient's BP and also provides a simple (although not necessarily true) explanation for the patient's condition that he/she can easily understand-'it runs in your genes'! How strong is the influence of a positive family history of hypertension? Two approaches have been used to analyse this. First, studies have looked at the effect of a family history on the risk of developing hypertension. [1][2][3] The most comprehensive analysis has been done by Hunt and colleagues in Utah. In a prospective study of 1482 adults, a positive family history (two first-degree relatives with hypertension) was associated with a 2.35-fold unadjusted and a 1.82-fold adjusted risk of hypertension. In a separate study of 94 292 persons, they investigated parameters that influenced this familial risk. Age of subject, number of affected relatives and the ages at which they developed hypertension all had significant effects. Risk was highest (4.1-fold for males, 5.0-fold for females) in young adults (20-39 years) when both parents were affected early (Ͻ55 years of age). The risk associated with a positive family history decreased rapidly and was not at all apparent, even with a strong family history, in subjects over the age of 60.The alternative approach has been to directly quantify the effect of a positive family history on BP. Again several studies have shown that subjects with a positive history (variously defined) have higher BP than those without such a history. [4][5][6][7] This is true for both clinic 4,5 as well as ambulatory BP 6,7 with group differences of between 3 and 13 mm Hg for systolic BP. Most of these studies have focused on relatively young subjects (Ͻ35 years) because of the view that familial factors are likely to act early. In this issue of the Journal of Human Hypertension Naruse et al 8

Exon repetition in mRNA

“…However, the exon 2-4 duplication would alter the reading frame, resulting in a truncated, altered protein product of 157 aa. The function of the SA protein, although possibly involved in blood pressure regulation (20), is currently unknown, and therefore any pathophysiological significance of these modified transcripts in the WKY kidney remains speculative. We have examined some other rat strains and crosses.…”

Very Long-chain Acyl-CoA Synthetases

“…Only one sequence for medium-chain acyl-CoA synthetase was found (Bos taurus xenobiotic/medium-chain fatty acid:CoA ligase form XL-III). However, human, rat, and mouse SA protein (a protein associated with essential hypertension and a putative acyl-CoA synthetase (27,28)) clearly belonged to the same family. In addition, proteins identified as "human unknown protein" and "rat kidney-specific protein" belonged to the medium-chain acylCoA synthetase family.…”