Genes influence blood pressure from early childhood 

Why do some people escape high blood pressure, while others battle it? Scientists are inching closer to the answer, and it involves a fascinating twist: our genes.

A recent study by the Norwegian University of Science and Technology has achieved a breakthrough in predicting blood pressure risk. By analyzing minuscule variations in DNA, they can now predict your risk of developing high blood pressure.

But this isn’t just about foretelling your future blood pressure. It’s about opening the door to personalized medicine, where treatments could be tailored to an individual’s unique genetic makeup.

Polygenic risk score 

Scientists used a powerful tool called a polygenic risk score (PRS) to predict high blood pressure risk in children and adults. It is similar to a genetic scan that analyzes tiny variations in your DNA, each with a score reflecting its impact on blood pressure. 

The bigger the impact, the higher the score. This score can reveal who has a greater risk of developing high blood pressure before symptoms even appear.

Differences start early in kids

The study revealed that children with a higher genetic risk for high blood pressure started showing differences in their actual blood pressure levels compared to children with lower risk. These differences were already noticeable as early as age three and became more pronounced as the kids grew older. 

“We found that genetic factors affect blood pressure from the first years of childhood and throughout your entire life,” said study lead author Karsten Øvretveit, a PhD candidate in the NTNU Department of Public Health and Nursing. 

Specifically, children with a high genetic risk reached certain blood pressure milestones, like having a systolic blood pressure (SBP) over 100mmHg, much earlier than kids with a lower risk. This suggests that genes might play a role in the early development of blood pressure differences, even in children.

Linear relationship in adults

In adults, the study discovered a direct correlation: individuals with a higher genetic risk had consistently higher readings in real life. Interestingly, this effect was measurable. 

Each incremental unit of genetic risk translated to a roughly 5 mmHg increase in systolic blood pressure and a 3 mmHg rise in both diastolic blood pressure and pulse pressure. Moreover, individuals with the highest genetic risk were significantly more likely to fall within the hypertensive range.

“We have been able to follow the same people from when they were around 37 until they were approximately 70 years old. We found that the differences persisted and resulted in various disease risks, where the differences in disease were quite large,” explained Øvretveit.

Additional health risks

People with a higher genetic risk were much more likely to experience various health problems compared to those with lower risk. These problems included:

• High blood pressure itself: Both early-onset (before age 55) and late-onset (after age 55) were more common in individuals with high risk scores.
• Heart-related issues: This included a higher risk of cardiovascular diseases (CVD) overall, as well as specific problems like heart attacks (myocardial infarction) and strokes.
• Kidney problems: People with high risk were more likely to develop chronic kidney disease (CKD).

On the other hand, those with a lower genetic risk were less likely to experience these negative health outcomes. This suggests that genetic risk scores can predict future health problems, which could be helpful in early prevention and intervention strategies.

Proactively blood pressure management

Individuals with a high genetic risk can actually lower it by proactively managing it. This means they can achieve a healthier outcome than those with “protective” genes who neglect their health or receive a late diagnosis. Lifestyle changes and medication can significantly impact your health, even if you have a genetic predisposition for a certain condition.

“By keeping their blood pressure at a low level, people with a high genetic risk score can achieve a lower risk of disease than people diagnosed with high blood pressure who we consider genetically protected. It seems that controlling your blood pressure matters more than genetics,” said Øvretveit.

The takeaway here is that taking charge of your health early on is important. Knowing your genetic risk profile, through tests or family history, can help you create targeted strategies to manage your blood pressure effectively. 

Study implications

This study has important implications for both individuals and the healthcare system. Knowing who’s at higher genetic risk early on allows for earlier intervention. This means lifestyle changes (healthy eating, exercise, stress management) and preventive measures can be started sooner, potentially preventing or delaying high blood pressure and its related diseases like heart disease and stroke.

Moreover, understanding the genetic side of high blood pressure allows for more targeted public health efforts. Resources can be focused on high-risk groups identified through genetic testing, making public health campaigns and interventions more effective in reducing future complications. 

The study is published in the European Journal of Preventive Cardiology. 

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