Introduction
I discovered a hereditary pattern of hypertension for myself due to the strong family history of high blood pressure. Several members of my family including my mother, father, maternal grandmother, and several aunts and uncles had or have hypertension.
The Risk of Transmission of Hypertension to Other. New Family Members
Hypertension is among the leading global causes of mortality and morbidity. According to Ahn and Gupta (2018), the etiology of hypertension is largely unknown despite its widespread prevalence. However, there is a growing body of evidence that this condition occurs due to a complex interaction of environmental, genetic, and epigenetic factors (Ahn & Gupta, 2018). A study by Niiranen et al. (2017) showed that cases of high blood pressure in parents and grandparents were associated with the risk of certain factors even in persons in the third generation. Specifically, this study showed that offsprings from a family with a history of having hypertension before the age of 55 years were highly likely to suffer from this condition. Niiranen et al. (2017) discovered that the risk of developing hypertension based on known environmental factors was lower as compared to the risk of genetics. Family-based and twin studies have shown that between 30 and 50 percent of blood pressure variances may be inheritable (Niiranen et al., 2017). The available studies show that multiple genetic variants contribute to or increase susceptibility to hypertension. One of the earliest and widely studied candidate genes for this condition is angiotensin (AGT). Dickson and Sigmund (2006) note that there is enough evidence to link AGT and the levels of blood pressure in humans. Some hypertensive disorders follow the Mendelian inheritance patterns, which are associated with singe-gene mutations. For instance, hypokalemia and metabolic alkalosis are caused by CYP11B1 gene fused with CYP11B2 gene on chromosome 8q (Ahn & Gupta, 2018). The mode of inheritance for this condition is autosomal dominant, and it leads to low renin and angiotensin II levels. The HapMap and Human Genome Project initiatives have shown the common genetic variants associated with hypertension. For instance, Niiranen et al. (2017) found out that 280 genetic variants are associated with an increased risk of developing hypertension. However, having these genes does not mean that an individual inherits the condition. On the contrary, it implies that one becomes highly susceptible to high blood pressure. Therefore, given the strong link between genetics and hypertension, it suffices to conclude that the susceptibility of having high blood pressure will be increased in other or new members of my family. For instance, given that I am at risk of developing hypertension due to my family history of having the condition, my children are highly likely to have the same problem. The risk of transmission is high.
Feasibility of using the Surgeon General’s Family History Tool in Primary Care
Risk assessment using family health history plays a major role in the management of different health conditions in diverse healthcare set-ups. According to Wu et al. (2015), the failure to assess risk regarding different chronic diseases, such as hypertension, will increase the probability of primary care patients facing premature mortality and morbidity. Therefore, given the strong link between genetics and hypertension as discussed in this paper, the Surgeon General’s Family History Tool should be used in the primary care clinical setting to assess the risk of developing certain chronic conditions. The use of this tool will allow primary healthcare practitioners to take preventive measures to address the underlying health conditions before they occur.
References
Ahn, S. -Y., & Gupta, C. (2018). Genetic programming of hypertension. Frontiers in Pediatrics, 5(285), 1-10. Web.
Dickson, M. E., & Sigmund, C. D. (2006). Genetics basis of hypertension: Revisiting angiotensin. Hypertension, 48(1), 14-20.
Niiranen, T., McCabe, E. L., Larson, M. G., Henglin, M., Lakdawala, N. K., Vasan, R. S.,& Cheng, S. (2017). Risk for hypertension crosses generations in the community: A multigenerational cohort study. European Heart Journal, 38(29), 2300-2308.
Wu, R. R., Myers, R. A., McCarty, C. A., Dimmock, D., Farrell, M., Cross, D., …Orlando, A. L. (2015). Protocol for the implementation, adoption, and utility of family history in diverse care settings study. Implementation Science, 10(163), 1-10. Web.