A consideration of genetic mechanisms behind the development of hypertension in blacks

Wanzhu Tu, J. Howard Pratt

Research output: Contribution to journalReview article

13 Scopus citations

Abstract

Hypertension is a more serious disease in blacks. The determinants of the blood pressure (BP) may be uniquely different from those in whites. The characteristic low-renin, salt-sensitive hypertension of blacks is consistent with the kidney reabsorbing additional sodium (Na), which leads to an expanded plasma volume that drives the BP. Mechanisms considered are genetically based. These include: (1) the intra-renal renin-angiotensin system (RAS), one based on molecular variations in angiotensinogen; (2) the Na, K, 2Cl cotransporter (NKCC2) and its regulators in the thick ascending limb, which are associated with a variety of phenotypes consistent with a more active cotransporter in blacks; and (3) the genes for MYH9 and APOL 1, which have been associated with kidney disease in blacks. To achieve a state of hypertension, an increase in Na uptake in proximal nephron regions may require a distal nephron that does not fully adjust due to less than adequate suppression of aldosterone production.

Original languageEnglish (US)
Pages (from-to)108-113
Number of pages6
JournalCurrent hypertension reports
Volume15
Issue number2
DOIs
StatePublished - Apr 2013

Keywords

  • Aldosterone
  • Angiotensin II
  • Angiotensinogen
  • APOL 1
  • Calcium
  • Calcium-sensing receptor
  • Epithelial sodium channel
  • Extracellular fluid volume
  • Hypertension
  • MYH9
  • NKCC2
  • Potassium
  • Proximal tubule
  • Race
  • Renin
  • Sodium
  • Thick ascending limb

ASJC Scopus subject areas

  • Internal Medicine

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