Is Hypertension Genetic?

Hypertension affects 46% of the overall population [1], and uncontrolled hypertension can lead to health problems. Is hypertension genetic, or is there a way to lower your risk or manage high pressure if you have it? Genes may play a role, but there is more to the story.

It turns out that your own choices, such as taking medications and choosing healthy behaviors, can lower blood pressure. The average participant in the Lark hypertension study lowered blood pressure, and Lark for Hypertension offers coaching based on those same principles that have been shown to lower blood pressure.

What Is Hypertension?

Hypertension is high blood pressure. Blood pressure is the force of your blood against your blood vessel walls. The cut-off for hypertension is blood pressure that is at least 130/80 mm Hg. The top number is the systolic blood pressure (SBP), and it is measured when your heart contracts. The number on the bottom is the diastolic blood pressure (DBP), which is measured when your heart is relaxed (in diastole).

Why Is Hypertension Important?

Hypertension is important because it affects so many people and because of its effects. Nearly half of the population has hypertension, including more than three-quarters of adults over 65 years [2].

After smoking, high blood pressure is considered the largest preventable cause of death in the United States [3]. Each 20 mmHg increase in blood pressure increases the risk of death by 49% to 104%, and is a risk factor for stroke and other cardiovascular diseases.

It is called the "silent killer" because it is so dangerous, but it does not usually cause symptoms. Many people do not know they have high blood pressure until they have a related event, such as a stroke.

Genetic Causes of Hypertension

Genetic factors can play a role in some cases of hypertension. You may even have family members who have or had high blood pressure. A few genes have been linked to high blood pressure, and several other genes may also affect blood pressure. However, the number of hypertension cases that are genetic appear to be only a small fraction of the total [4].

Environmental Causes of Hypertension

Many non-genetic, or environmental, factors appear to affect blood pressure. For many patients, environmental factors may be more influential than genetic factors in the development of high blood pressure. The good news is that unlike genetic facts, many environmental factors are considered modifiable, which means you can change them.

What you eat is extremely important. For example, did you know that people with hypertension who have the highest intake of dietary sodium have a relative risk of dying that is 7 times that of someone with a low intake? 

In addition to having a high-salt diet, having a high intake of sugar, fried foods, and processed and fatty red meats may raise blood pressure. Eating few fruits and vegetables, healthy fats such as olive oil and fatty fish, and calcium may increase blood pressure, too.

Obesity is another diet-related risk factor for high blood pressure. So is too much alcohol. Low physical inactivity is also linked to hypertension, as is smoking.

The Power of Behavior to Lower Blood Pressure

If you have high blood pressure, there are many things you can do to try to lower it. Taking medications properly may seem like a no-brainer, but only about half of patients nearly always take their anti-hypertensive medications as prescribed. If you tend to forget or are not sure how you are doing, Lark for Hypertension can keep track of your medications and remind you to take them.

Weight loss if you are obese is another tactic to lower blood pressure. Each kilogram (2.2 lb.) of excess weight that you lose can lower blood pressure by about 1 mm Hg. Those pounds can really add up to big results.

There are other simple choices that can have profound effects on your blood pressure. They include the following.

• Increasing intake of fruits and vegetables.
• Getting enough calcium and vitamin D, such as from dairy products.
• Getting more healthy fats, such as from olive oil and avocados, in place of unhealthy fats, such as from fried foods and fatty meat.
• Limiting sodium, such as from canned goods, pickled foods, and many processed foods.
• Getting at least 150 minutes per week of moderate-intensity physical activity, such as brisk walking, cycling, swimming, or gardening.
• Strength training the major muscle groups.
• Quitting smoking if you smoke.
• If you drink, keeping alcohol intake to a moderate maximum of 2 drinks per day for men and 1 for women.

In the Lark hypertension study, participants with hypertension were given Lark for Hypertension and a home blood pressure monitor. The Lark coach emphasizes medication adherence and the other behaviors mentioned above.  Over the course of six months, the average participant lowered SBP by 8.4 mm Hg. 

Taking Charge of Your Blood Pressure

Even if hypertension is partially genetic, chances are there are modifiable factors that you can work on to lower blood pressure.

The average decrease in blood pressure of 8.4 mm Hg SBP In the Lark hypertension study is a significant amount. Compare it, for example, to information that lowering blood pressure by 5 mm Hg can lower stroke and heart attack risk by one-third in the population.  

The results of the Lark hypertension study are impressive, the program used is one that participants used at home on their phones. Lark for Hypertension is a digital coach that is available, 24/7, for unlimited interactions. Along with text-based conversations, Lark offers food, weight, sleep, and physical activity, instant feedback, medication reminders and tracking, and automatic recording and tracking of blood pressure measurements. 

Lark's coaching program encourages you to make small changes that fit into your lifestyle. Lark uses principles of behavior change therapy and helps you practice these changes to establish long-lasting habits. The empathetic, compassionate coach works with you on the lifestyle choices known to lower blood pressure, such as weight loss, healthy eating, exercise, and medication adherence.

Hypertension may be a common condition that carries health risks, but self-management of hypertension can be effective. Lifestyle choices can lead to lower blood pressure, and Lark for Hypertension is designed to help you turn good choices into habits.

References

1. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:e127-e248
2. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:e127-e248 
3. Danaei G., Ding E.L., Mozaffarian D., et al. (2009) The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med 6. e1000058
4. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:e127-e248