Genetics of hypertension: from experimental models to clinical applications

Human essential hypertension is a complex, multifactorial, quantitative trait under a polygenic control. Over the last decade several strategies have been used to dissect the genetic determinants of hypertension. Of these strategies, the study of rare monogenic forms of hypertension has been the most successful. Attempts to identify the multiple genes involved in the more common polygenic form of hypertension has been more difficult. Many laboratories use rat models of genetic hypertension where some of the complexity of studying human hypertension can be removed. Numerous crosses between hypertensive and normotensive strains have produced several quantitative trait loci (QTL) for blood pressure and other related phenotypes such as left ventricular hypertrophy, stroke, insulin resistance and kidney failure. In this review we describe established and novel strategies to dissect the susceptibility and severity loci for human essential hypertension. We also illustrate a few successful examples of a direct translation of genetic discoveries from the experimental setting to human investigation. The use of new molecular tools such as gene 'chips' or microarrays for either gene expression profiling or single nucleotide polymorphisms (SNPs)-based total genome scanning strategies will ultimately result in new diagnostics and therapeutics for human essential hypertension.