Hypertension, Essential

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WHO-ICD-10 version:2010

Diseases of the circulatory system

OMIM Number

145500

Mode of Inheritance

Multifactorial

Gene Map Locus

1p36.12, 1q23.3, 1q24.2, 1q42.2,2p25-p24,3q24,4p16.3, 4q31.3,5p13-q12,7q22.1, 7q36.1,12p12.2-p12.1, 12p13.31,15q,17q, 17q11.2,20q11-q13, 20q13.13

Description

Essential hypertension is blood pressure that is consistently higher than normal when no cause for the high blood pressure can be found. Essential (or primary) hypertension is a frequent pathology (10% to 40% of the population, depending on the age group) causing significant cardiovascular morbidity and mortality. About 90-95% of patients with high blood pressure have essential hypertension. Black adults have a higher incidence of hypertension than Caucasian adults and typically a more severe form of the disease.

Epidemiology in the Arab World

View Map
Subject IDCountrySexFamily HistoryParental ConsanguinityHPO TermsVariantZygosityMode of InheritanceReferenceRemarks
145500.G.1.1Lebanon HypertensionNM_000603.5:c.894=, NM_000024.5:c.46A>GSoudani et al. 2014 Study with 134 hyper...
145500.G.2.1Lebanon HypertensionNM_001384479.1:c.776T>CHomozygousSaab et al. 2011 Study with 124 hyper...
145500.G.2.2Lebanon HypertensionNM_001384479.1:c.776T>CHeterozygousSaab et al. 2011 Study with 124 hyper...
145500.G.2.5Lebanon HypertensionNM_004835.4:c.*86A>CHomozygousSaab et al. 2011 Study with 124 hyper...
145500.G.2.6Lebanon HypertensionNM_004835.4:c.*86A>CHeterozygousSaab et al. 2011 Study with 124 hyper...
145500.G.3.1Lebanon HypertensionNM_000789.4:c.2306-105_2306-104insTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCCATACAGTCACTTTTHomozygousAkra-Ismail et al. 2010 Study with 115 hyper...
145500.G.3.2Lebanon HypertensionNM_000789.4:c.2306-105_2306-104insTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCCATACAGTCACTTTTHeterozygousAkra-Ismail et al. 2010 Study with 115 hyper...
145500.G.5.1United Arab Emirates HypertensionNM_000789.3:c.2328G>ASaeed Mahmood et al. 2003 118 hypertensives (6...
145500.G.7.1United Arab Emirates HypertensionNM_000537.3:c.1059+83G>AFrossard et al. 1998 331 hypertensives (1...
145500.G.8.1United Arab Emirates HypertensionNM_000537.3:c.98+1161A>GFrossard et al. 1999 280 hypertensives (1...
145500.G.8.2United Arab EmiratesNM_000537.3:c.98+1161A>GFrossard et al. 1999 274 normotensives (1...
145500.G.9United Arab Emirates HypertensionNM_001384479.1:c.776T>CFrossard et al. 1998 135 hypertensives (6...
145500.G.11.1United Arab Emirates HypertensionNM_000789.4:c.2306-105_2306-104insTTTTTTTTTTTGAGACGGAGTCTCGCTCTGTCGCCCATACAGTCACTTTTAlsafar et al. 2015 235 hypertensives. A...
145500.G.12.1United Arab Emirates HypertensionNM_000039.2:c.-75=HomozygousSadaf et al. 2002 Study with 82 hypert...
145500.G.12.2United Arab Emirates HypertensionNM_000039.2:c.-75=HeterozygousSadaf et al. 2002 Study with 82 hypert...
603028.G.1LebanonNM_001318787.2:c.-372-616A>GHeterozygousChedid et al. 2020 460 subjects (292 fe...
603028.G.2LebanonNM_001318787.2:c.-372-616A>GHomozygousChedid et al. 2020 460 subjects (292 fe...

Other Reports

Egypt

A study by Woodhouse et al. (2003) to investigate the possibility of familial hypertension being due to mineralocorticoid hypersecretion included an Egyptian patient [See: Oman > Woodhouse et al., 2003].

Eritrea

Mufunda et al. (2006) conducted a cross-sectional baseline survey of the risk factors for hypertension in the Eritrean population. All the nine ethnic groups in Eritrea were included in the study. The total sample consisted of 2352 subjects belonging to 123 primary sampling units from the six regions of the country. The prevalence of hypertension was found to be 16% in the general population (males: 16.88%, females: 15.28%). This rate is higher than values reported from Western African countries. A positive correlation was seen between BMI and hypertension. This association was however, significant only in women with normal BMI. In addition, the prevalence was higher in urban (16.5%) than in rural (14.5%) areas, and increased with age. Interestingly, only 20% of the hypertensive respondents were aware of their hypertensive state.

Kuwait

A review of data on hypertension in Kuwait by El-Reshaid et al. (1999) detected a prevalence rate of 26.3%, and mild to moderate hypertension in 86% of subjects studied. The proportion of hypertensives increased with age and obesity levels. The study also identified a very low level of awareness about the disease among affected patients. In 1997, hypertension was found to be responsible for 935 hospital admissions. Co-morbid conditions related to hypertension were responsible for several more admissions.

Saleh et al. (2000) studied a multistage, stratified random sample of 1312 Kuwaiti students (619 boys and 693 girls) aged 6-10 years to understand the prevalence of hypertension and the related risk factors in this population. The overall prevalence rate of hypertension in this group was calculated to be 5.1% (5.7% among boys, and 4.6% among girls). Multivariate analysis revealed that obese children and those with a family history of hypertension as well as children of consanguineous parents were particularly predisposed to developing hypertension.

Morocco

A study by Woodhouse et al. (2003) to investigate the possibility of familial hypertension being due to mineralocorticoid hypersecretion included a Moroccan patient [See: Oman > Woodhouse et al., 2003].

Oman

Hassan et al. (2001) conducted a study to determine the blood pressure reactivity of young offspring of first cousin hypertensive parents, in response to their first blood pressure measurement. Hassan et al. (2001) concluded that since the offspring of hypertensive first degree cousins reacted with exaggerated SBP and DBP responses than controls, research of the heredity of such response needed to be carried out. They also advised on educating the community on the consequences of consanguineous marriage as well as on the effects of environmental factors on the development of hypertension.

Woodhouse et al. (2003) conducted a study to investigate the possibility that familial hypertension was due to mineralocorticoid (MC) hypersecretion by using spironolactone, which selectively blocked the MC receptors, and would identify such patients. Over an 8-month period, out of 64 hypertensive patients with at least one or more affected parent or sibling, 45 patients (29 females and 16 males; mean age - 48 years; 28% being products of consanguineous marriages) had completed the therapeutic trial and had had hypertension for a range of one month to 33 years. Out of these, 22 were Omani patients. Woodhouse et al. (2003)  detected that inherited forms of mineralocorticoid hypertension were common, as 84% of the patients under study responded to spironolactone, and recommended that all patients with familial hypertension should undergo therapeutic trial with an MC receptor blocking agent, before undertaking expensive endocrine investigations. Since identified responders came from three continents, they postulated that MC hypertension was a worldwide problem rather than a Middle Eastern one.

Qatar

Bener et al. (2004a, 2004b) studied the prevalence of hypertension and its associated risk factors in the Qatari population through a cross-sectional study conducted between January and July 2003. A total of 1,500 Qatari subjects, selected by a multi-stage stratified cluster sampling method, were interviewed by means of a questionnaire. Obesity was found to be a significant risk factor associated with hypertension. Other risk factors significantly associated with hypertension were found to be low-educational level, advanced age, and predominantly sedentary life. Interestingly, current smoking habit was less frequent among hypertensive subjects, possibly an effect of education and anti-smoking campaigns. Almost all hypertensives were found to be diabetic. Other diseases seen in the hypertensives included heart disease and hormonal disorders. The hypertensive subjects were also found to include animal fat/butter and coffee in their diet as opposed to the normotensives, who relied on vegetable oils.

Saudi Arabia

Alghasham et al. (2012) performed a common-variant association study, investigating the association of MTHFR C677T and A1298C polymorphisms with hypertension in Saudi subjects.  This study involved 250 controls and 123 cases with hypertension, among which 44 were obese, and 53 were obese and diabetic.  All cases showed a higher carrier frequency of the mutant 1298C allele than controls (59% vs 42%, p=0.003), and significant association was described (OR=1.98, 95% CI 1.3-3.1).  In addition, hypertensive cases with obesity and diabetes showed a significantly higher carrier frequency (66% vs 42%, p=0.002) and odds ratio (OR=2.6, 95% CI 1.4-4.9).  Genotype data was further filtered through gender, age, parental consanguinity, and smoking, each of which showed no significant association with susceptibility to hypertension (p>0.05), suggesting that these polymorphisms predispose to hypertension regardless of the listed risk factors.

Ali A et al. (2013) partly investigated the association of ACE insertion/deletion (I/D) amd eNOS G894T (p.E298D) polymorphisms with hypertension in Saudi subjects.  This study involved 250 controls and 120 cases with hypertension among which 51 were obese and diabetic.  Genotype data was filtered through gender, age, parental consanguinity, and smoking, each of which showed no significant association with susceptibility to hypertension (p>0.05).  Results suggested that the ACE I/D polymorphism may predispose to hypertension, while the eNOS p.E298D variant does not.

Sudan

A study by Woodhouse et al. (2003) to investigate the possibility of familial hypertension being due to mineralocorticoid hypersecretion included nine Sudanese patients [See: Oman > Woodhouse et al., 2003].

United Arab Emirates

In 1998, El-Shahat et al. (1999) presented a prospective study comprising 3,150 individuals from the Emirate of Sharjah. Overall, the prevalence of hypertension in the screened sample was 36.6%. Most of the study subjects were aged from 30-50 years and hypertension occurred more in females than in males.

[El-Shahat YIM, Bakir SZ, Hashim T, BoHaliga A, Al-Hossani H, Jaffar A-R. Hypertension in UAE citizens - preliminary results of a prospective study. Saudi J Kidney Dis Transplant. 1999; 10(3):376-81.]

Frossard et al. (1999a) compared the distribution of the alleles of a highly polymorphic variable number of tandem repeats localized 3' to the human apoB gene, the apoB 3' hypervariable region (HVR), in a group of normotensive and a group of hypertensive individuals. In the UAE population, Frossard and colleagues (1999a) found 18 alleles underlying a total of 51 genotypes. The distribution of these alleles is significantly different between normotensive and hypertensive UAE nationals. The main peak of the distributions occurred at 35 repeats among hypertensives (with a relative frequency of 25.7% versus 19.6% in normotensives) and at 37 repeats among normotensives (28.8% versus 20.3% in hypertensives). Alleles with 21, 23, 25, 49, and 55 repeats are found in hypertensives only (with a combined relative frequency of 7.6%). Frossard et al. (1999a) concluded that variations of the apoB gene, or of a nearby gene, that may be in linkage disequilibrium with these alleles play a role in the development of essential hypertension in UAE nationals.

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