CLINICAL HYPERTENSION RESEARCH IN THE AGE OF MOLECULAR-GENETICS - PHENOTYPES OF HYPERTENSION

Essential hypertension is a complex phenotype, whose expression is influenced by both, environmental and genetic factors. While considerable research has gone into the study of the relationship between environmental factors and blood pressure, the understanding of the genetic factors remains limited. With the application of modern molecular genetics to hypertension research, it appears likely that several genetically well defined subtypes will emerge. For recognition of these subtypes to gain clinical relevance, however, it will be necessary to evaluate the clinical phenotype of each genetic subtype of hypertension. Clinical evaluation will include characterization of patients belonging to these subgroups with respect to secondary lesions, pathophysiological phenomena, prognosis and response to pharmacological and non-pharmacological intervention. These studies can only be performed by clinical investigators aware of the progress in molecular genetics and with access to well characterized patients with genetic hypertension.