Familial Aggregation of Blood Pressure and the Heritability of Hypertension

Within industrialized, high-income nations, it is evident that a pediatric obesity epidemic has taken place. Part of the transition to an increasing number of children and youth with obesity is elevated blood pressure (BP) (hypertension) during childhood and youth. Hypertension is a well-recognized risk factor for chronic kidney and cardiovascular diseases. Childhood hypertension, which is associated with adulthood hypertension and lifelong cardiovascular events, has been increasing over the past two decades. The tracking of BP from childhood to adulthood has led to a renewed focus on etiology, identification, prevention, diagnosis, and management. Within this emerging public health challenge, it is also acknowledged that genetic factors play an important role in a person’s propensity to develop hypertension. This chapter reviews the history and evolution of the field through the exploration of the familial aggregation of childhood BP. We will consider the genetic factors related to the familial aggregation of childhood BP as well as maternal factors, birth weight, obesity, health behavior influences, and socio-economic features. We conclude the chapter with a brief discussion of promising future research directions for assessing the genetic risk of BP in childhood.