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Unhealthy behavior + genes = hypertension

It all adds up – unhealthy behaviour and genes – to pave the way towards hypertension and cardiovascular disease.

We all know that certain lifestyle factors, e.g. cigarette smoking, alcohol consumption and lack pf physical exercise lead to high blood pressure. However, for the first time, researchers found that there are specific genes which interact with these behaviours and result in increased hypertension risk.

According to lead author Dr. Nora Franceschini, assistant professor of epidemiology at the University of North Carolina in Chapel Hill

“The three lifestyle characteristics are well-known risk factors for high blood pressure. What’s new is that we are showing that these behaviors interact with your genes to influence blood pressure levels.”

This means that your genes aren’t the only ones that determine your risk. You may be predisposed to hypertension based on your family history but by modifying your lifestyle, you can actually minimize your chances of being hypertensive.

“The most interesting study finding is that a susceptibility to hypertension in your genetic background doesn’t mean that your lifestyle exposures do not matter, they do. Drinking, smoking and exercise habits can be modified, which would, in turn, influence the risk of developing hypertension, even in people who are predisposed to the condition.”

The researchers looked at the medical and genetic history of 3,665 participants as part of the ongoing Strong Heart Family Study which is a large epidemiologic study of American Indians. The participants were aged 14 to 93 years of age and were part of large families of several generations. The goal of the study was to see how inherited genetic patterns vary among those with different lifestyles and educational levels. The results showed that lifestyle factors interact with genes/ethnicity and lead to hypertension. Educational level also seems to play a role but at a very minor level.

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Heavy drinking: bad for both male and female hearts

Heavy drinking is bad for the heart and for the arteries. Furthermore, heavy alcohol consumption affects men and women differently – although in the long run, the effects are never beneficial. This is according to a report presented at American Society of Hypertension 2008 Annual Meeting in New Orleans, LA in May.

Men: Heavy drinking among men leads to elevated blood pressure. Chronic high blood pressure then leads to stiffening of the arteries.

Women: Among women, heavy drinking does not necessarily cause high blood pressure but they are more at risk of developing enlarged hearts with structural abnormalities.

“Women … are at greater risk of developing increased left ventricular mass and septal thickness, whereas men experience more arterial and ventricular stiffness.“

The study investigated 200 men and women in Dublin, Ireland who were patients in a hypertension clinic. The drinking habits of the patients were classified as follows:

• nondrinkers
• moderate drinkers (males: 1 to 21 units of alcohol per week; females: 1 to 14 units per week)
• heavy drinkers (males: >21 units per week; females: >14 units per week)

The patients were then followed up by blood pressure measurements, conventional ECG and tissue Doppler imaging. Pulse-wave velocity and augmentation index were used to measure arterial stiffness.

“Investigators observed in men a dose-response relationship between alcohol intake and aortic systolic and diastolic blood pressure, the augmentation index, pulse-wave velocity, and indices of diastolic function. Even among those who drank moderately, there were significant increases in aortic blood pressures and the augmentation index. These findings, however, differed from the females in the study. In women, there was a dose-response relationship between alcohol and left ventricular septal and posterior wall thickness and left ventricular mass index. Even among heavy female drinkers, there was no relationship between drinking and arterial stiffness and high blood pressures.“

The results, especially those for women, were especially surprising. For one thing, heavy drinker females do not necessarily develop hypertension. It is a common belief that it is chronic hypertension that leads to the deleterious cardiovascular effects. Women, however, are more likely to develop liver disease than men. This difference is due to the fact that women are smaller and have relatively lesser liver enzymes to metabolize alcohol.

The study, however, shows that women are not only at risk for liver disease, but for heart disease as well. In fact, for women, the bad effects are not evident in the arteries but directly in the heart itself.

The heart enlargement among heavy drinking women can eventually lead to heart failure. With this condition, the heart muscles become weaker and weaker and will eventually lose the capacity to contract.

A rise in the rate of alcohol consumption among females has been the trend in Ireland. The researchers speculate that this might be due to the country’s booming economy as well as the belief that alcohol is actually beneficial to your health.

Indeed, several recent studies have reported that light to moderate alcohol consumption may actually be good for the heart. However, it seems that we need to draw a line between moderate drinking and drinking that is harmful to our health.

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