Essential hypertension: genes and dreams.

Herein we review all of the data from linkage by genome scanning and from association studies in essential hypertension. Genome scans have yielded loci linked to hypertension on almost every chromosome. We tabulate all of these loci to highlight the striking inconsistency. Similarly, association studies have implicated > 66 genes to date, which we also list, but virtually all have failed to show consistent replication in other settings. Nevertheless, we believe that molecular genetics should eventually find all of the major gene variants for essential hypertension. This will be a great scientific achievement and lead to new treatments. The dream, however, of using this information in clinical genetic testing could turn out to be a nightmare. Thus at present the hype surrounding genes for complex polygenic diseases like hypertension far exceeds the reality.