Blood pressure genetics: time to focus.

This review briefly charts the recent history of the genetic study of high blood pressure (BP). After an inconsistent start it was hoped that very large genome-wide association studies (GWAS) might be able to provide some reliable answers. The two largest and most recent GWAS: CHARGE and GlobalBPgen were able to identify, despite some significant inconsistencies, genetic loci that accounted for only about 2% of the genetic factors believed to influence BP. The loci were associated with an estimated effect on BP of 1 mm Hg or less. No doubt many other loci exerting even smaller (<0.5 mm Hg) exist. This review contends that it is time to focus on the loci that can be viewed as confirmed, rather than extending the GWAS searches for less significant genetic influences. It is time to identify the precise deoxyribonucleic acid variants affecting BP, understand their mechanisms of action and think of ways in which such knowledge can be used to prevent and treat high BP in novel, effective, and possibly tailored ways.