Genetic and Environmental Determinants of Hypertension in African Populations

Review Article

Abstract

Hypertension is a significant health burden in African populations, characterized by higher prevalence, earlier onset, and more severe complications compared to other ethnic groups. The distinct pathophysiology of hypertension in African populations stems from unique genetic variations, particularly in the renin-angiotensin-aldosterone system (RAAS), endothelial function regulators, and sodium handling genes. These genetic factors interact with environmental influences, including dietary patterns, physical activity levels, and socioeconomic conditions, contributing to the disproportionate impact of hypertension in African communities. Salt sensitivity, a prevalent characteristic in African populations, results from specific genetic polymorphisms affecting renal sodium handling and appears to be exacerbated by modern dietary practices. Recent advances in pharmacogenetics have revealed population-specific responses to antihypertensive medications, suggesting the need for tailored therapeutic approaches. The emerging role of the gut microbiome in blood pressure regulation adds another layer of complexity to the pathophysiology of hypertension in African populations. Combination use of genetic screening, personalized medicine approaches, and culturally appropriate lifestyle interventions may optimize hypertension management in African communities. Additionally, addressing socioeconomic barriers to healthcare access remains crucial for improving outcomes. The next big things in this area include large-scale genetic studies focusing on African-specific hypertension phenotypes, investigation of epigenetic modifications, and development of targeted therapeutic strategies based on individual genetic profiles.