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(Hypertension. 2001;38:19.)
© 2001 American Heart Association, Inc.

Commentary

Hypertension in an Anthropological and Evolutionary Paradigm

Robert S. Danziger

From the Division of Cardiology, University of Illinois School of Medicine, Chicago.

Correspondence to Robert S. Danziger, MD, Division of Cardiology, University of Illinois School of Medicine, 840 S Wood St, Chicago, IL 60612-7323. E-mail RDanziger@aol.com

Key Words: genetics • hypertension

	Introduction

 
The contingent, stochastic nature of genetic evolution [provides a]. . .historical trail [to help us] to identify genes affecting a trait, understand their origins, and to refine our ability to do genetic screening."¹

A renaissance is occurring in the field of molecular evolution. The reframing of questions about pathophysiology and disease in an evolutionary perspective is providing new insights and approaches to treatment. Evolutionary theory has recently been applied to such challenges as neonatal jaundice, otitis media, childhood asthma, allergies, infections such as HIV and sexually transmitted diseases, and cancer (for a review, see Trevathan et al²).

During the past several decades, blood pressure has been considered in an evolutionary paradigm. In the present discussion, the current state of this work is summarized. The first portion addresses the question of how blood pressure, in general, and hypertension, in particular, fit into the concept of darwinian selection. The latter portion provides insights into understanding and studying hypertension in the context of evolutionary genetics.

	Does Darwinian Selection Apply to Hypertension?

 
Natural selection reflects the observation made by Charles Darwin that individuals within a breeding population vary in their morphology and behavior and that these features are heritable. Not all members of a population contribute equal numbers of offspring to subsequent generations. There is an increase in the frequency of those traits that promote survival and reproduction from generation to generation.³ Today, it is understood that the passage of such "traits" is based on the interaction of genes and genotypes with the environment to produce specific phenotypes. Evolution . . . [Full Text of this Article]

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