on November 22, 2004
Published online before print November 22, 2004, doi: 10.1161/01.HYP.0000149952.84391.54
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Submitted on September 9, 2004
From the Department of Biological Psychology (N.K., W.G., D.P., D.I.B., E.J.C.G.), Vrije Universiteit Amsterdam; and the Department of Psychiatry (H.R.), University of Groningen, the Netherlands. * To whom correspondence should be addressed. E-mail: hm.kupper{at}psy.vu.nl.
Abstract--The present study estimated the genetic influences on ambulatory systolic and diastolic blood pressure, and on hypertensive status derived from ambulatory levels, in a family sample of 535 twins and 257 singleton siblings. This "extended twin design" was used to explicitly test the possibility that results obtained in singleton siblings are different from those obtained in twins. To examine the effects of excluding (medicated) hypertensive subjects, the genetic analyses were first performed under strict exclusion (medication and/or blood pressure >135/85 mm Hg), then without the medicated subjects, and, finally, without any exclusion. For the latter analysis, the untreated blood pressure values in subjects using antihypertensive medication were estimated by augmenting the observed blood pressure by the published efficacy of the specific antihypertensive medication used. No evidence was found for differential means, variances, or covariances of ambulatory blood pressure in singletons compared with twins. This indicates that estimates of heritability of ambulatory blood pressure from twin studies can be generalized to the singleton population. Heritability of hypertension, defined as a mean daytime blood pressure >135/85 mm Hg or antihypertensive medication use, was 61%. Genetic contribution to ambulatory blood pressure was highest when all subjects were included (systolic, 44% to 57%; diastolic, 46% to 63%) and lowest under strict exclusion (systolic, 32% to 50%; diastolic, 31% to 55%). We conclude that exclusion of (medicated) hypertensives removes part of the true genetic variance in ambulatory blood pressure.
Revised on September 30, 2004
Heritability of Daytime Ambulatory Blood Pressure in an Extended Twin Design
Nina Kupper*;
Key words: blood pressure monitoring • hypertension, genetic • antihypertensive agents • genetics • twins
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