News - Hypertension Week of Jan. 12, 2003/ Vol. 2 No. 02

Study: Some May Be Predisposed to Hypertension At Birth

Some people may be born with a predisposition toward developing hypertension, according to a study reported in the Jan. 9th issue of the New England Journal of Medicine.

German researchers have confirmed that the presence at birth of a relatively low number of nephrons (the functional units of the kidney) is a major contributor to the development of hypertension.

The researchers compared the number and volume of glomeruli, which make up nephrons, in 10 middle-aged white accident victims with a history of primary hypertension with a like number of accident victims with normal blood pressure.

Patients with hypertension had fewer glomeruli, a larger glomerular volume and more severe arteriolosclerosis than did the controls. The low volume may gradually damage the kidney as a result of the increased workload per nephron.

Lead researcher Dr. Kerstin Amann, of the University of Erlangen-Nurnberg in Germany, said it is difficult to know just how the findings will one day impact the treatment of hypertension.

"Hypertension is certainly a heterogeneous disease," Amann told Medical Week. "We could show that in some patients the kidney and in particular a low nephron number is responsible, but in other patients, a gene polymorphism is the cause of hypertension."

However, the findings could lead to an earlier diagnosis of hypertension for patients at risk and to earlier treatment. "As far as the kidney is concerned several agents in particular ACE-inhibitors are known to be extremely nephroprotective," said Amann. "Thus, for some patients earlier diagnosis can definitely improve the prognosis."

Other sources: New England Journal of Medicine (Volume 348:101-108)