UC San Diego

Hypertension is a chronic disease that is a risk factor for impaired cognition, stroke and heart attacks, among other diseases. Previous studies suggest that not accounting for the use of antihypertensive medication in genetic and population studies may confound results. Thus, identifying a model to correct for Blood Pressure- lowering medications is important. We assessed BP and antihypertensive medications in 1,237 male twins from the Vietnam Era Twin Study of Aging (VETSA). We used three approaches to correct BP measurements for antihypertensive treatment: (1) the addition of a fixed value of 10 mmHg and 5 mmHg to measured systolic and diastolic BP, respectively, for subjects on antihypertensive medication, (2) an incremented addition of mmHg to BP based on the number of different medications used, and (3) the addition of mmHg according to antihypertensive drug class and ethnicity. We used the classical twin design to estimate heritability of the corrected BPs. We also assessed whether the relationship between BP traits and Body-Mass Index (BMI) changed with corrections. The corrections for antihypertensive treatment did not significantly affect the heritability of BP measurements in VETSA data. However, corrections for antihypertensive treatments resulted in higher correlations between BP and BMI. We also analyzed demographic data on twins to compare prevalence of hypertension, prescribed BP medications, and BMI in regions across the United States, stratified by (1) geographic location, (2) political affiliation and (3) stress levels. The prevalence of hypertension significantly differed between regions of high stress and regions of low stress, suggesting a correlation between stress and hypertension