Description
Hypertension is a clinical manifestation of complex multigenic, pathophysiological, and environmental factors. Despite extensive work, there is still much to learn about its initiating causes, pathogenic mechanisms, and the pathways by which it predisposes to its well-known complications, such as heart failure, heart attack, heart disease, recurrent strokes, diabetes and chronic kidney disease. While antihypertensive medications and lifestyle modifications make it possible to reduce the risks of hypertensive complications, to date we do not know how to prevent or “cure” the disease. Recently, investigators are focusing on epigenetics as a means to better understand the causes, progression, and possible prevention of hypertension.
To explore the potential correlation between epigenetic modifications of genomic DNA and the development of hypertension, NHLBI convened a working group of multidisciplinary experts in Bethesda, Maryland on June 27-28, 2011. A major challenge in the field of epigenetics is the disentangling of causal pathways, i.e., epigenetic DNA modifications can induce disease, but disease can also induce epigenetic modifications. We know that some epigenetic modifications can be acquired, while others may be inherited. The working group was asked to review the state of knowledge in hypertension and epigenetics, as well as in several related fields; consider the potential for a causal relationship; and identify gaps in current knowledge and resources.