Researchers studied 143 older adults to understand why some people struggle to keep their blood pressure under control even with treatment. They discovered that certain genetic variations—inherited traits passed down from parents—can make it harder for the body to regulate blood pressure. The study found that people with specific versions of genes related to a system called the renin-angiotensin-aldosterone system had more difficulty controlling their blood pressure. This discovery is important because it suggests doctors might one day use genetic testing to identify which older adults need extra attention or different treatment approaches to manage their blood pressure effectively.

The Quick Take

  • What they studied: Whether certain inherited genetic variations affect how well older adults can control their blood pressure with treatment
  • Who participated: 143 community-dwelling older adults with high blood pressure who were being treated for the condition
  • Key finding: People carrying specific versions of two genes—the REN gene and the ACE gene—were significantly more likely to have poorly controlled blood pressure, even when receiving treatment
  • What it means for you: If you’re an older adult with high blood pressure that’s difficult to control, your genes may be partly responsible. This doesn’t mean treatment won’t work, but it suggests you might benefit from more aggressive or personalized treatment strategies. Talk to your doctor about whether genetic testing could help guide your care.

The Research Details

This was an observational study where researchers recruited 143 older adults living in the community who had high blood pressure. They collected blood samples to test for five different genetic variations in genes that control a body system responsible for regulating blood pressure and fluid balance. They also gathered information about each person’s lifestyle habits, diet, health history, and socioeconomic background through questionnaires. Blood pressure was measured using standard clinical methods. The researchers then used statistical analysis to determine which genetic variations, lifestyle factors, and health characteristics were most strongly associated with poor blood pressure control.

The genetic variations they studied are like different versions of instruction manuals in your cells. Just as different versions of a recipe might produce slightly different results, different versions of these genes can affect how your body regulates blood pressure. The researchers looked at five specific genes that are part of the renin-angiotensin-aldosterone system, which is your body’s main blood pressure control mechanism.

Understanding which genetic variations make blood pressure control more difficult is important because it helps doctors identify high-risk patients who may need more intensive treatment. This approach is called ‘precision medicine’—tailoring treatment to individual characteristics rather than using a one-size-fits-all approach. For older adults, who are at higher risk of complications from poorly controlled blood pressure, this information could help prevent heart attacks, strokes, and kidney disease.

This study has several strengths: it focused specifically on older adults, a population that really needs better blood pressure control strategies, and it examined multiple genetic factors together rather than looking at genes in isolation. However, the study size of 143 people is relatively modest, which means the findings need to be confirmed in larger studies. The study was observational rather than experimental, meaning researchers observed what was already happening rather than randomly assigning people to different treatments. This type of study can show associations but cannot prove that genes directly cause poor blood pressure control. Additionally, the study doesn’t provide information about the journal’s impact factor, which would help assess its prestige in the scientific community.

What the Results Show

The researchers found that two specific genetic variations were significantly associated with poor blood pressure control in older adults. First, people who carried the A allele (a version) of the REN gene were more likely to have inadequately controlled blood pressure. Second, people with the II genotype (a specific combination) of the ACE gene also had more difficulty controlling their blood pressure. These findings were statistically significant, meaning they were unlikely to have occurred by chance alone.

Interestingly, the study also found that LDL cholesterol levels—the ‘bad’ cholesterol that contributes to heart disease—were associated with poor blood pressure control. This suggests that blood pressure and cholesterol control may be connected through shared biological pathways. The researchers used a statistical method called Poisson multivariate regression, which allowed them to examine multiple factors simultaneously to see which ones were most important for predicting blood pressure control.

While the abstract doesn’t detail other secondary findings, the research approach suggests the scientists examined how sociodemographic factors (like age, income, and education), health habits (like exercise and diet), and other lifestyle characteristics might interact with genetic factors. The fact that they collected this information indicates they were exploring whether lifestyle modifications might be able to overcome genetic disadvantages in blood pressure control.

This research builds on decades of studies showing that the renin-angiotensin-aldosterone system plays a crucial role in blood pressure regulation. Previous research has identified that variations in these genes affect how well blood pressure medications work, particularly ACE inhibitors and ARBs (angiotensin receptor blockers), which are commonly prescribed drugs. This study extends that knowledge by specifically examining how these genetic variations affect overall blood pressure control in older adults, a population that has been less thoroughly studied in genetic research.

The study has several important limitations that readers should understand. First, with only 143 participants, the results may not apply to all older adults—larger studies are needed to confirm these findings. Second, the study is observational, meaning it shows associations but cannot prove that these genes directly cause poor blood pressure control; other unmeasured factors could be involved. Third, the study doesn’t provide detailed information about medication use, which is crucial for understanding blood pressure control. Fourth, the study population appears to be community-dwelling older adults, which may not represent older adults in hospitals or nursing homes. Finally, genetic studies often need to be replicated in different populations to confirm that findings apply broadly across different ethnic and geographic groups.

The Bottom Line

If you’re an older adult with high blood pressure that’s difficult to control despite medication, ask your doctor whether genetic testing might be helpful in your situation. The evidence suggests that genetic factors do play a role in blood pressure control, so understanding your genetic profile could help guide more targeted treatment. This might include trying different medication classes, more aggressive dosing, or combining medications in different ways. Additionally, focus on modifiable factors you can control: maintain a healthy diet low in sodium, exercise regularly, manage stress, limit alcohol, and maintain a healthy weight. These lifestyle changes remain important regardless of your genetic background. Confidence level: Moderate—this is promising research, but larger studies are needed to confirm these findings and determine how to best use genetic information in clinical practice.

This research is most relevant to older adults (typically 65 and older) who have been diagnosed with high blood pressure and are having difficulty controlling it despite taking medication. It’s also important for their healthcare providers, who may use this information to make treatment decisions. People with a family history of high blood pressure or heart disease may also find this information relevant. However, this research doesn’t directly apply to younger people with high blood pressure or to people whose blood pressure is well-controlled with current treatment.

If you and your doctor decide to pursue genetic testing and adjust your treatment based on the results, you should expect to see changes in blood pressure control within 2-4 weeks of starting new medications or adjusting doses. However, some people may take 6-8 weeks to reach optimal control. Lifestyle changes typically show benefits within 4-12 weeks, though some improvements in blood pressure can occur within days of reducing sodium intake or increasing exercise.

Want to Apply This Research?

  • Track your daily blood pressure readings at the same time each day (morning and evening) using a home blood pressure monitor, recording both systolic (top number) and diastolic (bottom number) readings. Also log any medication changes, dietary sodium intake, exercise duration, and stress levels to identify patterns in what affects your blood pressure control.
  • If you learn you have genetic variations that make blood pressure control more difficult, use the app to set up daily reminders for medication adherence, track sodium intake by logging meals, monitor exercise minutes, and record weekly weight. Create a goal to reduce sodium to less than 2,300 mg daily and aim for 150 minutes of moderate exercise weekly—these modifications may help overcome genetic disadvantages.
  • Establish a long-term tracking system that records blood pressure readings 2-3 times weekly, medication adherence daily, and lifestyle factors (diet, exercise, stress, sleep) weekly. Review trends monthly with your healthcare provider to assess whether current treatment is working or needs adjustment. Use the app’s data export feature to share reports with your doctor at regular appointments.

This research describes associations between genetic variations and blood pressure control in older adults but does not provide medical advice. Genetic testing and treatment decisions should only be made in consultation with your healthcare provider. If you have high blood pressure, continue taking prescribed medications as directed and do not make changes without discussing them with your doctor first. This study is preliminary research that needs confirmation in larger populations before it can be widely applied in clinical practice. Always consult with a qualified healthcare professional before making any changes to your blood pressure management plan.