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British Medical Bulletin 50:235-245 (1994)
© 1994 The British Council

research-article

Growth areas in hypertension

J D Swales

Department of Medicine, University of Leicester Leicester, UK

Abstract

Essential hypertension is an arbitrarily defined disorder to which both environmental arid genetic factors contribute.Identifying these factors is a difficult task because individually their contribution is relatively small and apparent causality may be the result of secondary changes or genetic drift. Associations between elevated blood pressure and genetic or phenotypic characteristics are insufficient therefore to demonstrate a cause and effect relationship. This conclusion requires that stringent criteria are met including the presence of the abnormality at or before the first manifestation of hypertension, co-segregation of the relevant gene, reversibility of hypertension when the abnormality is removed (at least during the early phases of hypertension) and failure of the abnormality to resolve with the correction of hypertension. It is proposed that these conditions constitute ‘Koch's postulates’ for defining the causes of elevated blood pressure.


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