Blood Pressure

Is high blood pressure genetic? What runs in families, and what you can do with that.

If your mum, dad or a sibling takes blood pressure tablets, it’s a fair question to ask about yourself. The short answer is partly. Here’s what the research says genes account for, what families pass on that isn’t in the DNA at all, and why a family history is mostly a reason to start checking earlier.

NK Medically reviewed by Dr Nouman Kazmi, MBBS FCPS ·8 min read

Key Takeaways

  • High blood pressure does run in families. The NHS lists having close relatives with it as one of the things that make it more likely.
  • It isn’t one gene. More than 100 genetic variations have been linked to the common form, each nudging the risk a little.
  • Families share habits as well as genes. The BHF points out that relatives often share similar traits and habits, which is part of why conditions cluster.
  • Genes are one input among several. Between them, the NHS and BHF lists also include age, ethnicity, salt, weight, alcohol, activity and long-term stress.
  • High blood pressure usually has no symptoms, so a family history is best used as a prompt to get checked, and to keep checking.
In This Article
  1. The short answer
  2. How much is down to genes
  3. What families share besides DNA
  4. When it tends to show up
  5. Rare genetic forms, and other causes
  6. What to do if it runs in your family
  7. Frequently asked questions
  8. The bottom line

The short answer

Yes, partly. The NHS includes having close relatives with high blood pressure in its list of things that make you more likely to develop it, alongside getting older, your ethnicity, a diet high in salt, being overweight, smoking, drinking too much alcohol and long-term stress. The BHF lists a family history of high blood pressure among the things that can increase your risk, alongside getting older and ethnicity.

MedlinePlus, the US National Library of Medicine’s genetics service, says it plainly: hypertension tends to run in families, and people whose parents have it have an elevated risk, particularly if both parents are affected.

So if you’ve watched a parent collect a small tin of blood pressure tablets over the years and wondered whether yours is already on order, the honest answer is that your odds are higher than someone without that history. Higher odds isn’t the same as a verdict, though. The rest of this page is about the gap between the two, and it’s a wider gap than it sounds.

Up to 5 million
The BHF estimates that as many as 5 million UK adults have high blood pressure that hasn’t been diagnosed, and don’t know they’re at risk. The only way to find out if you’re one of them is a blood pressure check.

How much is down to genes

The common form of high blood pressure, the kind most people mean when they say it runs in the family, isn’t caused by one faulty gene you either have or don’t. MedlinePlus describes it as a complex condition with a variety of factors, both genetic and environmental, contributing to it, and says more than 100 genetic variations have been associated with it. The US National Heart, Lung, and Blood Institute puts it the same way: many genes are linked to small increases in risk.

The list keeps growing. In 2021 the BHF reported on a study published in Nature Genetics that found 179 genes in the human kidney linked to high blood pressure, and around 80 per cent of them had never been associated with it before.

The harder question is how much of the difference between people those genes explain. A 2023 study in Medicine, citing a 2021 review, puts blood pressure’s heritability at an estimated 30 to 50 per cent. The same paper notes that the 1,400-plus variants found so far explain only about 27 per cent of that.

Genes are a real part of the picture, probably a sizeable one, and nobody can yet read yours and tell you your future reading. MedlinePlus says the inheritance pattern is unknown. That’s the scientific way of saying it doesn’t pass down neatly like eye colour.

Your genes don’t come with a reading. Your arm does.

What families share besides DNA

When a condition clusters in a family, genes aren’t the only thing being handed down. The BHF notes that as well as sharing genes, families often share similar traits and habits.

Think about what a household passes on without anyone noticing. How much salt goes in the pan and on the plate. Whether an evening walk is a normal thing or an odd one. How much gets drunk at the weekend. The NHLBI adds one more that sits right on the line between the two: salt sensitivity, how strongly your blood pressure responds to salt, can also run in families.

Which is useful to know, because you can’t change the genes, but you can change the salt, the walks and the weekend drinking. When people say it runs in the family, they usually mean both at once.

Related Article
What Causes High Blood Pressure? A UK Guide

When it tends to show up

There isn’t a set age when inherited risk switches on. What the NHS does say is that you’re more likely to get high blood pressure as you get older, and the NHLBI explains why: blood vessels naturally thicken and stiffen over time.

A family history seems to bring that curve forward. A Finnish study published in 2023 followed 780 people born between 1953 and 1956, measuring them at 35, 40, 45 and 50. Those with a family history of hypertension had higher systolic and diastolic readings from age 35 onwards, and their systolic pressure rose faster each year. By 50, they had about three and a half times the odds of having been diagnosed with high blood pressure.

It’s one study, in one country, and it describes odds across a group, not what will happen to any one person in it. But the direction is useful. If it runs in your family, your thirties and forties are when checking starts to pay off, not your sixties.

Ethnicity belongs in the same conversation. The NHS says you’re at higher risk if you have a Black African, Black Caribbean or South Asian ethnic background. If both apply to you, both count.

Related Article
Normal Blood Pressure by Age: A UK Guide

Rare genetic forms, and other causes

There are rare conditions where a single gene is the main driver. MedlinePlus names familial hyperaldosteronism, pseudohypoaldosteronism type 2 and Liddle syndrome, along with tumours called paragangliomas, as rare disorders where high blood pressure is a key feature. They’re uncommon, and they aren’t what most families with high blood pressure are dealing with.

High blood pressure can also come from another condition entirely. The BHF lists kidney disease, diabetes and obstructive sleep apnoea, and says some medicines can play a part too, including oral contraceptives and some over-the-counter and herbal medicines. If you’ve started something new and your readings have moved, mention it to your GP or pharmacist and let them decide what, if anything, changes.

Then there’s the question people ask when they feel fit and still get a high reading: why me? Being active and keeping to a healthy weight takes several items off the list. It doesn’t touch the ones you can’t control, which is exactly where family history sits. The effort still counts. It was just never going to cover the whole list.

What to do if it runs in your family

The single most useful thing a family history gives you is a reason to check. The NHS says high blood pressure does not usually cause any symptoms and that many people have it without realising. The BHF agrees it usually has no symptoms. So waiting to feel something doesn’t work.

  1. Tell your GP about it. The BHF says to tell your doctor if a blood relative has had a heart attack or a stroke, even if you feel healthy. The NHS Health Check asks the same question: whether any of your close relatives have had any medical conditions.
  2. Take up the NHS Health Check. If you’re 40 to 74 and don’t have certain existing conditions, the NHS says you should be invited every 5 years, and it includes a blood pressure test. If the invitation hasn’t come, you can contact your GP practice.
  3. Don’t wait five years if you’re unsure. The NHS says GP surgeries and pharmacies offer checks, and many pharmacies check for free if you’re 40 or over. The BHF adds that you can measure your blood pressure at home.
  4. Work on the part you can change. Several things on the BHF’s list of what can increase your risk are habits: smoking, drinking too much alcohol, eating too much salt and not enough fruit and vegetables, not getting enough exercise, and being overweight, especially around your middle. Unglamorous, and the part that’s yours.

One reading won’t tell you much either way. Blood pressure moves through the day, and a single number taken after a rushed morning can mislead in both directions. A few weeks of readings, taken the same way at the same times, shows you where you actually sit and whether it’s drifting. That trend is the thing a GP can do something with.

Keep the trend, not just the number
The Matter BP Tracker is free and plots your home readings over time, so you can walk into an appointment with six or eight weeks on one screen. Useful when the conversation starts with “my dad had it too”.
Related Article
How to Measure Blood Pressure Correctly at Home
Call 999 if you get sudden pain or discomfort in your chest that doesn’t go away, or chest pain with sweating, feeling sick, dizziness or breathlessness. Call NHS 111 if you often have headaches or blurred vision. That’s the NHS guidance, and it applies whatever your family history.
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For the part that’s yours.

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Frequently asked questions

It can come through either side. MedlinePlus says people whose parents have high blood pressure have an elevated risk, particularly if both parents are affected, and that the exact inheritance pattern isn’t known. So there isn’t a rule that it follows the mother’s or the father’s line. If either parent has it, count it as a family history and mention it to your GP.

There’s no fixed age. In a Finnish study that followed 780 people from 35 to 50, those with a family history already had higher readings at 35, and by 50 had about three and a half times the odds of a diagnosis. Blood pressure also tends to rise with age for everyone, so a family history is a reason to start checking in your thirties and forties.

Both, usually together. MedlinePlus describes the common form as a complex condition with genetic and environmental factors contributing, and the NHS and BHF lists of causes include family history alongside salt, weight, alcohol, activity and smoking. Heritability is estimated at 30 to 50 per cent, which leaves plenty of room for everything else.

Yes. You can’t change your genes, but several things the BHF lists as increasing your risk are habits: smoking, drinking too much alcohol, too much salt and not enough fruit and vegetables, too little exercise and being overweight. Just as useful is knowing your numbers early, through your GP, a pharmacy, the NHS Health Check or a home monitor, so any change is picked up while it’s small.

Because being fit covers some of the causes and not others. The NHS lists age, ethnicity and having close relatives with high blood pressure among the things that make it more likely, and none of those respond to exercise. Other conditions, such as kidney disease, diabetes and sleep apnoea, can also cause it, according to the BHF.

A handful of rare single-gene disorders can. MedlinePlus names familial hyperaldosteronism, pseudohypoaldosteronism type 2, Liddle syndrome and tumours called paragangliomas. They’re uncommon. Most family patterns of high blood pressure come from many small genetic effects combined with shared habits.

Sometimes. The BHF says it can be caused by kidney disease, diabetes or obstructive sleep apnoea, and that some medicines can contribute, including oral contraceptives and some over-the-counter and herbal medicines. If your readings have changed since starting something new, raise it with your GP or pharmacist.

Usually not. The NHS says it does not usually cause any symptoms and that many people have it without realising, and the BHF estimates as many as 5 million UK adults have it undiagnosed. That’s why a family history is best used as a reason to get checked, not to wait for symptoms.

The bottom line

High blood pressure does run in families. Genes are part of that, spread across a long list of small effects, and so are the habits a household shares. A family history raises your odds and seems to bring the rise forward, but it doesn’t decide your reading for you.

Because it usually has no symptoms, the useful thing to do with a family history is get measured. Tell your GP, take the NHS Health Check when it comes, and get a few weeks of home readings so you know your own trend and not just your parents’.

Continue Learning

Understand Your Numbers
Symptoms of High Blood Pressure: What to Look For
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The Complete Guide to Understanding Blood Pressure (UK)
Lifestyle
Does Stress Increase Blood Pressure? A UK Guide
Dr Nouman Kazmi
Medically reviewed by Dr Nouman Kazmi Consultant Cardiologist (MBBS, FCPS). Dr Kazmi reviews clinical content on the Matter Heart Health Resource Centre for accuracy.
View Dr Kazmi’s profile →

References

  1. NHS. High blood pressure. Available at: nhs.uk
  2. NHS. NHS Health Check. Available at: nhs.uk
  3. British Heart Foundation. High blood pressure. Available at: bhf.org.uk
  4. British Heart Foundation. Family history of heart and circulatory conditions. Available at: bhf.org.uk
  5. British Heart Foundation. Genes responsible for high blood pressure discovered in the human kidney (7 May 2021). Available at: bhf.org.uk
  6. MedlinePlus Genetics (US National Library of Medicine). Hypertension. Available at: medlineplus.gov
  7. National Heart, Lung, and Blood Institute. High blood pressure: causes and risk factors. Available at: nhlbi.nih.gov
  8. Kunnas T, Nikkari ST. Family history of hypertension enhances age-dependent rise in blood pressure, a 15-year follow-up, the Tampere adult population cardiovascular risk study. Medicine (Baltimore). 2023;102(39):e35366. Available at: pmc.ncbi.nlm.nih.gov
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