DNA strand with blood vessels and cityscape, symbolizing hypertension genetics.

Unlocking the Secrets of Hypertension: Can Genes Predict Your Risk?

Lena Voss in Health & Wellness December 2025 • 4 min read.

"New research explores the link between ACE2 gene variations and hypertension, offering insights into personalized health strategies."

High blood pressure, or hypertension, is a major health concern affecting millions worldwide. While lifestyle factors like diet and exercise play a significant role, genetics can also influence your susceptibility to this condition. Recent research has begun to uncover the complex interplay between our genes and our risk of developing hypertension, potentially paving the way for more personalized prevention and treatment strategies.

One area of particular interest is the ACE2 gene, which plays a crucial role in regulating blood pressure. Scientists have been investigating how variations in this gene might impact our risk of developing not only hypertension but also related conditions like dyslipidemia (abnormal cholesterol levels) and even stroke. Understanding these genetic connections could help us better assess individual risk and tailor interventions accordingly.

A groundbreaking study conducted in the Xinjiang region of China delved into the association between ACE2 gene polymorphisms (variations) and susceptibility to essential hypertension (EH) and dyslipidemia. This research aimed to determine if specific ACE2 gene variations are more prevalent in individuals with these conditions, offering a potential genetic marker for risk assessment.

Decoding the ACE2 Gene: What Does It Do?

DNA strand with blood vessels and cityscape, symbolizing hypertension genetics.

The ACE2 gene provides instructions for making a protein called angiotensin-converting enzyme 2. This enzyme is a key component of the renin-angiotensin-aldosterone system (RAAS), which helps regulate blood pressure, fluid balance, and electrolyte balance in the body. ACE2 works by counteracting the effects of another enzyme called angiotensin-converting enzyme (ACE). While ACE increases blood pressure, ACE2 helps to lower it, maintaining a delicate balance.

Variations in the ACE2 gene, known as polymorphisms, can alter the way the ACE2 enzyme functions. Some variations might lead to reduced ACE2 activity, potentially disrupting the RAAS balance and increasing the risk of hypertension and related cardiovascular issues. The study in Xinjiang, China, sought to identify which specific ACE2 polymorphisms were most strongly associated with hypertension and dyslipidemia.

Here's what the study revealed:

Hypertension Links: Certain ACE2 gene variations, including those labeled rs2074192, rs4646155, rs4646188, rs4240157, rs4830542, and rs879922, were found to be significantly associated with an increased risk of essential hypertension.
Dyslipidemia Connections: Other ACE2 variations, such as rs1978124, rs2106809, rs233575, rs4646188, and rs879922, were linked to dyslipidemia, specifically increased LDL-C (bad cholesterol) levels.
Ischemic Stroke Risk: The study also found an association between specific ACE2 variations (rs4240157, rs4646188, and rs4830542) and a higher prevalence of ischemic stroke.

These findings suggest that ACE2 gene variations can indeed influence an individual's susceptibility to hypertension, dyslipidemia, and related cardiovascular events. However, it's important to remember that genetics is only one piece of the puzzle.

Taking Control of Your Health: What You Can Do

While genetic predispositions can increase your risk, lifestyle modifications remain crucial in preventing and managing hypertension and dyslipidemia. By adopting a heart-healthy lifestyle, you can significantly reduce your risk, even if you have a genetic predisposition. This includes maintaining a healthy weight, eating a balanced diet low in sodium and saturated fat, engaging in regular physical activity, managing stress, and avoiding smoking.

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This article is based on research published under:

DOI-LINK: 10.1186/s12944-018-0890-6, Alternate LINK

Title: Association Of Ace2 Polymorphisms With Susceptibility To Essential Hypertension And Dyslipidemia In Xinjiang, China

Subject: Biochemistry (medical)

Journal: Lipids in Health and Disease

Publisher: Springer Science and Business Media LLC

Authors: Yizhi Pan, Tianyi Wang, Yanfang Li, Tianwang Guan, Yanxian Lai, Yan Shen, Abudurexiti Zeyaweiding, Tutiguli Maimaiti, Fang Li, Haiyan Zhao, Cheng Liu

Published: 2018-10-20

Everything You Need To Know

How does the ACE2 gene influence blood pressure regulation?

The ACE2 gene provides instructions for creating the angiotensin-converting enzyme 2, a crucial part of the renin-angiotensin-aldosterone system (RAAS). ACE2 helps regulate blood pressure by counteracting the effects of the angiotensin-converting enzyme (ACE). While ACE increases blood pressure, ACE2 lowers it, helping maintain a balanced cardiovascular system. Disruptions in ACE2 function, often due to genetic variations, can impact this balance, influencing hypertension risk. This complex interplay is further modulated by factors influencing fluid and electrolyte balance, also under RAAS influence, showcasing the broad impact of ACE2 beyond just blood pressure.

What did the study in Xinjiang, China, reveal about ACE2 gene variations and their connection to hypertension and dyslipidemia?

The study in Xinjiang, China, identified specific ACE2 gene variations (polymorphisms) associated with an increased risk of essential hypertension and dyslipidemia. Variations like rs2074192, rs4646155, rs4646188, rs4240157, rs4830542, and rs879922 were linked to hypertension, while variations like rs1978124, rs2106809, rs233575, rs4646188, and rs879922 were associated with dyslipidemia, particularly increased LDL-C levels. The research suggests that genetic predispositions related to the ACE2 gene can influence susceptibility to these conditions. Furthermore, the finding of links to ischemic stroke through ACE2 variations such as rs4240157, rs4646188, and rs4830542 underscores the gene's wider cardiovascular implications, warranting further investigation into preventive measures.

If I have ACE2 gene variations that increase my risk of hypertension, what lifestyle changes can help mitigate that risk?

Even with genetic predispositions indicated by ACE2 gene variations, lifestyle modifications can significantly reduce your risk of hypertension. Key changes include maintaining a healthy weight, adopting a balanced diet low in sodium and saturated fat, engaging in regular physical activity, managing stress levels, and avoiding smoking. These lifestyle adjustments can positively influence the renin-angiotensin-aldosterone system (RAAS) and overall cardiovascular health, helping to counteract the genetic influences of ACE2 variations. Besides these general recommendations, personalized advice from healthcare professionals considering your specific ACE2 polymorphism profile could optimize preventative strategies.

Besides hypertension and dyslipidemia, what other health conditions have been linked to ACE2 gene variations in the study?

In addition to hypertension and dyslipidemia, the Xinjiang study found an association between specific ACE2 gene variations (rs4240157, rs4646188, and rs4830542) and a higher prevalence of ischemic stroke. This suggests that variations in ACE2 may have broader implications for cardiovascular health beyond just blood pressure and cholesterol levels. Further research should explore potential connections between ACE2 variations and other cardiovascular or related conditions, such as heart failure or kidney disease, to fully understand the gene's role in overall health.

How does ACE2 counteract the effects of ACE in regulating blood pressure?

ACE2, or angiotensin-converting enzyme 2, counteracts the effects of angiotensin-converting enzyme (ACE) within the renin-angiotensin-aldosterone system (RAAS). ACE increases blood pressure, while ACE2 works to lower it, thereby maintaining a delicate balance essential for cardiovascular health. Specifically, ACE converts angiotensin I to angiotensin II, a potent vasoconstrictor that raises blood pressure. ACE2, conversely, converts angiotensin II into other peptides that have vasodilatory and anti-inflammatory effects, thus reducing blood pressure. Variations in the ACE2 gene can disrupt this counter-regulatory action, leading to an imbalance and potentially contributing to hypertension. The precise enzymatic mechanisms involving other RAAS components like renin and aldosterone further determine blood pressure outcomes and therefore should also be considered.