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1. HYPERTENSION
By: Group 6 (Sayson, Seposo, Silva, Tuson, and Zerrudo)
I. Introduction
Hypertensionisacommonandcomplex humandisease thatcauses significantmorbidity
and mortalityworldwide.Unfortunately, despiterecentadvancesinunderstandingand
treatinghypertension,itsprevalence continuestorise.
Recentresultsof the National NutritionandHealthSurvey(NNHeSII) FNRIshowedthat
more Filipinoshave hypertension,highfastingbloodsugar,andhighcholesterol and
triglyceride levels,which are riskfactorsforcardiovasculardiseases,diabetes,andother
lifestyle-relateddiseases.
Theyfoundoutthat one in everyfourFilipinoadults(25.3percent) hashypertensionor
a bloodpressure (BP) readingequal toorhigherthan140/90 millimeter mercury(mmHg),a
significantincreaseinthe prevalence of hypertension.In2008, the prevalence of
hypertensionincreasedto25.3 percentfrom22.5 percentin2003.
Withits associationtogeneticfactors,astudywas conductedtodetermine itspattern
of inheritance inthe mother’sside of ShangrillaSeposo’sfamily,the Tesoro-Joloclan,fora
numberof the extendedfamilymembersinthe clanare knowntobe hypertensive. Its
patternof inheritance is heterogeneous,but the frequenciesof differentmode of
inheritance varyindifferentpopulations.Determiningof the mode of inheritance ineach
familyisthe basicinformation thatisneededforthe riskestimationinthose family
members.
II. Case Definition
Hypertension is the term used to describe high blood pressure. Blood pressure is a
measurement of the force against the walls of arteries as the heart pumps blood through
the body. It could be considered high if the systolic pressure is over 140 most of the time,
normal if it is 120 or lowermost of the time. Also for the diastolic pressure, it is high is it is
over 90 most of the time, and normal if it is 80 or below most of the time. In between is
considered pre-hypertension, which usually leads to hypertension.

2. Many factors may affect ones’ hypertension. These include the water and salt intake,
diet, family history. It is usually in the adult stage when one can determine if he is
hypertensive ornot,thisisbecause adultsgive the fixedvaluesof theirbloodpressure.Also,
the risk of getting hypertension goes higher as someone ages because of the stiffening of
the arteries. It is usually asymptomatic, but in rare cases, headache, confusion, ear noise,
fatigue, irregular heartbeat, and nosebleed are felt which can be severe.
Hypertensive individuals are usually prescribed with drugs like Catapres for
maintenance while some get hospitalized when attacked.
A related literature by Pour-Jafari et al., 2006 about Hypertension’s pattern of
inheritance in100 Iranianfamiliesconcludedthathypertensioncouldbe caused by not only
one pattern of inheritance. The results revealed that hypertension’s frequency orders are
multifactorial, autosomal dominant and autosomal recessive, respectively.
III. Presentationofthe Clan
The clan coveredinthisstudywasthe Tesoro-Joloclanwhichisthe mother’sside of
ShangrillaSeposo’sextendedfamily. The greatgrandparents,namelyCandidoTesoroand
RufinaJolo,whowere bothhypertensive,bore tenchildren.Five of whichwere
hypertensive.The hypertensive oneswere Elias,Mansueto,Ma.Luz, Floreta,andEmma.
Those whoweren’twere Vicente,Ephipania,Luisa,AgapitoandCaridad.
Vicente andhiswife bore Vicente Jr.whowashypertensive.Eliasandhiswife
Marieta,who wasnon-hypertensive,hadsevenchildren.Four of whichwere hypertensive
namelyElma,Candido,Francisco,andEliasJr.Those whowere notwere Eleanor,Elsa,and
Elizabeth.Ephipaniaandherhusband,Frederiko,didn’thave anychildren.Mansuetoand
Esperanza,onthe otherhand,had tenchildren.Three of the tenwere hypertensive.They
are Warlito,Antonio,andNiorlito.Those whoweren’twereLinda,Roselia,Mahelia,Merlin,
MansuetoJr.,Ma. Luz, andJoselito.LuisaandherhusbandRamon,bothnon-hypertensive,
bore Helen,alsonon-hypertensive.Ma.Luz and herhusbandRamonbore three children
namelyRamonJr.,Candelaria,andMarilou.Marilouishypertensive.AgapitoandTeresita,
whois hypertensive,didn’tproduce anychildren.Floreta,whowashypertensive,and
Genelo,whowasn’t,hadtwochildrennamelyAlmaandGeneflor.Almaisthe only
hypertensive one.CaridadandAdrianodidn’thave anychildren.Lastly,EmmaandGeorge
had three children,one of whichwashypertensive namelyEmerson.The othertwo,Emily

3. and Jojie,were not.The fourthandfifthgenerationsare still atthe age groupbelongingto
the youngerones.Onlyafew were adultsandmostdidn’treachthe age of 30 yet,so the
signsof hypertensionstill aren’tvisible.
IV. Methodology
Interviewwasusedasthe basisfordetermining hypertension among the individuals in
the clan. The researcherswenttoGuintas, Leganes which was the residence of most of the
interviewees.Four people were interviewed: a grandparent, an aunt, her mother, and her
father. The study focused on her mother’s side covering five generations. The following
questions were asked:
a.Have you been diagnosed with Hypertension (High Blood Pressure)?
b.If yes, at what age did it start, or at what age was it discovered?
c.What was/were the treatment(s) toit?Orhow do you keepitunder
maintenance?
While the majorityof the supposedintervieweesweren’table to be contacted, Teresita
(a grandmother), Alma (an aunt), and Marilou (the mother) were interviewed on their
behalf.
Specifically,one wasproventobe hypertensive if he or she kept under maintenance or
was hospitalized.
V. Analysis
Basing on the study by Pour-Jafari et al., 2006, this study was analyzed using the
Pedigree chart tool to determine the pattern and to identify by the possible genotypes of
the individuals. Althoughhypertensionisdominantlyclassifiedasmultifactorial,analysiswas
able to match the results with the autosomal dominant.
Candido and Rufina were determined to have Hh and Hh as their possible genotypes,
respectively. Their children Elias, Mansueto, Ma. Luz, Floreta, and Emma also had Hh as
their genotypes. Those who weren’t hypertensive had hh genotype.
Eliasand hiswife Marieta,whowasnon-hypertensive,hadthe possible genotypesof Hh
and hh respectively. With the 50-50% percent chances, four of which were hypertensive
namelyElma,Candido, Francisco, and Elias Jr and their genotypes being possible to be Hh.
Those who were not, Eleanor, Elsa, and Elizabeth, had hh genotype.

4. Mansueto and Esperanza, bearing the genotypes Hh and hh respectively, had ten
children. The three hypertensive ones had Hh while those who weren’t had hh. Luisa and
her husband Ramon, both non-hypertensives, bore Helen, also non-hypertensive. All had
the genotype hh.
Ma. Luz and her husband Ramon carrying the genotypes Hh and hh respectively, bore
three childrennamelyRamonJr.,Candelaria,andMarilou.Marilouishypertensive also with
genotype Hh.
Floreta,whowashypertensive, and Genelo, who wasn’t, had the genotypes Hh and hh
respectively, and they had two children namely Alma and Geneflor. Alma is the only
hypertensive one.
As forEmma and George,theyhad Hh and hh for theirgenotypesrespectively,and they
had three children,one of whichwashypertensive namely Emerson whose genotype is Hh.
The other two, Emily and Jojie, were not.
Since the fourth and fifth generations didn’t show any signs of hypertension yet, they
considered phenotypically non-hypertensive with the genotype hh.
Although an inconsistency was found with Vicente Jr., it could be pointed out that he
has acquiredhypertensionnotbydirectgeneticfactors,butbyenvironmental ones as what
the case definitionhaspointedout about the environmental factors being one of the main
causes of hypertension.
VI. Conclusion
Thisstudyconcludesthathypertension’spatternof inheritanceinthe Tesoro-Joloclanis
classified as autosomal dominant.
References:
1. http://www.nlm.nih.gov/medlineplus/ency/article/000468.htm
2. Dreisbach, Albert., Sharma, Sat., Cortas, Claude., (2010, February 19). Hypertension.
http://emedicine.medscape.com/article/241381-overview
3. Pour-Jafariet al., 2006, Patterns of Inheritance of Essential Hypertension in Hundred Iranian Families, J Res Health Sci,
Vol6, No 1, pp 4-7