**4. Conclusions**

Hypertension in African Americans is the leading cause of cardiovascular disease in this population. The complex interactions between genetic and environmental determinants are yet to be identified. Several genes implicated in RAAS activation have been studied in African American populations and have revealed a surprising number of novel variants and pathways possibly implicated in the pathogenesis of hypertension. Among them, variants in the *ARMC5* gene appear to be a rare but inherited cause of primary aldosteronism and consequently low-renin hypertension in African Americans. Further studies are needed to determine the significance of the genes discussed in this review and respective pathways, which will guide personalized precision therapy for hypertension.

**Author Contributions:** M.Z. and F.H.-S. co-authored the manuscript. C.A.S. provided oversight and edited the manuscript.

**Acknowledgments:** This research was supported in part by the Intramural Research Program of The *Eunice Kennedy Shriver* National Institute of Child Health and Human Development, National Institutes of Health (NIH), clinical trials NCT00005927 (Clinical and Molecular Analysis of ACTH-Independent Steroid Hormone Production in Adrenocortical Tissue) and NCT00001595 (A Clinical and Genetic Investigation of Pituitary Tumors and Related Hypothalamic Disorders). We thank Diane Cooper, MSLS, NIH Library, for assistance in writing this manuscript.

**Conflicts of Interest:** The authors declare no conflict of interest. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

#### **Abbreviations**

