**Preface to "Role of Genomics in the Management of Hypertension"**

Arterial hypertension, affecting about 1 billion people worldwide, is the strongest modifiable risk factor for cardiovascular disease and related disability, leading to 9.4 million deaths each year. Notwithstanding major advances in understanding the etiology of hypertension, it remains largely underdiagnosed and often undertreated in the general population. The pathophysiology of hypertension involves the complex interplay between environmental (such as high sodium intake, excess alcohol consumption, and mental stress) and genetic factors, which, in turn, result in the disruption of factors involved in blood pressure control.

Monogenic forms of hypertension are rare conditions, due to loss or gain of function mutations in genes ultimately involved in salt and water homeostasis. The identification of the molecular basis of Mendelian forms of hypertension has provided important insights into the pathophysiology of blood pressure regulation and enabled effective etiological therapy.

Twin and family studies have demonstrated that 30–50% of the individual risk comes from genetic factors and a family history of hypertension increases the risk of developing high blood pressure levels by four times. However, genome-wide association studies demonstrated that hypertension-associated variants can only explain 2–3% of blood pressure variance and the effect size for each identified SNP was about 1 mmHg for SBP and 0.5 mmHg for DBP.

Additionally, genome science is providing new tools for understanding variability in drug response and can be applied to patients affected by arterial hypertension, with the ultimate goal of improving drug efficacy and reducing toxicity.

This book focuses on recent advances in genetic and genomic alterations in patients affected by arterial hypertension and their potential clinical and therapeutic implications.

> **Paolo Mulatero, Silvia Monticone** *Editors*
