Emerging Areas of Human Health Essay

Emerging Areas of Human Health Essay

Health people 2020 and 2030 included biological and genetic factors among specific populations as important determinants of health (U.S. Department of Health and Human Services, 2022). Genetics play a role in familial diseases and how they are passed down from generation to generation. Genetic diseases present at different ages and in different sexes depending on their pattern of heredity. While most genetic diseases have autosomal dominant and autosomal recessive, others are sex-linked and passed down through the sex chromosomes thus tend to present more in the male sexes and females remain carriers most of the time. Analysis of the family genogram enhances our understanding of the inheritance of the disease in the family between generations. Family health history is thus, an important first approach to acquiring genomic information. However, the role of lifestyle, habits, and environment should not be overlooked in some diseases that are believed to be familial. The purpose of this paper is twofold: to describe my family genogram and to explain the heredity pattern of a specific condition in my family using the Surgeon General’s tool, My Family Health Portrait.

My Family Pedigree

The use of the Surgeon General’s tool enabled me to document my family tree diagram for four generations from my grandparents to my children. In this risk assessment tool, I designated myself as the proband because I have hypertension. I wanted to understand if there are hereditary patterns in hypertension and other cardiovascular diseases in my family. Various documented literature has reported that hypertension is some heredity component. However, there is a big component of lifestyle and habits in the causation of essential hypertension (Singh & Watson, 2018). A case-control study by Li et al. (2019) among the Han Population in China found that essential hypertension has a familial aggregation and that the first-degree relatives have high heritability than second and third-degree relatives. The genetic heritability behind secondary hypertension has been explained by various genes that cause monogenic disorders such as familial hypertension such as glucocorticoid-remediable aldosteronism, Liddle’s syndrome, and mineralocorticoid receptor mutations, Gordon’s syndrome, and hypertension with brachydactyly (Ehret, 2018). The role of genetics in the causation of hypertension in these diseases is therefore indirect.

There has been a history of hypertension in my maternal grandmother, maternal uncle, mother, and myself. Heredity is in my maternal side of the family. However, there is no monogenic disease that accompanies familial hypertension in my family. Unfortunately, deaths among family members with hypertension have arisen from heart diseases. Hypertension and hypertensive heart disease lead to deaths from cardiovascular and end-organ complications such as renal diseases, stroke, and heart complications (Grundy et al., 2019). Deaths from heart disease have been seen in the maternal and paternal sides of my family in the presence and absence of hypertension. However, the Surgeon’s tool risk assessment showed that I might be more likely to develop heart disease based on my positive familial history.

Transmission

The risk of death from heart disease is higher in my family according to the tool. However, there is a clear pattern of inheritance that was realized from the pedigree. The risk of transmission of hypertension to my children is higher owing to the presence of hypertension in every generation, especially female family members. This risk cannot be ascertained for sure because this tool did not take into account the environmental risks such as overweight, obesity, smoking, sedentary lifestyle, dietary salt intake, anxiety, excessive alcohol intake, and emotional factors. In the absence of a clear pattern of inheritance, it is difficult to ascertain the risk of transmission to the children. But the presence of hypertension increases the chances of my children getting the disease. Monogenic hypertension is rare among populations and in most cases, the genes causing these diseases are not related to the primary essential hypertension. The Surgeon’s tool does not consider hypertension as an inheritable condition and does not calculate the risks of transmission. However, the risk of heart disease is documented as high and thus needs preventive intervention.

The number of family members with hypertension and the severity of hypertension relate to the risk of hypertension among relatives. In this case, four family members across three generations have hypertension but the severity and types of this hypertension were not assessed. Therefore, the risk of transmission is high but there is a need to consider the modifiable factors such as diet, lifestyle habits, and physical activity (Moonesinghe et al., 2019). The concept of heterogeneity in the genetic transmission of hypertension has also been reported in the literature. With multiple gene loci for hypertension-causing genes, most studies average the risk of heritability to be about 30% (Singh & Watson, 2018). The role of nonmodifiable risks such as age and ethnicity cannot be overlooked (Centers for Disease Control and Prevention, 2022). My ethnicity, black race, might have played a huge role in hypertension and other cardiovascular diseases in my family.

Feasibility of Using the Surgeon’s Tool

The tool provided a variety of features and is usable by both care providers and the patients in making a decision regarding their health. Alongside, visualizing the family tree, this tool identifies documented inheritable conditions. Patients with suspected familial illnesses will require the use of this tool to calculate their risks of acquiring or transmitting these diseases to immediate family members. However, these risk findings must be tied together with other risk assessments that do not rely on genetic inheritance to provide patient education. I will use this tool in my practice to in practice because I think it is safe and beneficial. It is self in that, the patient data is protected from access to the third party and can only be accessed by the patient at their will. The findings of this tool will provide a basis for genetic testing and genetic counseling for patients and their families

Conclusion

The surgeon’s tool has enabled me to compute my family health history to assess my risk of transmission to my children. From the tool, I found out that I might have a familial predisposition because there has been a familial inheritance in the maternal line. The high number of affected relatives has increased the risk of transmission to my future generations. However, the environmental risks have not been considered in this tool. Nevertheless, I will apply this tool in my practice to assess the risks in my patient owing to its safety and usability.

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References

Centers for Disease Control and Prevention. (2022, February 9). Heart disease, family health history, and familial hypercholesterolemia. Cdc.Gov. https://www.cdc.gov/genomics/disease/fh/index.htm

Ehret, G. B. (2018). Genetics of Hypertension. In Hypertension: A Companion to Braunwald’s Heart Disease (pp. 52–59). Elsevier. https://doi.org/10.1016/b978-0-323-42973-3.00006-8

Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., Braun, L. T., de Ferranti, S., Faiella-Tommasino, J., Forman, D. E., Goldberg, R., Heidenreich, P. A., Hlatky, M. A., Jones, D. W., Lloyd-Jones, D., Lopez-Pajares, N., Ndumele, C. E., Orringer, C. E., Peralta, C. A., … Yeboah, J. (2019). 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: A report of the American college of cardiology/American heart association task force on clinical practice guidelines: A report of the American college of cardiology/American heart association task force on clinical practice guidelines. Circulation, 139(25), e1082–e1143. https://doi.org/10.1161/CIR.0000000000000625

Li, A.-L., Fang, X., Zhang, Y.-Y., Peng, Q., & Yin, X.-H. (2019). Familial aggregation and heritability of hypertension in Han population in Shanghai China: a case-control study. Clinical Hypertension, 25(1), 17. https://doi.org/10.1186/s40885-019-0122-z

Moonesinghe, R., Yang, Q., Zhang, Z., & Khoury, M. J. (2019). Prevalence and cardiovascular health impact of family history of premature heart disease in the United States: Analysis of the National Health and Nutrition Examination Survey, 2007-2014. Journal of the American Heart Association, 8(14), e012364. https://doi.org/10.1161/JAHA.119.012364

Singh, V., & Watson, R. R. (2018). Lifestyle features and heart disease. In Lifestyle in Heart Health and Disease (pp. 223–226). Elsevier. https://doi.org/10.1016/b978-0-12-811279-3.00017-3

U.S. Department of Health and Human Services. (n.d.). Determinants of health. Healthypeople.Gov. Retrieved June 15, 2022, from https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

1. Use the Surgeon General\’s tool, \”My Family Health Portrait,\” located in the topic Resources, to document a family history.
2. Designate a proband for the pedigree with a disease or condition of interest.
3. Write a summary (750-1,000 words) of your findings that includes the following: (a) Discuss of the heredity patterns discovered; (b) Evaluate the risk of transmission to other/new family members; and (c) Propose the feasibility of using this tool in your own practice.
4. This assignment requires that at least two additional scholarly research sources related to this topic and at least one in-text citation for each source be included.