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The etiology of hypertension in the metabolic syndrome part two: the gene-environment interaction.

The pathogenesis of obesity, insulin resistance and hypertension begins with an interaction between genetic factors and environmental factors. The search for the underlying genetic basis of these conditions has yielded disappointing results. It is possible that the importance of environmental influences has been underestimated. In Part Two of our series of reviews, we discuss the key genetic, environmental and evolutionary influences which lead to the development of these conditions, and provide a detailed account of the mechanisms by which these influences produce their effects.