The number of people with hypertension in China has exceeded 260 million, and the incidence of hypertension is on the rise. Poor lifestyle habits and diet can lead to an increase in the chance of hypertension, and genetic factors are also critical for hypertension. Some people may ask, “Is hypertension hereditary? Will it affect the next generation? The following content is for hypertension patients will be hereditary, let’s understand it. First, how high are the chances of heredity of hypertension? People with a family history of hypertension are more likely to develop hypertension than people without a family history of hypertension. If one parent is hypertensive, the incidence of hypertension in children can be up to 28%, and if both parents are hypertensive, the incidence of hypertension in children can be up to 45%, while the incidence in children of parents with normal blood pressure is only 3-5%. Sixty-five percent of adult siblings of hypertensive patients can develop hypertension, with monozygotic twins having a higher correlation with hypertension than other relatives. Some factors associated with the development of hypertension, such as hyperlipidemia, obesity, diabetes mellitus, and high salt diet, are also closely related to genetics. The two main factors are genes and environment, i.e., the tendency to develop multiple diseases in the family due to polygenic inheritance and the common living environment, food habits, and personality preferences of the same family. However, this does not mean that if parents have hypertension, their children will definitely suffer from hypertension. By controlling other triggers of hypertension, such as smoking, alcoholism, excessive fatigue, emotional instability, etc., the incidence of hypertension can be reduced. The genetic factor of hypertension accounts for 30% to 50%. Then we can not help but ask genetic testing note can predict hypertension disease? Second, is genetic prediction of hypertension disease needed? The ability of clinical genetic testing to determine the cause of hypertension is related to the heritability of hypertension. There are two modes of hypertension heritability. 1. The polygenic pattern in which multiple micro-effect genes act together is a non-Mendelian mode of inheritance and is seen in most patients with hypertension. The cumulative effect of all blood pressure-associated loci found based on genome-wide association analysis explains only about 2% of the heritability, and this type of hypertension is currently not amenable to genetic testing to determine the cause. 2. Hypertension caused by a single gene mutation, inherited in a manner consistent with Mendel’s law of inheritance, and a single gene mutation that causes alterations in water-electrolyte transport, and salt-corticoid synthesis or function in the distal renal unit is called monogenic hypertension, such as Liddle syndrome. Although this type represents a small percentage of the total hypertensive population, it has an early onset, mostly in adolescence, and often presents as malignant or refractory hypertension. A clear diagnosis and differential diagnosis of such patients can be made by testing for the presence of mutations in the relevant genes. Therefore, for most patients with essential hypertension, well controlled by medication and without adverse effects, going for genetic testing is not currently recommended. Screening for monogenic hypertension is necessary in patients with moderate to severe hypertension at age <30 years at first onset, especially those with low renin activity. Currently, genetic testing for the diagnosis of monogenic hypertension is relatively mature and is gradually being applied to clinical practice, and as research progresses and methods advance, more and more monogenic hypertension will be identified.