The CC genotype of the CYP11B2 rs1799998 (T-344C) promoter polymorphism carried a 6.35-fold greater odds of hypertension (95% CI: 2.60–15.54) compared to the TT genotype in a Ghanaian case-control study of 200 subjects (100 hypertensive, 100 controls). The risk C-allele frequency was nearly double in hypertensive patients (0.565) versus controls (0.315, p<0.0001), and the CC genotype independently associated with elevated plasma aldosterone levels.
This finding matters for several reasons. CYP11B2 encodes aldosterone synthase, and its T-344C promoter variant has been studied predominantly in European and East Asian populations, where associations with hypertension are inconsistent. This is among the first data from a West African population — a group historically underrepresented in cardiovascular genomics — suggesting the variant may carry particularly strong penetrance in this genetic background. Hyperaldosteronism is increasingly recognized as an underdiagnosed driver of treatment-resistant hypertension, making actionable genetic markers clinically valuable. However, critical limitations temper enthusiasm: the sample of 200 is modest, the case-control design cannot establish causality, and unmeasured confounders (diet, sodium intake, BMI) may bias results. The single-metropolis recruitment also limits generalizability across Ghana's ethnically diverse population. As a preprint posted on medRxiv and not yet peer-reviewed, these findings should be interpreted cautiously — independent replication in larger, multi-ethnic African cohorts is essential before any clinical translation. Overall, this is a promising, hypothesis-generating contribution to an understudied area.