rs5186
The salt-and-water system, and why it now works against us
What this position does
The renin-angiotensin system evolved to hold on to salt and water, which was the right instinct for almost all of human history. In an environment of abundant salt it contributes to high blood pressure, and it is the system that ACE inhibitors and angiotensin blockers act on.
Kidney and blood pressure. Shaped by holding on to salt and water. This is one of the variants that differs sharply between human populations, because something in the environment made one version worth having.
Salt, fat and blood pressure
Holding on to salt and water was the right instinct for almost all of human history. So was storing fat. Neither is an advantage in a shop.
What changed: Industry, roughly the last two centuries. Indoor work, heated buildings, refined food, cheap salt and sugar, tobacco at scale, and a collapse in infectious disease. This is where most of the deals in your genome came undone.
Why it spread: a strong case, not settled. There is a clear signal of recent selection and a widely favoured explanation for it, which is not the same as a proven one.
Spiral Staircase, chapter 17: The Water You Forgot to Drink Spiral Staircase is written by the same author as this site.
What each result means
| If you carry | What it means |
|---|---|
| No copies of the effect version AA | You have the common version on both copies The usual form of the receptor. |
| One copy AC | You carry one variant copy Associated in some studies with slightly higher blood pressure. |
| Two copies CC | You have the variant version on both copies Associated with modestly higher blood pressure in several studies. The effect is small, and salt intake, weight and activity move blood pressure a great deal more. |
How common each version is
| Ancestry group | C (the effect version) | |
|---|---|---|
| African | 2.0% | |
| American | 23.3% | |
| East Asian | 6.0% | |
| European | 27.2% | |
| South Asian | 6.9% |
1000 Genomes Project phase 3, via Ensembl, retrieved 2026-09-23. These groupings are coarse and flatten a great deal of internal diversity, particularly within Africa. A variant being common somewhere tells you where a piece of your ancestry probably comes from, and nothing else.
How many people carry each result
| Ancestry group | AA | AC | CC |
|---|---|---|---|
| African | 634 / 661 | 27 / 661 | 0 / 661 |
| European | 269 / 503 | 194 / 503 | 40 / 503 |
| East Asian | 445 / 504 | 58 / 504 | 1 / 504 |
| South Asian | 425 / 489 | 61 / 489 | 3 / 489 |
| American | 202 / 347 | 128 / 347 | 17 / 347 |
Counts of people, not modelled frequencies: every one of the 2,504 individuals sequenced by the 1000 Genomes Project phase 3, tallied by the genotype they carry. Deriving these from allele frequencies instead would assume random mating inside each group and undercount the homozygotes.
How to find out which you have
If you have taken a test with 23andMe, AncestryDNA, MyHeritage, Family Tree DNA, TellMeGen or Living DNA, this position is very likely already in the raw data file they gave you. You do not need another test.
One thing to watch if you look it up by hand: testing companies report some positions from one DNA strand and some from the other, and the file does not say which. Read the letters as they appear and you will get the opposite of the truth for some positions. Sequencings resolves that automatically.
Source
Coordinates and allele pair verified against Ensembl GRCh37. Direction of effect verified against VEP protein consequences or 1000 Genomes population frequency. Category: Population adaptation.
Where this fits
Common questions
What is rs5186?
rs5186 is a position in the AGTR1 gene on chromosome 3. The renin-angiotensin system evolved to hold on to salt and water, which was the right instinct for almost all of human history. In an environment of abundant salt it contributes to high blood pressure, and it is the system that ACE inhibitors and angiotensin blockers act on.
What does it mean if I have CC at rs5186?
You have the variant version on both copies. Associated with modestly higher blood pressure in several studies. The effect is small, and salt intake, weight and activity move blood pressure a great deal more.
What does it mean if I have AA at rs5186?
You have the common version on both copies. The usual form of the receptor.
How do I find out my rs5186 genotype?
If you have taken a home DNA test, this position is very likely in the raw data file you were given. Sequencings reads that file in your browser without uploading it, and resolves which DNA strand each position was reported from, which is the step most manual lookups get wrong.
This is reference information, not medical advice, and not a diagnosis. See the medical disclaimer. Category: Population adaptation.