Cardiac autonomic modulation in response to stress in normotensive young adults with parental history of hypertension

Abstract

BackgroundHypertension is the major health burden associated with increased cardiovascular morbidity and mortality. Positive family history and stress are the risk factors for hypertension. The present study aims to evaluate the effect of acute stress on the cardiac autonomic modulation in normotensive individuals with parental history of hypertension.MethodsSixty healthy male volunteers (30 with parental history of hypertension-NTPH+ group and 30 without parental history of hypertension-NTPH− group) in the age group of 18–24 years were included in the study. Short-term baseline heart rate variability (HRV) evaluation was done in frequency domain. Volunteers performed mental arithmetic stress task (MAST). HRV was measured before MAST, during MAST, and recovery period. HRV in both groups were compared.ResultsAnalysis showed a significant increase in heart rate (p-value = 0.038) and systolic blood pressure (p-value = 0.01) in NTPH+ group compared to the NTPH− during MAST. NTPH+ group showed significantly higher LFnu (p-value = 0.03) and LF/HF ratio (p-value = 0.02) during MAST. Reduction in HFnu (p-value = 0.027) was significantly higher in the study group. ANOVA analysis demonstrated significant increase in LFnu [F(2.602, 75.46) = 18.60; p < 0.001; ηp2 = 0.391] and LF/HF ratio [F(1.76, 51.043) = 29.952; p < 0.001; ηp2 = 0.508] during MAST and 10 min of recovery period from baseline value in NTPH+ group. HFnu has significantly reduced during MAST and 5 min recovery period from baseline value in NTPH+ group [F(2.78, 80.72) = 12.77; p = 0.033, ηp2 = 0.28].ConclusionsAcute mental stress leads to exaggerated sympathetic response and vagal suppression in healthy individuals with parental history of HTN. This study concludes that HRV, which reflects autonomic flexibility, is lower during acute mental stress and post-stress recovery period in normotensive males with parental history of HTN.

Influence of family history of hypertension on blood pressure and heart rate variability in young adults: a meta-analysis

“…Of the HRV studies, 14 included only men [15–17,20,22–25,27,32,33], four included both sexes [9,14,26], and no HRV study included only women. HRV was measured through ECG [9,17,20,23–26,32,33] or heart rate monitor [14–16,22,27], with 5-min [17,20,23,24] to 30-min [33] analyses. Table 1 shows the main characteristics of selected studies.…”

“…Twenty [8,15–20,22,27,31,33,35,37–39,41] and 34 studies [8–28,31–33,36,37,39–42] reported body mass and BMI data, respectively. Some studies were matched according to body mass or BMI to a control group FHH − [12,40].…”

“…Figure 1 shows a flowchart of selected studies. Among the 38 studies included in the quantitative analysis, with 2025 participants with ~25 years old, 21 included only men [11,12,15–17,20–25,27,31–36], five included only women [18,28,37,38], and 12 both sexes [8–10,13,14,19,26,39–42]. Of these studies, 37 assessed clinic BP, 18 HRV indices, and five ambulatory BP.…”

“…Another factor seems to be early-onset (at age <55 years) hypertension in parents, a factor that was reflected in a higher risk for the development of hypertension throughout offspring adult life [43]. However, few studies [9,20,21,28,38] in our meta-analysis presented information about the age of onset hypertension in the parents.…”

“…Although many studies have shown that the FHH + can impair the clinical outcomes of offspring, robust evidence about the effects on young adults is sparse and contested, with some studies showing a high BP [8–13] and a low HRV [14–17] or no influence [18–25]. To the date of this writing, to our knowledge, no meta-analysis has attempted to summarize this evidence within the perspective of FHH + on BP and HRV in young populations.…”