Family history of hypertension and left ventricular mass in youth: possible mediating parameters

Abstract

Whether positive family history (FH) of essential hypertension (EH) in normotensive youth is associated with increased left ventricular mass (LVM) and hemodynamic, anthropometric, and demographic parameters previously associated with increased LVM in adults is unknown. To examine these issues, 323 healthy youth (mean age, 13.6 +/- 1.3 years), 194 with positive FH of EH (61% African Americans, 39% whites) and 129 with negative FH of EH (33% African Americans, 67% whites) were evaluated. Hemodynamics were measured at rest and during four stressors (ie, postural change, car driving simulation, video game, forehead cold). Echocardiographic-derived measures of LVM were indexed separately to body surface area and height(2.7). Controlling for age and race differences (ie, 74% of African Americans v 47% of whites had positive FH), the positive FH group exhibited greater LVM/height(2.7), LVM/body surface area, higher systolic (SBP) and diastolic blood pressures (DBP), and total peripheral resistance index (TPRI) and lower cardiac index at rest (P < .05 for all). The positive FH group also displayed higher peak SBP or DBP and higher TPRI increases to each stressor and came from lower socioeconomic status backgrounds (P < .05 for all). Regression analyses indicated that FH of EH was not a significant determinant of LVM/height(2.7) after accounting for contributions of gender (greater in men), general adiposity, resting cardiac index and blood pressure (BP), and TPRI responsivity to video game and cold stimulation (P < .05 for all). Thus, greater LVM index in positive FH of EH youth appears in part related to their greater BP and TPRI at rest and during stress.

Growth of Left Ventricular Mass in African American and European American Youth

“…14 LVM was calculated using the necropsy-validated formula of Devereux et al 21 Intra-and interrater coefficients of variation for all cardiac structures assessed were Ͻ10%. 22 Because we were interested in LVM growth as a function of age, we did not adjust LVM for body size (height 2.7 or body surface area [BSA]). We do report these mean values for each ethnic/gender group at first visit in Table 1, however, to enable comparison with values in the literature.…”

Physiological stress response to video-game playing: the contribution of built-in music

“…Besides effects on the neurological system, many other studies have reported arousal and physiological reactions in video game playing, Reported effects include increases in breath duration in children (Denot-Ledunois et al, 1998) and increases in cardiovascular reactivity, blood pressure (most often systolic blood pressure), and oxygen consumption in children or adolescents (Modesti et al, 1994), as well as in adults of all ages (Segal and Dietz, 1991;Mounier-Vehier et al, 1995), especially in those with a family history of hypertension (Ditto and Miller, 1989;Cook et al, 2001) and in those with Type A personality (i.e., competitive individuals; Griffiths and Dancaster, 1995). Cardiovascular reactivity to video games in young men has also been taken as a reliable predictor of the future occurrence of hypertension (Markovitz et al, 1998).…”

“…Additionally, the finding of dopamine release during video game playing (which involved learning to navigate a tank for a monetary incentive) suggests that, as in the case of animals, this neurotransmitter may play a role in the anticipatory or appetitive phase of motivated behavior in humans (Koepp et al, 1998). Based on these findings, video games have often been used in studies as a stressor to measure cardiovascular reactivity (e.g., Modesti et al, 1994;Cook et al, 2001). Yet, secretion of the stress-related hormone per se, namely cortisol, has rarely been measured.…”

New Finger-Occlusion Plethysmograph for Estimating Peripheral Blood Flow and Vascular Resistance

“…A previous study reported that PVR is higher in young subjects with than without FHT. 48 FHT is known to be a major risk factor in the development of essential hypertension. 49,50 The results of the present study also suggested that PVR was elevated in the subjects with high BP0 and/or FHT.…”