Haemodynamic, metabolic and neuro-humoral abnormalities in young normotensive women at high familial risk for hypertension

Abstract

We analysed the haemodynamic, metabolic and hormonal status at rest and in response to exercise, in young normotensive women with two hypertensive parents (FH þ þ ; n ¼ 17; 25.1±4.8 years), one hypertensive parent (FH þ ; n ¼ 18; 24.9 ± 4.1 years) and normotensive parents (FHÀ; n ¼ 15; 25.3 ± 3.8 years). Casual and ambulatorial blood pressure (BP), carotid-femoral pulse wave velocity (PWV) and biochemistry were analysed. BP, nor-epinephrine (NE), epinephrine (EPI), endothelin-1 (ET-1) and nitrite/nitrate (NOx) levels were also analysed during a graded exercise test (GXT). Casual and ambulatorial BP were not different between groups, but PWV was 7.5 and 12.6% higher in FH þ þ than FH þ and FHÀ, respectively, and 4.8% higher in FH þ than FHÀ (Pp0.01). Insulin and insulin-to-glucose ratio were increased in FH þ þ and FH þ (Po0.05), and lowdensity lipoprotein (LDL)-cholesterol tended to be higher only in FH þ þ (P ¼ 0.07). FH þ þ showed higher exercise and recovery diastolic BP and EPI levels, and increased resting, exercise and recovery NE, and ET-1 levels than FHÀ (Po0.05). FH þ showed only greater resting, exercise and recovery NE, and rest ET-1 (Po0.05). Resting, exercise and recovery NOx were lower in FH þ þ and FH þ than FHÀ (Po0.01). Haemodynamic, metabolic and hormonal abnormalities were presented in nonhypertensive young women offspring of hypertensive parents before any increase in BP. Greater abnormalities were observed in women with a strong family history of hypertension (FH þ þ ). These results suggest that there is an early vascular, metabolic and hormonal involvement in a familial hypertensive disorder.

Effects of high-intensity aerobic interval training vs. moderate exercise on hemodynamic, metabolic and neuro-humoral abnormalities of young normotensive women at high familial risk for hypertension

“…GXT was carried out on a programmable treadmill (TMX425 Stress Treadmill; TrackMaster, Newton, KS, USA) in a temperaturecontrolled room (21-23 1C) using a ramp protocol until exhaustion and with monitoring of cardiac rhythm (CardioSoft 6.5; GE Medical Systems IT, Milwaukee, WI, USA) and BP (Tango Stress BP; SunTech Medical Inc, Morrisville, NC, USA) as previously described. 7 Ventilation (VE), oxygen uptake (VO 2 ) and carbon dioxide output (VCO 2 ) were measured breath-bybreath using a computerized system (Vmax Encore29; SensorMedics Corp., Yorba Linda, CA, USA). The respiratory exchange ratios were recorded as the averaged samples obtained during each stage of the protocol.…”

“…Serum insulin and ET-1 were measured by radioimmunoassay as previously described. 7 Plasma NOx levels were measured by spectrophotometry using a commercially available kit (Colorimetric Nitric Oxide Assay Kit; Calbiochem, San Diego, CA, USA) according to the method described by Green et al 28 Norepinephrine was extracted from the plasma by aluminum oxide and measured by highperformance liquid chromatography. To estimate insulin sensitivity, the homeostasis model assessment (HOMA) was used.…”

“…4 Moreover, hemodynamic, metabolic and hormonal abnormalities, as well as concentrations of biomarkers that may have a key role in the development of HPT, are increased in nonhypertensive offspring of parents with HPT. [5][6][7] Higher levels of physical activity 8,9 and cardiorespiratory fitness 9 have been shown to reduce the risk of HPT in healthy normotensive persons. Acute 10,11 and chronic [12][13][14] exercise can also reduce resting blood pressure (BP) in hypertensive adults.…”

“…4 Moreover, hemodynamic, metabolic and hormonal abnormalities, as well as concentrations of biomarkers that may have a key role in the development of HPT, are increased in nonhypertensive offspring of parents with HPT. [5][6][7] …”

Daily Physical Activity Improves Vascular Function and Motor Skills in Children

“…Data from prospective observational cohort studies indicate that aPWV relates to future cardiovascular risk even after accounting for other accepted cardiovascular risk factors such as peripheral BP [15]. Moreover, young healthy subjects with familial risk for hypertension showed increased arterial stiffness before any increase in BP [11,16]. In the PANIC-Study, poor cardio-respiratory fitness was independently associated with increased arterial stiffness and impaired arterial dilation capacity already among pre-pubertal children [5].…”