Normotensive Male Offspring of Essential Hypertensive Parents Show Early Changes in Left Ventricular Geometry Independent of Blood Pressure

Abstract

For the purpose of detecting early left ventricle (LV) abnormalities in normotensive offspring of hypertensive parents (EH+), 23 normotensive sedentary male EH+ (age 25 ± 3 years) and 20 matched offspring of normotensive families (EH-), underwent: clinic bloop pressure (BP) measurement, 24-hour ambulatory BP monitoring (ABPM), frequency-domain parameters of autonomic heart rate control and conventional and Doppler tissue echocardiographic (DTE) study of both ventricles, including relative wall thickness (RWT) as an index of LV remodeling. EH+ subjects had slightly higher office systolic and diastolic (P < 0.05), average 24-hour systolic (P < 0.001), diastolic (P < 0.01), and mean BP (P < 0.05). No between-group differences were detected for heart rate variability, LV mass and systolic and diastolic function in both ventricles. RWT was greater in EH+ (0.38 ± 0.05 vs. 0.34 ± 0.03 SD; P < 0.01), which was significantly related, at the univariate analysis, to the condition of EH+ (P < 0.004) and to the clinic and ambulatory BP parameters as well (P = 0.06-0.01). However, at the stepwise multiple regression analysis, with RWT used as the dependent variable, only the condition of EH+ was independently associated with RWT (P < 0.008), whereas BP did not. RWT, according to receiver operating characteristic curves analysis, predicted the condition of EH+ (cutoff point 0.369, specificity 90%, sensitivity 65%). Our data suggest that an higher RWT, as an index towards LV concentric remodeling, is the earliest change in LV geometry in EH+ subjects, independent of any slight elevation in BP. Thus, RWT measurement may be a quite specific tool to detect early LV alterations due to the condition of EH+.

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

“…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][16][17][20][21][22][23][24][25]27,[31][32][33][34][35][36], five included only women [18,28,37,38], and 12 both sexes [8][9][10]13,14,19,26,[39][40][41][42]. Of these studies, 37 assessed clinic BP, 18 HRV indices, and five ambulatory BP.…”

“…Of these studies, 37 assessed clinic BP, 18 HRV indices, and five ambulatory BP. Of the HRV studies, 14 included only men [15][16][17]20,[22][23][24][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][24][25][26]32,33] or heart rate monitor [14][15][16]22,27], with 5-min [17,20,23,24] to 30-min [33] analyses.…”

“…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].…”

“…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.…”

“…To our knowledge, this is the first meta-analysis that summarizes evidence on the impact of FHH + on BP and HRV in young adults. Several studies included in this meta-analysis showed higher clinic systolic [9,13,32] and diastolic BPs [27,33,35,38] or both [8,11,12,39] in the offspring of hypertensive parents, without publication bias since the analysis of funnel plots for these outcomes were symmetric. Compared with individuals with FHH − , individuals with FHH + had a significantly higher rate of systolic BP increase (2.9 vs. 2.6 mmHg) over 10 years, after time-varying adjustment for BMI, cigarette smoking, alcohol consumption, coffee drinking, and physical activity.…”