Parati G, Ravogli A, Giannattasio C, Mutti E, Trazzi S, Villani A, Mancia G
Cattedra di Semeiotica Medica, Ospedale Maggiore, Milano, Italy.
Clin Exp Hypertens A. 1992;14(1-2):67-83. doi: 10.3109/10641969209036172.
Subjects with family history of hypertension represent a suitable model to investigate the mechanisms responsible for early cardiovascular structural and functional changes occurring in essential hypertension. In our study we have addressed the factors involved in determining the mild elevation in office blood pressure frequently observed in normotensive subjects with hypertensive parents. In 15 normotensive subjects with both parents hypertensive (FH++) and in 15 normotensive subjects with one parent hypertensive (FH(+)-) we found no evidence of a hyperreactivity to stress as compared to the responses of 15 normotensive subjects with no parental hypertension (FH--). On the contrary FH++ subjects were characterized by a significant although mild increase in their blood pressure values recorded either at rest and in ambulatory conditions over the 24 hours, including night sleep. FH++ and FH(+)- subjects also showed a greater left ventricular mass thickness and a greater minimal forearm vascular resistance than FH-- subjects. Thus, the elevation in blood pressure found in the pre-hypertensive stage in subjects with positive family history for hypertension does not reflect a hyperreactivity to the stress associated with physician's visit but indicates an early and persistent blood pressure elevation. This blood pressure elevation is accompanied by early cardiovascular structural changes which may indicate that these subjects are exposed to a higher risk even before developing overt hypertension.
有高血压家族史的受试者是研究原发性高血压早期心血管结构和功能变化机制的合适模型。在我们的研究中，我们探讨了导致有高血压父母的血压正常受试者中经常观察到的诊室血压轻度升高的相关因素。在15名父母均患有高血压的血压正常受试者（FH++）和15名父母一方患有高血压的血压正常受试者（FH(+)-）中，与15名无父母高血压的血压正常受试者（FH--）的反应相比，我们没有发现对压力反应过度的证据。相反，FH++受试者的特点是，在包括夜间睡眠在内的24小时静息和动态条件下记录的血压值显著但轻度升高。与FH--受试者相比，FH++和FH(+)-受试者还表现出更大的左心室质量厚度和更大的最小前臂血管阻力。因此，有高血压家族史的受试者在高血压前期出现的血压升高并不反映对与医生问诊相关压力的反应过度，而是表明血压早期持续升高。这种血压升高伴随着早期心血管结构变化，这可能表明这些受试者在出现明显高血压之前就面临更高的风险。
