Zhou Lin, Chen Yuanyuan, Sun Ningling, Liu Xirong
Cardiovascular Department, People's Hospital, Peking University, Beijing, PR China.
Hypertens Res. 2008 May;31(5):833-9. doi: 10.1291/hypres.31.833.
Family history of hypertension is a primary predictor of high blood pressure (BP). This study attempted to determine whether there is a gradual increase in BP and an early change in arterial elasticity characteristics between young healthy individuals with or without a family history of hypertension and whether or not this increase is apparent in males as well as in females. A total of 270 normotensive healthy individuals (112 men and 158 women, aged 16 to 30 years) with or without a family history of hypertension, participated in conventional BP measurement and completed questionnaires covering basic information and a detailed family history of cardiovascular disease. Large arterial (capacitive) compliance (C1) and small arterial (oscillatory or reflective) compliance (C2) were derived from HDI/PulseWave CR-2000 (Hypertension Diagnostics, Minneapolis, USA). Based on family history information about parents and grandparents, three groups were formed: subjects with at least one hypertensive parent (group A), subjects with only hypertensive grandparents (group B), and subjects with normotensive parents and grandparents (group C). Men in group A had lower C1 and C2 along with higher systolic BP (SBP), diastolic BP (DBP), and heart rate than men in group C. Those in group B had intermediate C1, C2 and BP levels. C1 had a linear relationship with SBP, DBP, and heart rate. In the logistic regression model of family history of hypertension, C2 was lower in young normotensive males with parental hypertension (B = -0.315, exp B = 0.73, p = 0.03), independently of SBP, DBP, and heart rate. Among females, subjects with parental hypertension had higher systolic, mean arterial pressure, and pulse pressure (p < 0.05), and there were no significant differences in C1 and C2 between those with and those without parental hypertension. In conclusion, compared with normotensive offspring of normotensive parents, normotensive offspring of hypertensive parents had increased BP and impaired arterial properties, namely large and small arterial compliance as measured noninvasively by HDI. These differences were exhibited conspicuously in men but not in women. Alteration in arterial function in young non-hypertensive subjects may be a risk factor for hypertension and may contribute to the progression to hypertension later in life.
高血压家族史是高血压(BP)的主要预测因素。本研究试图确定,在有或无高血压家族史的年轻健康个体之间,血压是否会逐渐升高以及动脉弹性特征是否会早期改变,以及这种升高在男性和女性中是否都很明显。共有270名有或无高血压家族史的血压正常的健康个体(112名男性和158名女性,年龄在16至30岁之间)参与了常规血压测量,并完成了涵盖基本信息和详细心血管疾病家族史的问卷。大动脉(电容性)顺应性(C1)和小动脉(振荡性或反射性)顺应性(C2)由HDI/PulseWave CR - 2000(美国明尼阿波利斯市高血压诊断公司)得出。根据父母和祖父母的家族史信息,分为三组:至少有一位高血压父母的受试者(A组)、只有高血压祖父母的受试者(B组)以及父母和祖父母血压正常的受试者(C组)。A组男性的C1和C2较低,收缩压(SBP)、舒张压(DBP)和心率较高,高于C组男性。B组的C1、C2和血压水平处于中间。C1与SBP、DBP和心率呈线性关系。在高血压家族史的逻辑回归模型中,父母患有高血压的年轻血压正常男性的C2较低(B = -0.315,exp B = 0.73,p = 0.03),独立于SBP、DBP和心率。在女性中,父母患有高血压的受试者收缩压、平均动脉压和脉压较高(p < 0.05),父母患有高血压和未患高血压的受试者之间C1和C2无显著差异。总之,与血压正常父母的血压正常后代相比,高血压父母的血压正常后代血压升高且动脉特性受损,即通过HDI无创测量的大动脉和小动脉顺应性。这些差异在男性中表现明显,在女性中则不然。年轻非高血压受试者的动脉功能改变可能是高血压风险因素,并可能导致日后发展为高血压。