Contribution of genes and environment to variation in postural changes in mean arterial and pulse pressure.

We have demonstrated that familial genetic and shared environmental factors influence postural responses of blood pressure, such that some families show a fall and others show a rise in systolic pressure on standing. These differences might reflect programmed differences in the underlying responses in mean arterial pressure and pulse pressure that together determine systolic pressure. Using variance components modelling techniques, we assessed familial aggregation of postural changes in mean arterial pressure and pulse pressure in 767 adult families from the Victorian Family Heart Study. On average mean arterial pressure rose (P < 0.001) and pulse pressure fell (P < 0.001) on standing, but there were no significant correlations between the two. We found little evidence of genetic effects on changes in either mean arterial pressure or pulse pressure, although significant spouse correlations indicated that some shared environmental effects might be present. The majority of variation in postural responses of mean arterial pressure (69.5%) and pulse pressure (81.2%) was attributable to individual-specific factors. These findings were not altered by adjustments for height or body mass index. Total variance was greater for males than females for both change in mean arterial pressure (33.7 versus 30.2, P = 0.04) and change in pulse pressure (70.7 versus 56.8, P < 0.001), differences also attributable to individual rather than familial factors. These findings suggest that the postural autoregulatory responses in peripheral arterial resistance and cardiac output that determine mean arterial and pulse pressure are not programmed by familial factors.