College of Nursing, University of Central Florida, Orlando, FL 32816-2210, USA.
J Cardiovasc Nurs. 2012 Nov-Dec;27(6):476-84. doi: 10.1097/JCN.0b013e31822f7971.
Globally, the health disparity of hypertension is disproportionately greater within the African American population and develops at an earlier age. Elevated and continuous interaction of biologic measures during adolescence may be precursors and indicators of risk for blood pressure changes and the subsequent development of adult essential hypertension. The purpose of this study was to describe (1) the prevalence of biologic measures of risk of hypertension, specifically family history of hypertension, prehypertension, elevated salivary cortisol, and hyperresponsive cortisol and cardiovascular reactivity, and (2) the gender difference in the prevalence of biologic risk factors of hypertension.
This was an exploratory descriptive design with a nonrandom purposive sample. Participants (N = 106) were high school, African American adolescents, aged 14 to 18 years. Data, including family history of hypertension, resting blood pressure, and blood pressure and cortisol levels before and after induced physiologic stress by cold water hand immersion, were measured.
One hundred six African American participants (49 males and 57 females) completed the study. Data described that 71% had a positive family history of hypertension. Overall, the resting blood pressures were 120 mm Hg for systolic and 68 mm Hg for diastolic. Forty-one percent of the patients had prehypertensive blood pressures; 86% had elevated cortisol; 49% had hyperresponsive blood pressure reactivity; and 35% had cortisol hyperresponsivity. Excluding ethnicity, 65% had 3 or more biologic measures of risk of hypertension. Statistically significant gender differences included male systolic pressure and number of males with prehypertension.
This study provides evidence of the high prevalence of multiple physiologic biologic measures of risk of hypertension factors within a vulnerable population. The continuous interaction of biologic measures over time may increase the susceptibility and risk of essential hypertension development and supports the development of appropriate physiologically based behavioral interventions.
在全球范围内，高血压的健康差距在非裔美国人中不成比例地更大，而且发病年龄更早。青春期期间生物测量指标的持续升高和相互作用可能是血压变化和随后发生成人原发性高血压的风险的前兆和指标。本研究的目的是描述：(1) 高血压的生物风险指标的流行情况，特别是高血压家族史、血压前期、唾液皮质醇升高和皮质醇反应过度以及心血管反应性；(2) 高血压生物风险因素的性别差异。
这是一项探索性描述性设计，采用非随机目的抽样。参与者（N=106）为年龄在 14 至 18 岁的非裔美国高中生。测量了包括高血压家族史、静息血压以及冷水浸泡诱导生理应激前后的血压和皮质醇水平在内的数据。
106 名非裔美国参与者（49 名男性和 57 名女性）完成了研究。数据表明，71%的人有高血压家族史。总的来说，收缩压为 120mmHg，舒张压为 68mmHg。41%的患者血压前期；86%的人皮质醇升高；49%的人血压反应过度；35%的人皮质醇反应过度。排除种族因素，65%的人有 3 种或更多高血压的生物风险指标。具有统计学显著差异的性别包括男性收缩压和患有血压前期的男性人数。
本研究为高危人群中存在多种高血压生理生物风险因素提供了证据。随着时间的推移，生物测量指标的持续相互作用可能会增加原发性高血压发生和发展的易感性和风险，并支持开发基于生理的适当行为干预措施。
