[Selected problems of diagnosis, natural course and prognostic significance of borderline arterial hypertension. IV. Evaluation of the usefulness of diagnostic methods].

In 80 subjects, aged 19-28 years with elevated blood pressure 10 years earlier, compared with a group of normotensives (n = 69) family history of hypertension and the results of echocardiography, dynamic exercise stress testing and cold pressor test were evaluated. Pathogenic role of family history was shown by the diagnosis of arterial hypertension in 84% of the parents of children and adolescents with initially elevated blood pressure. The effects of elevated blood pressure on its further course are confirmed by the incidence of borderline hypertension in 26.3% of the studied group as compared with 5.8% of the controls. The patients with elevated blood pressure were characterized by hyperkinetic cardiac state manifested by a significantly higher heart rate, higher ejection fraction and cardiac output. The results of bicycle exercise test and cold pressor tet proved useless in the prognosis. However, despite the lack of prognostic value it was found that in studied population an exercise induced rise of systolic blood pressure correlated with echocardiographic parameters of cardiac size and mass. Similarly a positive correlation was found between the highest blood pressure during exercise and left ventricular mass in patients with borderline hypertension. The studies showed prognostic difficulties in the early stage of primary hypertension emphasizing the usefulness of modern methods providing an insight into the state of labile at that age cardiovascular system.