Department of Cardiovascular Medicine, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, PR China.
Eur Rev Med Pharmacol Sci. 2020 Sep;24(17):9030-9040. doi: 10.26355/eurrev_202009_22846.
Arterial stiffness may be an early marker for vascular changes associated with hypertension in young adults. Individuals with a family history of hypertension are at high risk of developing hypertension. We investigated whether arterial stiffness measured, such as mean arterial pressure (MAP) and brachial to ankle pulse wave velocity (baPWV), were increased in normotensive offspring with a parental history of hypertension.
We compared MAP and baPWV in a sample of 1953 non-hypertensive participants (974 men, mean age 42±3 years) recruited in the previous Hanzhong adolescent hypertension cohort study. Standardized questionnaires, physical examinations and laboratory tests were used to obtain information, with a particular focus on family hypertension history, anthropometric, hemodynamic, and biochemical factors.
A total of 1039, 759, 155 participants had 0, 1, and 2 parents with hypertension, respectively. Parental hypertension was associated with elevated offspring MAP (in multivariable-adjusted models, B=1.5 mm Hg, 95% CI 0.8-2.2 for 1 parent with hypertension; B=3.0 mm Hg, 95% CI 1.8-4.3, for 2 parents with hypertension; p<0.001 for each). A significant positive correlation was also observed between MAP and baPWV (r=0.543, p<0.001). BaPWV displayed a similar correlation with parental hypertension in age-adjusted, sex-adjusted and body mass index (BMI)-adjusted models (B=23.1 cm/s, 95% CI 8.0-38.1, for 1 parent with hypertension, p<0.01; B=53.0 cm/s, 95% CI 25.8-80.2, p<0.001 for 2 parents with hypertension), but associations were attenuated in multicovariate models after adjustment for MAP. In multivariable-adjusted models, logistic regression analysis showed that the risk of belonging to the upper quartile of MAP was significantly increased for offspring whose parents had hypertension (OR=1.5, 95% CI 1.2-1.9, for 1 parent with hypertension; OR=2.3, 95% CI 1.6-3.4, for 2 parents with hypertension; p<0.001 for each). Similarly, the odds ratios of belonging to the upper quartile of baPWV increased (OR=1.3, 95% CI 1.1-1.6, for 1 parent with hypertension, p<0.05; OR=2.1, 95% CI 1.5-3.0, for 2 parents with hypertension, p<0.001, in age-sex-BMI-adjusted models), and were then brought down in the fully adjusted models including MAP, but the increase remained significant for 2 parents with hypertension (OR=1.6, 95% CI 1.0-2.3, p<0.05).
These findings provide evidence that arterial stiffness is higher in young-to middle-aged normotensive subjects with a family history of hypertension, suggesting that increased arterial stiffness may occur in the early stages during the pathogenesis of hypertension.
动脉僵硬度可能是与年轻人高血压相关的血管变化的早期标志物。有高血压家族史的个体患高血压的风险很高。我们研究了在父母有高血压史的血压正常的后代中，是否会出现平均动脉压（MAP）和肱踝脉搏波速度（baPWV）等动脉僵硬度的升高。
我们比较了之前汉中青少年高血压队列研究中招募的 1953 名非高血压参与者（974 名男性，平均年龄 42±3 岁）的 MAP 和 baPWV。使用标准化问卷、体格检查和实验室检查来获取信息，特别关注家族高血压史、人体测量学、血流动力学和生化因素。
共有 1039、759、155 名参与者的父母分别有 0、1、2 人患有高血压。父母的高血压与后代 MAP 的升高有关（在多变量调整模型中，父母有 1 人患有高血压的 B 值为 1.5 毫米汞柱，95%CI 为 0.8-2.2；父母有 2 人患有高血压的 B 值为 3.0 毫米汞柱，95%CI 为 1.8-4.3，p<0.001）。MAP 与 baPWV 之间也存在显著的正相关（r=0.543，p<0.001）。在年龄调整、性别调整和体重指数（BMI）调整模型中，baPWV 与父母的高血压也存在类似的相关性（父母有 1 人患有高血压的 B 值为 23.1 厘米/秒，95%CI 为 8.0-38.1，p<0.01；父母有 2 人患有高血压的 B 值为 53.0 厘米/秒，95%CI 为 25.8-80.2，p<0.001），但在多变量调整模型中，调整 MAP 后，相关性减弱。在多变量调整模型中，逻辑回归分析显示，父母有高血压的后代属于 MAP 上四分位数的风险显著增加（父母有 1 人患有高血压的 OR=1.5，95%CI 为 1.2-1.9；父母有 2 人患有高血压的 OR=2.3，95%CI 为 1.6-3.4，p<0.001）。同样，属于 baPWV 上四分位数的比值比也增加（父母有 1 人患有高血压的 OR=1.3，95%CI 为 1.1-1.6，p<0.05；父母有 2 人患有高血压的 OR=2.1，95%CI 为 1.5-3.0，p<0.001，在年龄-性别-BMI 调整模型中），但在包括 MAP 的完全调整模型中则降低，但父母有 2 人患有高血压的比值比仍显著增加（OR=1.6，95%CI 为 1.0-2.3，p<0.05）。
这些发现提供了证据，表明有高血压家族史的年轻至中年血压正常的个体动脉僵硬度更高，提示在高血压发病机制的早期阶段，动脉僵硬度可能会增加。
