Bansal Charu, Kuppusamy Saranya, Gandhipuram Periyasamy Senthil Kumar, Kt Harichandrakumar, Fredrick Jean, Subramanian Senthil Kumar
Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.
Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.
Cureus. 2023 Sep 4;15(9):e44636. doi: 10.7759/cureus.44636. eCollection 2023 Sep.
Children of hypertensive parents have an increased propensity of developing hypertension, at an age very much prior to their parents. Understanding the pathophysiology of hypertension in such young individuals, especially baroreflex sensitivity (BRS), is necessary. Reduced heart rate variability (HRV), insulin resistance (IR), dyslipidemia, and decreased vasodilatory adipokines, namely, apelin and relaxin, in normotensives may predispose to the onset of hypertension. Thus, this study compared autonomic functions, vascular markers, and metabolic profiles between normotensive male offspring with and without parental hypertension.
This analytical cross-sectional study comprised 40 male normotensive offspring of hypertensive parents, aged 18-35 years, recruited as the study group and 40 age- and body mass index (BMI)-matched normotensive male offspring with non-hypertensive parents enrolled as controls. Cardiovascular autonomic functions, including BRS, HRV, diastolic blood pressure response to isometric handgrip test (ΔDBPIHG), Valsalva ratio, and metabolic and vascular markers, were assessed.
The study group exhibited reduced BRS, HRV, and Valsalva ratio and higher ΔDBPIHG compared to controls, indicating impaired autonomic functions. The study group had higher IR and triglyceride levels and reduced apelin and relaxin levels. BRS showed significant correlations with HRV, Valsalva ratio, ΔDBPIHG, and metabolic and vascular markers.
Normotensive male offspring of hypertensive parents exhibit impaired autonomic functions, as evidenced by reduced BRS, HRV, and Valsalva ratio. Additionally, they have higher IR, dyslipidemia, and decreased levels of vasodilatory adipokines, indicating an increased risk for future hypertension development. These findings signify that early identification of hypertensive potential in this high-risk population is warranted, which would enable taking necessary preventive measures.
高血压患者的子女在比其父母小得多的年龄就有患高血压的更高倾向。了解这类年轻人高血压的病理生理学，尤其是压力反射敏感性（BRS），很有必要。正常血压者心率变异性（HRV）降低、胰岛素抵抗（IR）、血脂异常以及血管舒张性脂肪因子（即apelin和松弛素）减少，可能易患高血压。因此，本研究比较了有和没有父母患高血压的正常血压男性后代的自主神经功能、血管标志物和代谢谱。
这项分析性横断面研究包括40名年龄在18 - 35岁、有高血压父母的正常血压男性后代作为研究组，以及40名年龄和体重指数（BMI）匹配、父母无高血压的正常血压男性后代作为对照组。评估了心血管自主神经功能，包括BRS、HRV、等长握力试验时的舒张压反应（ΔDBPIHG）、瓦尔萨尔瓦比率，以及代谢和血管标志物。
与对照组相比，研究组的BRS、HRV和瓦尔萨尔瓦比率降低，ΔDBPIHG升高，表明自主神经功能受损。研究组的IR和甘油三酯水平较高，apelin和松弛素水平降低。BRS与HRV、瓦尔萨尔瓦比率、ΔDBPIHG以及代谢和血管标志物显著相关。
有高血压父母的正常血压男性后代表现出自主神经功能受损，表现为BRS、HRV和瓦尔萨尔瓦比率降低。此外，他们有更高的IR、血脂异常以及血管舒张性脂肪因子水平降低，表明未来患高血压的风险增加。这些发现表明，有必要在这一高危人群中早期识别高血压发病潜力，这将有助于采取必要的预防措施。
