Himmelmann A
Department of Medicine, Ostra Hospital, Faculty of Medicine, Göteborg University, Sweden.
Blood Press Suppl. 1994;3:1-46.
The etiology of essential hypertension is still a matter of some speculation. Research concerned with pre-hypertensive mechanisms of human essential hypertension usually includes subjects with either borderline hypertension or with a positive family history of hypertension. High blood pressure and increased left ventricular mass are risk factors for cardiovascular disease in adults. Much information about hypertension and other coronary artery disease risk factors in children and adolescents has been collected in the past two decades, and during the last years new evidence has emerged which indicates that essential hypertension originates early in life. Several studies have suggested that children and adolescents born following hypertensive pregnancies may constitute a risk group for future hypertension. The present study addresses the question concerning the future cardiovascular risk in offspring of women who had hypertension during pregnancy. The subjects in the present study were also studied in the search for early pre-hypertensive mechanisms. Fifty-nine children were studied, their mean age being 12.6 years. Forty-two children were born to mothers who had hypertension during pregnancy and 17 children were born after normotensive pregnancies by mothers who remained normotensive at follow-up 7-12 years after pregnancy. Blood pressure was measured at rest and during physical exercise. Left ventricular mass was calculated from M-mode echocardiogram. Erythrocyte concentrations of sodium and potassium and Na-K-ATPase activity were determined. Perinatal and maternal characteristics were collected from hospital records for all deliveries. Twenty-nine males and 23 females, of the initially studied children, were reexamined after 5.6 years. The present study demonstrates that children whose mothers had hypertension during pregnancy and were hypertensive at follow-up had higher blood pressure than children born following normotensive pregnancies. A familial factor for hypertension was an independent determinant of blood pressure, but not a determinant of left ventricular mass. Children born following hypertensive pregnancies had lower birth weight, shorter gestational period and higher blood pressure at follow-up. There was no relationship between birth weight and blood pressure in these children, but there were associations between maternal blood pressure during pregnancy and birth weight as well as blood pressure at follow-up. The difference in blood pressure persisted as the children matured. Particularly the children whose mothers had hypertension during pregnancy and were hypertensive at follow-up maintained their rank with regard to blood pressure and left ventricular mass during adolescence.(ABSTRACT TRUNCATED AT 400 WORDS)
原发性高血压的病因仍存在一些推测。关于人类原发性高血压的高血压前期机制的研究通常包括临界高血压患者或有高血压家族史的患者。高血压和左心室质量增加是成人心血管疾病的危险因素。在过去二十年中，已经收集了许多关于儿童和青少年高血压及其他冠状动脉疾病危险因素的信息，并且在过去几年中出现了新的证据，表明原发性高血压在生命早期就已出现。几项研究表明，高血压妊娠后出生的儿童和青少年可能构成未来高血压的风险群体。本研究探讨了妊娠期高血压妇女后代未来心血管风险的问题。本研究中的受试者也被用于寻找早期高血压前期机制。研究了59名儿童，他们的平均年龄为12.6岁。42名儿童的母亲在怀孕期间患有高血压，17名儿童的母亲在怀孕期间血压正常，且在妊娠后7至12年的随访中血压保持正常。在静息和体育锻炼时测量血压。根据M型超声心动图计算左心室质量。测定红细胞钠和钾浓度以及钠钾ATP酶活性。从所有分娩的医院记录中收集围产期和母亲特征。最初研究的儿童中有29名男性和23名女性在5.6年后接受了复查。本研究表明，母亲在怀孕期间患有高血压且在随访中仍患高血压的儿童，其血压高于血压正常妊娠后出生的儿童。高血压家族因素是血压的独立决定因素，但不是左心室质量的决定因素。高血压妊娠后出生的儿童出生体重较低、妊娠期较短且随访时血压较高。这些儿童的出生体重与血压之间没有关系，但母亲怀孕期间的血压与出生体重以及随访时的血压之间存在关联。随着儿童的成长，血压差异持续存在。特别是母亲在怀孕期间患有高血压且在随访中仍患高血压的儿童，在青春期时其血压和左心室质量的排名保持不变。（摘要截断于400字）
