Abstract P172: Postural Hand Tremor and Incident Hypertension in Young-to-middle Aged Adults: The Bogalusa Heart Study

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Introduction: Increased sympathetic nervous activity is a feature of postural hand tremor and increases blood pressure. Beta-blocker therapy is effective in managing postural hand tremor and hypertension. However, the relationship between postural hand tremor and hypertension has not been examined in a population-based cohort study. Methods: We prospectively examined the association between postural hand tremor and incident hypertension in a community-based cohort of 715 (184 Black, 531 White) American adults without hypertension and not using medications to control tremor (e.g., beta-blockers). At a baseline examination in 2000-2002, postural hand tremor was measured by having participants in a darkened room use their outstretched arms to point a laser beam for 8 seconds at a sheet of Polaroid film 8 feet away. Hand tremor was characterized by the width of the circular diameter that encompassed all laser beam exposures and enumeration of exposure dots in the contained area. Both hands were assessed sequentially. Incident hypertension was defined as new elevation of blood pressure (systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg, based on an average of six readings over two visits), or self-report of hypertension, or antihypertensive medication use. Results: During a median follow-up of 6.4 years, 198 (69 Black and 129 White) participants developed hypertension. Tremor measurements (by quartile) were positively associated with incident hypertension after adjustment for demographics, lifestyle and metabolic risk factors at baseline. There was significant interaction by race (P: 0.01). Among Whites, tremor was positively associated with incident hypertension (Hazard ratio highest vs. lowest quartile: 2.35 [95% CI: 1.35 - 4.09], P - linear trend: 0.007 for the dot numeration method; and 3.02 [95% CI: 1.69 - 5.38], P - linear trend: 0.002 for the circular method). Among Blacks, tremor was not associated with hypertension risk. Conclusions: In this community-based cohort, postural hand tremor was strongly associated with the risk of incident hypertension among Whites, and merits further study as a potential indicator of risk for hypertension.