Hypertensive Parents Research Articles

PP.15.16] A NEW MODEL FOR OBTAINING THE RISK ASSESSMENT OF DEVELOPING HYPERTENSION BASED ON ARTIFICIAL NEURAL NETWORKS

Objective: Implement a computational system using a novel model based on neural networks and fuzzy logic to assess the risk of developing hypertension in 4 years based on previous data of patients as an alternative to the Framingham Heart Study guidelines, in this way providing physician with a tool to help them in their treatment of patients. Design and method: The artificial neural network (ANN) is trained with the risk factors of the patients, considering as the inputs: the systolic and diastolic blood pressures, age, sex, smoking, body mass index and if the patient has hypertensive parents. The ANN models the information, obtaining as output the percentage of the risk of developing hypertension in the next 4 years. Different tests are performed by varying the ANN architecture parameters, such as the number of layers, the number of neurons per layer, training algorithm, and epochs. The best results are obtained with 2 hidden layers, 10 and 14 neurons in each layer, 500 epochs and with the Levenberg-Marquart training algorithm. Results: The results obtained with the ANN model and the traditional Framingham Heart Study are compared, and it can be observed that there is no significant difference between them, that is, the neural network is learning correctly, of the set of patients used for testing, and it is observed that in only one there was a variation between the methods of 1%. Conclusions: This soft computing paradigm is powerful for these cases, as it demonstrates that it can be applied with a high level of confidence, since, as can be observed the variation between the results obtained by the formula given by the Framingham Heart Study and the artificial neural network is very low.

BP.11.05] URIC ACID AND HYPERTENSION. ROLE OF RENIN ANGIOTENSIN AND SYMPATHETIC NERVOUS SYSTEMS ACTIVITY

Objective: A number of studies have documented an association of serum uric acid (SUA) with risk of hypertension. We did a prospective study to investigate whether SUA was an independent predictor of risk of hypertension in the young and whether plasma renin activity (PRA) and office and ambulatory heart rates differed according to SUA tertile. Design and method: The study was conducted in a cohort of 1156 young-to-middle-age subjects screened for stage 1 hypertension and followed for a median of 11.4 years. Mean age was 33.0 ± 8.6 years and mean office blood pressure at screening was 145.3 ± 10.6/93.4 ± 5.8 mmHg. PRA was measured in 799 participants. In multivariable Cox analyses, data were adjusted for age, gender, body mass index, parental hypertension, 24-hour systolic and diastolic BP, serum creatinine, and lifestyle factors. Results: At follow-up end, 63.3% of study participants developed hypertension needing treatment. SUA was an independent predictor of future hypertension (p = 0.005). Participants with SUA >5.60 mg/dL (top tertile) had a 31% (95%CI, 6%-60%) increase in risk compared to those of the bottom tertile (SUA <4.32 mg/dL). Office heart rate, average 24-hour heart rate, and night-time heart rate significantly increased across SUA tertiles (p = 0.008, p = 0.033, and p = 0.007, respectively, for ANCOVA after adjusting for age, sex, and lifestyle factors). PRA adjusted for age, sex, smoking, coffee and alcohol use increased on going from the first to the third SUA tertile (mean ± SEM, 3.1 ± 0.5, 3.8 ± 0.4, and 4.9 ± 0.5 ng/ml/h, respectively, p = 0.038). Inclusion of physical activity in the model slightly attenuated the relationship (p = 0.044). PRA was lower in active than in sedentary participants (3.2 ± 0.7 versus 4.8 ± 0.4 ng/ml/h, p = 0.050) as were office and ambulatory heart rates (both p < 0.001). No association between SUA and risk of hypertension was found among the active participants (p = 0.71). Conclusions: In keeping with our previous results, these data confirm that SUA is an independent predictor of hypertension in young-to-middle-age subjects. This may be due to the unfavourable effect of SUA on several factors including sympathetic tone and renin-angiotensin-system activity. Regular physical activity can counteract these pathophysiological mechanisms and prevent the development of hypertension in hyperuricemic subjects.

Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study.

The conjoint association of gestational diabetes mellitus (GDM) and gestational hypertension (GH) with cardiometabolic disease has not been well studied. We evaluated a combined GDM/GH risk indicator in both mothers and fathers because of shared spousal behaviors and environments. In the present population-based retrospective cohort study, GH was identified in matched pairs of mothers with GDM or without GDM (matched on age group, health region, and year of delivery) who had singleton live births in Quebec, Canada (1990–2007). A total of 64,232 couples were categorized based on GDM/GH status (neither, either, or both). Associations with diabetes, hypertension, and a composite of cardiovascular disease (CVD) and mortality were evaluated using Cox proportional hazard models (from 12 weeks postpartum to March 2012). Compared with having neither GDM nor GH, having either was associated with incident diabetes (hazard ratio (HR) = 14.7, 95% confidence interval (CI): 12.9, 16.6), hypertension (HR = 1.9, 95% CI: 1.8, 2.0), and CVD/mortality (HR = 1.4, 95% CI: 1.2, 1.7). We found associations of greater magnitude among participants who had both (for diabetes, HR = 36.9, 95% CI: 26.0, 52.3; for hypertension, HR = 5.7, 95% CI: 4.9, 6.7; and for CVD/mortality, HR = 2.4, 95% CI: 1.6, 3.5). Associations with diabetes were also observed in fathers (for either, HR = 1.2, 95% CI: 1.1, 1.3; for both, HR = 1.8, 95% CI: 1.4, 2.3). In conclusion, we found associations of a combined GDM/GH indicator with cardiometabolic disease in mothers and with diabetes in fathers, with stronger associations when both GDM and GH were present.

Differences in prevalence, treatment and control rates of hypertension between male and female in the area of Blida (Algeria)

PurposeTo compare differences in prevalence rates, treatment and control of hypertension (AHT) between males and females in general medicine consultation in the area of Blida (Algeria). MethodsWe included 3622 patients in the study (42% males and 58% females), with a mean age of 48.14±10.11 years, examined between January 2014 and June 2016 in general medicine consultation in the area of Blida (Algeria). Data was collected with individual questionnaires. Measurement of blood pressure was made using validated semi-automatic devices (OMRON HEM model 705CP). Individuals using antihypertensive drugs and/or blood pressure (BP) greater than or equal to 140/90mmHg were considered as hypertensives. The knowledge about the disease was identified among those who claimed to be aware of the diagnosis before the measurements. The treatment rate was calculated with those who reported using antihypertensive drugs. Controlled blood pressure was considered in individuals with values lower than 140/90mmHg. Lipid profile (total cholesterol, triglycerides, HDL and LDL cholesterol), and fasting blood sugar were measured. All calculations and statistical analyses are processed by the SPSS 20.0. ResultsThe prevalence of hypertension was higher among men (46.2%) than women (31.6%) (P<0.001), and among aged over 55 years (P< 0.05) and those that have referred hypertensive parents (P<0.05). Among hypertensive men, 55.7% knew the diagnosis, 63.6% of them were under treatment, and 22% had controlled BP. Among the hypertensive women 69.8% knew the diagnosis, 85.1% were under treatment and 35.6% were with controlled BP (P<0.001 for the three variables). The most frequent associated risk factors were diabetes mellitus in 36.8% of the patients, obesity in 35.7% of the patients, microalbuminuria in 23.6% of the patients, hypercholesterolemia>2g/L in 11.6% of the patients, smoking in 7.7% of them. Presence of controlled AHT was not found to be associated with presence of other risk factors. The likelihood of having AHT was higher among men, diabetics, older subjects and higher BMI. ConclusionOur study confirmed the high prevalence of AHT in general medicine consultation in Blida, which is a representative city in the north of Algeria. Although women are better treated, much remains to be done to reach BP goal, much in our countries which have the least financial resources to combat cardiovascular disabilities.

Heritability and risks associated with early onset hypertension: multigenerational, prospective analysis in the Framingham Heart Study

Objective To determine the role of early onset versus late onset hypertension as a risk factor for hypertension in offspring and cardiovascular death.Design Multigenerational, prospective cohort study.Setting Framingham Heart Study.Participants...

Risk for hypertension crosses generations in the community: a multi-generational cohort study.

Parental hypertension is known to predict high blood pressure (BP) in children. However, the extent to which risk for hypertension is conferred across multiple generations, notwithstanding the impact of environmental factors, is unclear. Our objective was therefore to evaluate the degree to which risk for hypertension extends across multiple generations of individuals in the community. We studied three generations of Framingham Heart Study participants with standardized blood pressure measurements performed at serial examinations spanning 5 decades (1948 through 2005): First Generation (n = 1809), Second Generation (n = 2631), and Third Generation (n = 3608, mean age 39 years, 53% women). To capture a more precise estimate of conferrable risk, we defined early-onset hypertension (age <55 years) as the primary exposure. In multinomial logistic regression models adjusting for standard risk factors as well as physical activity and daily intake of dietary sodium, risk for hypertension in the Third Generation was conferred simultaneously by presence of early-onset hypertension in parents [OR 2.10 (95% CI, 1.66-2.67), P < 0.001] as well as in grandparents [OR 1.33 (95% CI, 1.12-1.58), P < 0.01]. Early-onset hypertension in grandparents raises the risk for hypertension in grandchildren, even after adjusting for early-onset hypertension in parents and lifestyle factors. These results suggest that a substantial familial predisposition for hypertension exists, and this predisposition is not identical when assessed from one generation to the next. Additional studies are needed to elucidate the mechanisms underlying transgenerational risk for hypertension and its clinical implications.

Central blood pressure parameters in young adults with and without parental history of hypertension

Hypertension is increasingly being found in children and adolescence. The purpose of this study was to find out differences in the central arterial (aortic) blood pressure parameters in young adults with hypertensive and normotensive parents. 109 healthy volunteers between the ages of 17 and 25 years were enrolled for the study after taking consent. Brachial artery pressures and aortic parameters were recorded using PeriScope™ which determines aortic parameters and functional vascular age non-invasively based on oscillometric method. The results of this study showed no statistically significant difference between offspring of hypertensive parents and offspring of normotensive parents for both peripheral and central blood pressure parameters.

Abstract P182: Risk for Hypertension Extends Across Generations in the Community: a Multi-generational Cohort Study

Background: Hypertension is a major risk factor for cardiovascular disease, and parental hypertension is known to predict high blood pressure (BP) in children. However, the extent to which risk for hypertension is conferred across multiple generations, notwithstanding the impact of environmental factors, is unclear. Our objective was therefore to evaluate the degree to which risk for hypertension extends across multiple generations. Methods: We studied three generations of Framingham Heart Study participants with objectively ascertained, uniform BP measurements performed at serial examinations spanning 5 decades: First Generation cohort (1948-2005), Second Generation cohort (1971-2008), and Third Generation cohort (2002-2005). We examined the simultaneous associations of early-onset hypertension (prior to age 55 years) in parents or grandparents with normotension (BP &lt;120/80; reference), prehypertension (BP 120-139/80-89 mmHg), and hypertension (BP ≥140/90 mmHg, or use of antihypertensive medication) in the Third Generation cohort. We estimated odds ratios (OR) and 95% confidence intervals (CI) for prehypertension and hypertension per additional parent or grandparent with early-onset hypertension using multinomial logistic regression adjusting for standard environmental factors. Results: Our final dataset for analyses included BP measurements collected from 2280 First Generation participants (i.e., grandparents), 3122 Second Generation participants (i.e., parents), and 3608 Third Generation participants (mean age 39 years, 53% women). In Third Generation participants, risk for elevated BP was conferred simultaneously by both parental (OR for prehypertension 1.72 [CI, 1.42-2.08]; OR for hypertension 2.22 [CI, 1.72-2.86]) and grandparental (OR for prehypertension 1.24 [CI, 1.05-1.46]; OR for hypertension 1.38 [CI, 1.11-1.73]) early-onset hypertension. In a secondary analysis with a subset of 3319 Third Generation participants with all covariates available, results were also similar in models additionally adjusting for physical activity and daily dietary intake of sodium. Conclusions: A predisposition for developing hypertension is conferred from grandparents to grandchildren, even after adjusting for parental history of hypertension and lifestyle factors. Additional studies are warranted to elucidate how identifying transgenerational risk for early-onset hypertension can improve the care of individuals at risk. Our results also suggest that when assessing an individual’s risk for hypertension, more accurate risk stratification could be achieved by considering both parental and grandparental history of hypertension.

Relationship between parental hypertension and cardiometabolic risk factors in adolescents.

This study aimed to investigate the relationship between parental hypertension and cardiometabolic risk factors in adolescents. The authors analyzed data of 554 adolescents aged 13 to 19years from the Korean National Health and Nutrition Examination Survey 2013. The associations between parental hypertension and cardiometabolic abnormalities in adolescents were evaluated through multivariate logistic regression. Parental hypertension was noted in 16.2% of participants. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for overweight (OR, 2.08; 95% CI, 1.01-4.28) and obesity (OR, 2.11; 95% CI, 1.09-4.07) were significantly higher in participants with parental hypertension. The adjusted ORs for abdominal obesity (OR, 2.36; 95% CI, 1.01-5.56), high blood pressure (OR, 3.05; 95% CI, 1.19-7.78), and elevated alanine transaminase defined as >35IU/L (OR, 2.86; 95% CI, 1.03-7.95) were significantly higher in participants with parental hypertension. Prevention of cardiometabolic risk factors should be reinforced in the offspring of hypertensive parents.

Analysis of beat-to-beat blood pressure variability response to the cold pressor test in the offspring of hypertensive and normotensive parents.

Abnormal autonomic nervous regulation has an important role in the development of hypertension. As to whether blood pressure (BP) or BP variability represents the proper characteristics for predisposition to hypertension in Chinese young adults remains controversial. We studied the properties of the indices extracted from beat-to-beat BP during a 13 min cold pressor test (CPT). In this study, 69 Chinese young adults including 34 offspring of hypertensive parents (OHPs; 25.6±2.5 years) and 35 offspring of normotensive parents (ONPs; 25.3±2.3 years) were analyzed. We assessed the differences between the two groups regarding mean beat-to-beat BP and variability indices. Beat-to-beat BP variability indices included time-domain indices and frequency-domain indices. Our results showed that the differences in beat-to-beat systolic BP and mean BP levels between the OHPs and the ONPs were statistically significant (P<0.05). Furthermore, more BP variability indices in the frequency domain were significantly different between the two groups. We concluded that BP variability was superior to BP as an index to evaluate the cardiovascular and sympathetic reactivity to the CPT. Moreover, compared with time-domain BP variability, we found more differences in frequency-domain BP variability between the two groups, thus indicating that frequency-domain BP variability may be a potential index of predisposition to hypertension.

Evaluation of sympathetic reactivity by Hand Grip Exercise test in children of hypertensive parents.

Background - Genetic factors likely play some role in causing a high blood pressure. About 40% of patients with primary hypertension have genetic predisposition. It is a well documented fact that sympathetic dominance increases heart rate and blood pressure and the same has been observed in young normotensive off springs of hypertensive parents. Aim - Our present study was focused to evaluate blood pressure responses to isometric hand grip exercise test in children of hypertensive and non- hypertensive parents. Methods - The present study was conducted in 50 healthy subjects doing MBBS, 25 of whom had a positive family history and 25 had no family history of hypertension. Isometric hand grip test for sympathetic evaluation was carried out in both the groups following measurement of resting blood pressure. Rise in diastolic blood pressure measured during isometric hand grip taken as a test response. Results - Results were tabulated and analysed using paired t test, p value <0.001 was considered as significant. Higher values were obtained in diastolic and systolic blood pressure in children of hypertensive parents at rest when compared to age matched controls while during isometric hand grip increase in diastolic blood pressure in offspring of hypertensives was statistically significant. Findings are suggestive of an increased sympathetic dominance in children of hypertensive. Conclusion - The present study suggests that healthy children of hypertensive parents have a higher sympathetic dominance when compared to healthy children of non hypertensive parents. DOI: 10.21276/AABS.2017.1351

Cardiovascular reactivity in young adults with hypertensive and normotensive parents: A gender based comparative study

Introduction: Essential hypertension begins due to mutation of specific genes that contribute to the risk of developing hypertension. Genetic contribution was recognized 25 years ago, now formulated from time to time. Some studies have also proven that the hypertension in father had strong contribution in their individual than mother. The aim of the study is to compare the cardiovascular reactivity in male and female subjects with hypertensive and normotensive parents. Materials and methods: This comparative study was conducted in physiology department of Teerthanker Mahaveer medical college and research center, Moradabad. The research work was initiated after taken the ethical clearance from the ethical committee of the college. Three different stressors: cold pressor task, cycling and videogame were used. Total 120 subjects were taken for the study in which 77 were male and 43 were female. Result: Male subjects of normotensive parents had slightly higher HR rate (mean: 76.73/min) compared to the female subjects (mean: 75/min) with p value >0.05. Female subjects of hypertensive parents had higher HR rate (mean: 82.72/min) compared to the male subjects (mean: 73.95/min) with p value

PREVALENCE OF ARTERIAL HYPERTENSION AND RISK FACTORS IN YOUNG ADULTS

Arterial hypertension (AH) is one of the most widespread diseases in whole the world. AH in youth is associated with high cardiovascular mortality in middle age. Objectives: The study objectives were to studied prevalence of AH and risk factors in young adults. Methods. We studied prevalence of AH and risk factors in 981 young adults aged 20-29 years old (22,3 ± 2,26) in cross-sectional epidemiological study. Results. Prevalence of AH was 14,2%, it was significantly higher in men (22,2%) then in women (4,5%), p&gt;0,05. There was a high prevalence of AH risk factors: overweight (35,4% in men), smoking (27,8% in men), parental hypertension (57,8%), noncompliance of day regimen (58,8%), high stress level (37,7%). In AH group prevalence of overweight, smoking, high salt consumption, parental hypertension and hypodinamia was significantly higher than in population. Conclusions . Prevalence of AH was 14,2%, main risk factors of AH were observed in more then quarter of studied persons.

Development and validation of a prediction model for gestational hypertension in a Ghanaian cohort

ObjectiveTo develop and validate a prediction model for identifying women at increased risk of developing gestational hypertension (GH) in Ghana.DesignA prospective study. We used frequencies for descriptive analysis, χ2 test...

Peripheral Vascular Resistance Impairment during Isometric Physical Exercise in Normotensive Offspring of Hypertensive Parents.

BackgroundA family history of hypertension is associated with vascular and autonomic abnormalities, as well as an impaired neurohemodynamic response to exercise.ObjectiveTo test the hypothesis that normotensive individuals with a family history of hypertension present an impaired peripheral vascular resistance response to exercise.MethodsThe study included 37 normotensive volunteers of both sexes who were sedentary, eutrophic, and nonsmokers, comprising 23 with (FH+; 24 ± 3 years) and 14 without (FH-; 27 ± 5 years) a family history of hypertension. Blood pressure, heart rate (DIXTAL®), forearm blood flow (Hokanson®), and peripheral vascular resistance were simultaneously measured for 3 minutes during rest and, subsequently, for 3 minutes during an isometric exercise at 30% of maximal voluntary contraction (Jamar®).ResultsAt rest, the FH+ and FH- groups present similar mean blood pressure (83 ± 7 versus 83 ± 5 mmHg, p = 0.96), heart rate (69 ± 8 bpm versus 66 ± 7 bpm, p = 0.18), forearm blood flow (3 ± 1 mL/min/100 mL versus 2.7 ± 1 mL/min/100 mL, p = 0.16), and peripheral vascular resistance (30 ± 9 units versus 34±9 units, p = 0.21), respectively. Both groups showed a significant and similar increase in mean blood pressure (∆ = 15 ± 7 mmHg versus 14 ± 7 mmHg, p = 0.86), heart rate (∆ = 12 ± 8 bpm versus 13 ± 7 bpm, p = 0.86), and forearm blood flow (∆ = 0.8 ± 1.2 mL/min/100 mL versus 1.4 ± 1.1 mL/min/100 mL, p = 0.25), respectively, during exercise. However, individuals in the FH+ group showed no reduction in peripheral vascular resistance during exercise, which was observed in the FH- group (∆ = -0.4 ± 8.6 units versus -7.2 ± 6.3 units, p = 0.03).ConclusionNormotensive individuals with a family history of hypertension present an impaired peripheral vascular resistance response to exercise.

Progressive Muscle Relaxation Training Blunts Cardiovascular Autonomic Excitatory Response in Offspring of Hypertensive Parents

The objective of the study was to study the effect of progressive muscle relaxation on cardiovascular autonomic functions in offspring of hypertensive parents. A total of 40 normotensive offspring of hypertensives, who were participants of relaxation training programme at Bengaluru, were divided into study group and control group with 20 subjects in each group by randomization. Initially, the HR, HRV and BP response to mental stress were measured in all the subjects. Then the study group underwent twelve weeks of progressive muscle relaxation training whereas the control group did not. At the end of twelve weeks, second recording session was held and the same parameters were reassessed in all the subjects. Twelve weeks of relaxation training had caused significant decline in heart rate reactivity, reactivity values of total power, LF power, reactivity as well as recovery of diastolic pressure. The study concluded that twelve weeks of progressive muscle relaxation training significantly reduced the cardiovascular autonomic excitatory response to mental stress in offspring of hypertensive parents.

Blood pressure and lipid profiles in adolescents with hypertensive parents

problem of increasing prevalence and causes high morbidityand mortality. It is found primarily in young males, with afamilial history of hypertension and/or cardiovascular disease.Examination of lipid profiles has been used to detect the risk ofhypertension in adolescents.Objective To compare blood pressure and lipid profiles inadolescents with and without a parental history of hypertension.Methods This cross-sectional study was conducted from January toFebruary 2012 on students from a senior high school in the TobaSamosir District, North Sumatera. Sixty-eight adolescents wereincluded, aged 15 to 18 years. Group I comprised 34 adolescentswith hypertensive parents, and group II comprised 34 adolescentswith normotensive parents. Subjects were selected based onquestionnaires. Subjects’ blood pressures were measured at rest.Three measurements were made in intervals of 10-15 minutes,then averaged for both systolic and diastolic blood pressures. Lipidprofiles were measured using the CardioCheck cholesterol testafter subjects had fasted for 12 hours.Results The median systolic blood pressures (SBP) in groupsI and II were 110 mmHg (range 93.3-123.3) and 106.7 mmHg(range 96.7-123.3), respectively, (P=0.584). The median diastolicblood pressures (DBP) were 73.3 mmHg (range 66.7-83.3) and71.7 mmHg (range 63.3-80.0), respectively, (P=0.953). Totalcholesterol and low-density lipoprotein cholesterol (LDL-C) levelsin group I were significantly higher than those levels in group II[median total cholesterol: 162.0 (range 158-170) vs. 159.0 (range150-170), respectively; (P=0.001); and mean LDL-C: 103.5 (SD3.72) vs. 99.1 (SD 4.63), respectively; (P=0.001). Multivariateanalysis revealed a correlation of moderate strength betweenparental history of hypertension and increased LDL-C (P&lt;0.001)in adolescents.Conclusion Adolescents with and without familial historyof hypertension have no significant median blood pressuredifferences. However, adolescents with hypertensive parents have afsignificantlyhigher median total cholesterol and mean LDL-C.Furthermore, we find a correlation between parental history ofhypertension and increased LDL-C in adolescents.

Abstract 11411: Parental Age of Hypertension Onset and Risk of Hypertension in the Offspring: The Framingham Heart Study

Introduction: Parental hypertension (HTN) is known to predict HTN in offspring. However, the relative impact of objectively diagnosed early- vs. late-onset parental HTN on risk of HTN in the community is unknown. Hypothesis: We hypothesized that parental early- vs. late-onset HTN is associated with a substantially greater risk of HTN in offspring. Methods: We analyzed serially collected blood pressure data in the Original cohort (since 1948) and in the Offspring cohort (since 1971) of Framingham Heart Study participants. We identified 1635 non-hypertensive Offspring (32±9 years, 54% women) with longitudinal blood pressure data available for both parents. We defined HTN onset as blood pressure ≥140/90 mmHg or taking antihypertensive medication at ≥2 consecutive exams, and early-onset HTN as onset age &lt;55 years. We analyzed the risk for HTN in Offspring in relation to their parental HTN status: (1) no parents with HTN (N=107); (2) ≥1 parent with late-onset HTN (N=480); (3) 1 parent with early-onset HTN (N=721); and, (4) both parents with early-onset HTN (N=327). Results: Incident HTN was most common in Offspring whose both parents had early-onset HTN (Figure, log-rank p&lt;0.0001). Incidence rates for HTN per 1000 person-years increased across the 4 groups: 5.9 in group 1, 8.3 in group 2, 11.0 in group 3, and 18.9 in group 4. In a multivariable-adjusted discrete logistic model, Offspring HTN risk increased from group 1 (referent) to group 2 (hazard ratio [HR] 1.50, 95% confidence interval [CI] 0.85-2.68), and from group 3 (HR 2.04, 95% CI 1.18-3.54) to group 4 (HR 3.45, 95% CI 1.93-6.14). In 463 Offspring who developed HTN, a 10-year lower parental age of HTN onset was associated with a 1.28-fold (95% CI 1.02-1.61) greater odds of early-onset HTN. Conclusions: Early-onset and not late-onset HTN in parents is a strong risk factor for HTN in offspring. It may be important to differentiate between early- and late-onset parental HTN when estimating an individual’s HTN risk.

Familial history of hypertension as a predictor of increased arterial stiffness in normotensive offspring.

BackgroundIncreased arterial stiffness can be used as a prognostic marker of arterial hypertension. The relationship between arterial stiffness and arterial hypertension seems to be reciprocal.ObjectiveEvaluation of changes of the arterial elastic prosperities in normotensive subjects, with and without parental history of hypertension.Subjects and MethodsOne hundred and ten normotensive individuals, aged 20–30 years, were divided into two groups: group-A (n = 57) and group-B (n = 53) subjects with positive and negative parental history of hypertension, respectively. Systolic, diastolic and pulse pressures were measured using mercury sphygmomanometer. The elastic properties of the ascending aorta and the common carotid arteries were assessed using M-mode echo and B-mode imaging, respectively. Stiffness index of the digital volume pulse (SIDVP) was measured in the right index finger using photoplethysmography.ResultsGroup A subjects showed higher aortic stiffness index (p = 0.002), carotid stiffness index (p = 0.001), carotid pulse wave velocity (p ⩽ 0.001) and stiffness index of digital volume pulse (p = 0.001). Group A subjects showed lower aortic distensibility (p = 0.001), aortic strain (p = 0.004), changes in aortic diameter (p = 0.022), carotid distension (p = 0.026), carotid distensibility coefficient (p ⩽ 0.001) and carotid compliance coefficient (p = 0.002).ConclusionThe aortic and carotid stiffness parameters and SIDVP were higher in normotensive offspring of hypertensive parents. This finding could direct the attention towards the increased cardiovascular risk in this group and thus prompt earlier and tighter prevention of cardiovascular risk factors.

Performance of targeted screening for the identification of hypertension in children

Targeted screening of hypertension in childhood might be more efficient than universal screening. We estimated the sensitivity, specificity, negative and positive predictive values of combined parental history of hypertension and overweight/obesity for the diagnosis of hypertension in 5207 children aged 10–14 years. Children had hypertension if they had sustained elevated blood pressure over three separate visits. The prevalence of hypertension was 2.2%. 14% of children were overweight or obese, 20% had a positive history of hypertension in at least one parent and 30% had either or both conditions. Targeted screening of hypertension to children with either overweight/obesity or with hypertensive parents limits the proportion of children (30%) to screen and identifies up to 65% of all hypertensive cases.