Positive Parental History Of Hypertension Research Articles

Oscillometric casual blood pressure normative standards for Swedish children using ABPM to exclude casual hypertension.

Casual blood pressure (CBP) is considered a reliable proxy for cardiovascular health. Although the auscultatory technique is the reference standard method for measuring CBP, oscillometric devices are increasingly being used in children. We sought to establish oscillometric CBP normative standards for Swedish children. Cross-sectional oscillometric CBP readings were obtained by the Welch Allyn Spot Vital Signs 420 monitor and measured according to the International Guidelines' recommendations. Participants with elevated oscillometric CBP levels underwent verification by the auscultatory method. Ambulatory blood pressure monitoring (ABPM) was used to exclude casual hypertension. Data on 1,470 (772 males) apparently healthy Swedish schoolchildren aged 6-16 years were analyzed and sex-specific reference charts normalized to age or height were constructed. Systolic and diastolic CBP values were significantly higher with age, height, height standard deviation score (SDS), body mass index (BMI), and BMI SDS. Gender differences for systolic CBP were present starting from age of 15 years and revealed significantly higher values in boys than in girls, whereas for diastolic CBP, the differences were apparent at the age of 12 years, with higher values in girls. Increased BMI and BMI SDS were positively associated with CBP levels. Positive parental history of hypertension turned out to be a risk factor for higher systolic and diastolic CBP across all ages. Our normative standard for CBP can be used for blood pressure screening and control programs in Swedish children. The use of ABPM should be considered to confirm the diagnosis of casual hypertension.

Parental history of hypertension and dietary intakes in early adolescent offspring: a population-based study

We investigated the cross-sectional association between parental history of hypertension and dietary intakes among early adolescent schoolchildren. A total of 1845 participants aged 12 years had complete data on diet and parental medical history, and thus they were included in the final analyses. Dietary data were assessed from validated semi-quantitative food-frequency questionnaires. Parents completed questionnaires about their medical conditions. Cases where the biological mother and/or father had hypertension were classified as positive parental history of hypertension. After multivariable adjustment, participants with positive versus negative parental history of hypertension had 33% greater likelihood of consuming soft drinks ⩾1 per week. Boys with a parental history versus boys without a parental history of hypertension consumed more energy-dense, nutrient-poor foods: 379.4 g per day and 318.0 g per day, respectively, P=0.02. Girls with a positive versus a negative parental history consumed more vegetables: 164.1 versus 142.6 g per day, P=0.01. Significant associations were not observed between those with and those without a positive parental history in mean dietary intakes of carbohydrates, fats, sugars and sodium. Children with a positive parental history of hypertension were 67% more likely to simultaneously engage in three unhealthy lifestyle behaviors (excessive recreational screen viewing, high consumption of snacks and and high consumption of soft drinks). Parental hypertension was associated with unhealthy dietary behaviors among offspring, including higher consumption of soft drinks and energy-dense, nutrient-poor foods.

Influence of parental history of hypertension on screen time and physical activity in young offspring

Epidemiological data on the relationship between parental hypertension and lifestyle factors among children are limited. We assessed the associations between positive parental history of hypertension with a range of indicators of sedentariness (television viewing, computer and videogame usage) and physical activity (outdoor and indoor activity) among prepubertal children. Six-year-old (1765 of 2238 eligible) students from a random cluster sample of 34 Sydney schools were examined. Parents completed questionnaires about their medical conditions and the child's activities. If the biological mother and/or father had hypertension, then this was classified as positive parental history of hypertension. Parents of 160 (9.2%) children gave a positive family history of hypertension. After adjusting for age, sex, ethnicity, parental education and employment and exposure to passive smoking, children with, compared with those without, a family history of hypertension were more likely to spend above the median time (hours/day) watching television and playing videogames [odds ratio (OR) 1.41, 95% confidence interval (CI) 1.02-1.96; OR 1.52, CI 1.12-2.06, respectively]. The offspring of hypertensive parents were more likely to spend above the median time in total physical activity (OR 1.67, 95% CI 1.23-2.27). Maternal (but not paternal) hypertension was associated with increased time spent watching television (P = 0.03) and in outdoor activity (P = 0.01). Parental hypertension influences the time that prepubertal offspring spend in both active and sedentary pursuits. These findings highlight potential factors that could be addressed in the development of cardiovascular disease-preventive measures starting early in life among the offspring of hypertensive parents.

Parental History of Hypertension Is Associated With Narrower Retinal Arteriolar Caliber in Young Girls

We aimed to assess the associations between parental history of hypertension and indicators of cardiovascular risk (retinal vessel diameter, presence of obesity, and elevated blood pressure) in prepubertal children. There were 1739 (77.7% of those eligible) 6-year-old students (863 girls and 876 boys) who were examined from a random cluster sample of 34 Sydney schools. Parents completed questionnaires about their medical conditions, including whether they have/had hypertension. Retinal images were taken with a digital fundus camera, and retinal vessel caliber was quantified using computer software. Anthropometric (height, weight, percentage of body fat, and body mass index) and blood pressure measures were collected. There were 160 children (9.2%) with a positive parental history of hypertension (either biological mother and/or father). Children with a positive versus negative parental history of hypertension had significantly higher body mass index (16.8 versus 16.5 kg/m(2); P=0.04) and systolic blood pressure (101.3 versus 99.8 mm Hg; P=0.01). Girls with positive versus negative parental history of hypertension had significantly higher diastolic blood pressure (≈3.1 mm Hg; P=0.01) and narrower retinal arteriolar caliber (≈4.3 μm; P=0.0004). Positive parental history of hypertension was not associated with mean retinal vascular caliber among boys. We show that a positive parental history of hypertension in healthy prepubertal girls, but not boys, is associated with narrower retinal arteriolar vessels, likely conveying a predisposition to develop hypertension later in life. These findings may indicate the need for cardiovascular disease prevention measures starting early in life among offspring of hypertensive parents.

Longitudinal Relationship of Parental Hypertension with Body Mass Index, Blood Pressure, and Cardiovascular Reactivity in Children

To investigate whether parental hypertension (HTN) affects children's body mass index (BMI) and cardiovascular reactivity (CVR) over time. A longitudinal study of 315 students (black: 23 females, 19 males; white: 142 females, 131 males) was conducted in the public schools of Obion County, Tennessee, between 1987 and 1992. BMI and BMI z scores were calculated. The CVR task was a series of video games (taking approximately 10 minutes to play) given to the same students in their third-, fourth-, fifth-, seventh-, and eighth-grade years. CVR was defined as the change in blood pressure (delta_BP) or heart rate (delta_HR) between before playing and while playing the video game. Positive parental history of HTN (27.6%) was defined as at least 1 parent with HTN. Multivariable regression analyses were performed to estimate the effects of parental HTN on children's BMI and CVR over time. Children with parental HTN had significant higher BMI, BMI z score, and R_BP than did children without parental HTN (BMI: 21.6 vs 19.9, P = .001; BMI z score: 1.6 vs 1.1, P = .003; R_SBP: 112.6 vs 110.4 mm Hg, P = .01; R_DBP 62.7 vs 60.6 mm Hg, P = .003) after adjustment for covariates. Increased CVR was observed in children with parental HTN compared with children without parental HTN but was statistically significant only for SBP (delta_SBP: 17.2 vs 14.9 mm Hg; P = .01) after adjustment for covariates. Parental HTN independently predicted children's BMI, BMI z score, resting BP, and BP reactivity.

Parental History of Hypertension and Coping Responses Predict Blood Pressure Changes in Black College Volunteers Undergoing a Speaking Task About Perceptions of Racism

This investigation explored the relationship of coping responses and parental history of hypertension to task-induced blood pressure changes. The sample consisted of 215 black college student volunteers (median age = 25.95 y). During the speaking task, participants responded to standardized questions about perceptions of intra-ethnic and inter-ethnic group racism. Systolic blood pressure and diastolic blood pressure were measured via an automated blood pressure monitor. Usual ways of coping with intra-ethnic group racism were assessed with the COPE Scale, and parental history of hypertension (PHH) was self-reported by participants. Findings from the final step of hierarchical general linear models indicated that the main effect of emotion-focused coping was negatively associated with diastolic blood pressure (p = 0.02) and systolic blood pressure (p = 0.002) changes. Further, these analyses revealed that PHH interacted: (1) with the coping responses of planning (p = 0.007) and denial (p = 0.002) to predict changes in systolic blood pressure and (2) with the planning coping response to predict diastolic blood pressure changes (p = 0.02). The direction of these effects indicated that among participants who were high in these coping responses, participants who also had a positive PHH had larger blood pressure changes. Regression analyses also revealed that PHH interacted with the cognitive coping response (p = 0.01) to predict changes in systolic blood pressure. The direction of this effect indicated that among participants who were low in this coping response, participants who also had a positive PHH had larger systolic blood pressure changes. This study highlights the importance of examining the joint contribution of biological and psychosocial parameters to blood pressure reactivity in blacks.

Relationship between a genetic predisposition to hypertension, blood pressure levels and pain sensitivity

Introduction: The aim of this study was to determine whether the degree of blood pressure elevation and/or a genetic predisposition to hypertension have a major role in determining a reduced pain perception in hypertensives. The reasons underlying the relationship between blood pressure elevation and pain perception mechanisms are not completely understood. Methods: One hundred and four untreated hypertensive patients (65 subjects with and 39 without a positive parental history of hypertension) together with a control group of 42 subjects (20 normotensive offspring of normotensive parents, and 22 normotensive offspring of hypertensive parents) were submitted to standard blood pressure evaluation, 24-h blood pressure monitoring and dental pain perception evaluation. Results: Both pain threshold and tolerance were found to be higher in hypertensive than normotensive subjects ( P<.0001 and P<.015, respectively). Positive significant correlations were found between both 24-h systolic and diastolic pressure and the pain perception variables. When a 2×2 ANOVA test was performed, factoring for the effects of both blood pressure status and family history of hypertension on pain sensitivity, a significant effect was revealed only for blood pressure status. Moreover, after controlling for blood pressure by a covariate analysis, no significant difference was found between the subjects with or without hypertensive parents as regards pain perception variables. Conclusions: Pain sensitivity is correlated to blood pressure levels whereas the parental history of hypertension per se does not affect the pain perception pattern. Thus, the degree of blood pressure elevation, more than a genetic predisposition to hypertension may influence the mechanisms leading to hypalgesia in hypertension.

Exercise training in female patients with a family history of hypertension.

The purpose of this study was to determine whether there are differences in the effects of exercise training between those with a parental history of hypertension and those without such a history. A group of 39 middle-aged hypertensive women were submitted to a 4-month exercise training programme. On the basis of their family histories, 18 individuals were classified as those having a positive parental history of hypertension (group P) and 21 individuals as those without such a history (group N). Both groups participated in a supervised training programme with the intensity set at the level producing the threshold lactate concentration for 90-120 min twice a week, together with self-determined aerobic exercise three times a week. Vital age was estimated to determine the health-fitness status. At the end of the training, group N exhibited reductions in the systolic and diastolic blood pressures at rest (12.6/ 8.0 mmHg) and increases in the peak oxygen uptake [VO2peak 21.1 (SD 5.2) vs 25.2 (SD 5.7) ml x kg(-1) x min(-1)] and oxygen uptake corresponding to lactate threshold [13.7 (SD 2.4) vs 17.0 (SD 2.0) ml x kg(-1) min(-1); P < 0.05]. Group P also showed reductions in the resting blood pressures (8.9/2.9 mmHg; P < 0.05), with no change in VO2peak (P > 0.05). There were no changes in the blood lipid and haematocrit variables in either group. The vital age decreased by approximately 4 and 7 years (P < 0.05) for groups P and N, respectively. These results would indicate that exercise training is a useful, nonpharmacological tool for the treatment of essential hypertension, especially in patients with no family history of arterial hypertension.

Anger expression and incident hypertension.

It has long been thought that anger is important in the development of essential hypertension. However, tests of this hypothesis have yielded conflicting findings. This study prospectively examined the relationship between anger expression style and incident hypertension in a population sample of middle-aged men. Participants were 537 initially normotensive men from eastern Finland, who completed a medical examination and series of psychological questionnaires at baseline and at 4-year follow-up. Anger expression was assessed by Spielberger's Anger-out and Anger-in scales. At follow-up, 104 men (19.4%) were hypertensive (blood pressure > or = 165 mm Hg systolic and/or 95 mm Hg diastolic). Age-adjusted logistic regression analyses revealed that each 1-point increase in Anger-out was associated with a 12% increase in risk of hypertension after 4 years of follow-up (p < .002), which corresponded to a two-fold increased risk of hypertension among men with scores in the top tertile of the Anger-out scale, relative to those with scores in the bottom tertile (odds ratio = 2.00, 95% confidence interval 1.20-3.38). Each 1-point increase on the Anger-in scale also was related to a 12% increased risk of hypertension (p < .01). Adjustments for body mass index, smoking, alcohol consumption, physical activity, a positive parental history of hypertension, and baseline resting diastolic blood pressure had little impact on the findings. These data provide strong epidemiological evidence for a positive relationship between anger expression style and subsequent hypertension, independent of known risk factors. Findings support the hypothesis that extreme expression of anger in either direction has adverse cardiovascular consequences.

HEMODYNAMIC RESPONSES TO EXERCISE IN CHILDREN OF HYPERTENSIVE PARENTS 91

This study was designed to investigate whether children with a positive parental history of hypertension exhibit an elevated resting blood pressure(BP) or an exaggerated BP response during dynamic submaximal exercise. We studied 11 children (12.0 ± 2.4 yrs) of at least one hypertensive parent and 11 children (12.2 ± 1.8 yrs; M ± SE) of normotensive parents who served as the control group. On separate days, each subject completed a graded cycle test to maximal effort and a submaximal exercise bout consisting of 6 min each of steady state cycling at 50 and 80% of maximal heart rate reserve. BP, cardiac output (CO), and total peripheral resistance(TPR) were measured at rest and during the last 3 min of each submaximal exercise stage. CO was determined using transthoracic impedance cardiography, BP was measured by auscultation, and TPR was calculated as mean arterial pressure (MAP) divided by CO. The data were analyzed using an independent t-test and a 2-way (group x intensity) ANOVA. The groups were similar in age, weight, height, and body fatness (p<0.05). At rest, the positive history group had higher systolic BP, diastolic BP (DBP), and MAP (p<0.05). MAP and DBP remained significantly higher throughout exercise. Although differences between groups were not statistically significant, TPR was consistently higher(15-20%) in the positive history group at rest and during exercise, while CO tended to be slightly lower during exercise (p>0.05). In conclusion, children of at least one hypertensive parent exhibit a significantly higher MAP and DBP at rest and during submaximal exercise. The elevated BP in the positive history group may be due to an early trend towards a higher TPR at rest and during exercise.

Racial differences in minimum lower leg vascular resistance in normotensive young adults with positive and negative parental histories of hypertension.

To determine whether peripheral hemodynamic differences exist in young adult normotensive African Americans and white Americans with a positive and negative parental history of hypertension. The participants were healthy men of whom 13 were African Americans and nine white Americans with a positive parental history and 19 were African Americans and 13 white Americans with a negative parental history. Lower leg blood flows were obtained at rest and during reactive hyperemia. Lower leg minimum vascular resistance (Rmin) was computed from reactive hyperemic blood flow measured by venous occlusion plethysmography, and mean arterial blood pressure was determined by auscultation of the brachial artery. Resting blood flow and mean arterial pressure were similar in all groups. A significant race x parental history interaction effect was observed for lower leg Rmin. In the white men the lower leg Rmin was significantly greater in the positive than the negative parental group (P < 0.05). Lower leg Rmin was significantly greater in African Americans than in white men without a parental histoy (P < 0.05). Mean arterial blood pressure and heart rate were similar among the groups. This study demonstrates that lower leg Rmin is greater in young white men with a positive parental history of hypertension than those with a negative parental history. In African Americans with either positive or negative parental histories, lower leg Rmin is not different. This finding suggests that heredity may have a greater influence in white populations than in African Americans on the structural changes in resistance vessels. The study also suggests that African Americans have an earlier structural change in the resistance vessels compared with white people, regardless of a parental history of hypertension. This suggests that factors other than heredity are of importance in changing the structure of the resistance vessels.

Cardiac adaptation to increased systemic blood pressure in borderline hypertensive men

The present study examined cardiac characteristics of borderline hypertensive men with a positive parental history of hypertension. Hemodynamics in relation to left ventricular function and structure were evaluated in 15 borderline hypertensive men with a parental history of hypertension and in 20 normotensive control subjects with a negative parental history. Groups were matched in age, height, weight and percent body fat. Left ventricular mass and dimensions were measured by M-mode echocardiography, and left ventricular function was assessed by radionuclide ventriculography. Both groups had similar left ventricular mass, dimensions and wall thicknesses. In relation to control subjects, borderline hypertensive men had a significantly higher heart rate and blood pressure (BP) (p <0.001), but a similar cardiac index. Borderline hypertensive men had a higher peripheral resistance index (p <0.02), longer time to peak filling rate, and a reduced cardiac efficiency, whereas they had higher contractility, minute and stroke work indexes than did control subjects (all p <0.05); they also had higher diastolic BP (p <0.03) during exercise, and sustained higher BP during recovery than did controls. Although this group of borderline hypertensive men did not have an altered cardiac anatomy, they had an increased vascular resistance, an altered diastolic function and a reduced sac efficiency while undergoing a greater work load. These cardiodynamic profiles are consistent with functional vascular changes and a parallel compensation by the heart. It is concluded that increased cardiac output may not be a universal hemodynamic characteristic of all borderiins hypertensive subjects and that cardiac adjustments to increased BP may be secondary to vascular resistance changes in certain subgroups of borderline hypertensives, especially those with positive parental history of hypertension.

Heart Rate Reactivity, Behavior Pattern, and Parental Hypertension as Predictors of Cardiovascular Activity During Cognitive Challenge

Hemodynamic responses were studied during work on serial subtraction and digits backwards tasks in 99 healthy male undergraduates jointly classified as high or low heart rate reactors, Type A or Type B behavior pattern, and as having positive or negative parental history of hypertension. Heart rate, systolic blood pressure, and diastolic blood pressure were recorded, and rate pressure product was calculated at rest and during the tasks. High heart rate reactors to a cold pressor task responded with relatively higher heart rate and rate pressure product during both cognitive tasks than low heart rate reactors. Type A subjects defined by Jenkins Activity Survey did not differ from Type Bs on any of these physiological variables, although behavioral evidence demonstrated greater effort and superior performance by the Type As. Subjects with a positive parental history of hypertension manifested greater systolic and diastolic pressures and rate pressure product responses to the cognitive challenge than those lacking such parental history. These results indicate that the individual difference variables of heart rate reactivity and parental history of hypertension predicted different hemodynamic response patterns to behavioral challenge.

Blood Pressure Dysregulation Associated with Alcohol Withdrawal

Alcoholics' blood pressures (BP) are typically elevated during withdrawal. Do such elevations predict future blood pressure dysregulation or are they simply a transitory effect of alcohol toxicity? Thirty-two patients admitted to the hospital for alcohol detoxification were tested to examine the relationship between admission BP and response to isometric handgrip administered 4 to 5 days (session 1) and 3 to 4 weeks (session 2) postdetoxification. Alcoholics were divided into three groups based on admission BPs: Hypertensive (HT, greater than or equal to 160/95 mmHg), Borderline Hypertensive (BHT, 140/90-159/94 mmHg), and Normotensive (NT, less than 140/90 mmHg). In sessions 1 and 2, the groups no longer differed on resting BP or heart rate (HR) but did differ on BP and HR response to handgrip: Compared with the NT group, the HT and BHT groups had greater rises in systolic and diastolic BP and HR. There was a trend for HT alcoholics to report a positive parental history of hypertension (91%) compared to BHT and NT alcoholics (64% and 60%, respectively), suggesting the existence of premorbid factors to this exaggerated cardiovascular response. Further, alcohol consumption, based on a quantity-frequency index, was significantly higher in the HT group than in the NT group. The results suggest that transitory elevations in blood pressure observed during alcohol withdrawal may predict future BP abnormalities.