Positive Parental History Research Articles

Nociception and baroreceptor stimulation in hypertension‐prone men and women

We examined the effects of baroreceptor stimulation on nociceptive responding in men and women with a positive or negative parental history of hypertension. The effects of three baroreceptor conditions (stimulation, inhibition, and control) on subjective pain and nociceptive responding were evaluated during electrocutaneous sural nerve stimulation. Pain ratings were lower in men with positive parental history relative to men with negative parental history, but this difference was not found in women. Both stimulatory and inhibitory baroreceptor conditions were associated with reduced pain reports compared to the control condition. There were no significant differences in nociceptive responding as a function of parental history of hypertension. Although this study confirms a link between hypoalgesia and risk for hypertension in men, it does not support the hypothesis that this attenuated pain perception is due to enhanced baroreceptor activity.

Normal Exercise Blood Pressure Response in African-American Women with Parental History of Hypertension

Genetic and environmental hypotheses may explain why normotensive persons at high risk of developing hypertension often exhibit greater cardiovascular reactivity to stressors than those at low risk. Pearson's correlation was used to evaluate reproducibility and independent t test to compare the cardiovascular responses to 30 W of exercise of normotensive young adult African-American women with positive and negative parental histories (PH) of hypertension (PH, n = 23; PH, n = 20). Correlations were significant for duplicate measurements. The effects of PH on blood pressure measured at rest and during exercise were not statistically significant (P > 0.1). A nearly significant trend for greater resting (.-)VO(2) (P = 0.08) was detected in the PH than in the PH group (3.67 +/- 0.18 versus 3.26 +/- 0.14 mL/kg/min). A hyper-reactive blood pressure response to exercise, characteristic of the evolution of hypertension, may not be present among the normotensive female offspring of hypertensive African Americans. The significance of an 11% intergroup difference in the mean resting (.-)VO(2) observed in this study is unclear.

Family history, dust mite exposure in early childhood, and risk for pediatric atopy and asthma

BackgroundDust mite allergen exposure is considered a major determinant of sensitization to these allergens during childhood and a risk factor for pediatric asthma. ObjectiveBy using a birth cohort in a setting with a substantial burden of dust mite allergen, we evaluated exposure and risk for outcomes related to allergy and asthma. MethodsWe collected dust from the bedrooms of 428 children born from 1987 to 1989 and measured Der f 1 and Der p 1 (μg/g dust, combined). Follow-up at 6 to 7 years of age included clinical examination, skin prick testing, specific serum IgE measurement, and methacholine challenge. ResultsNo overall association was evident for any outcome except bronchial hyperresponsiveness (adjusted odds ratio [OR], 0.62; 95% CI, 0.38-1.00; P < .050; and OR, 0.53; CI, 0.27-1.04; P < .065 for dust mite allergen levels ≥2 μg/g and >10 μg/g, respectively). With a parental history of allergy and asthma, there was an association between a positive dust mite skin test (OR, 2.09; CI, 0.93-4.73; P < .076) and dust mite allergen level >10 μg/g. The inverse was true for children without a parental history. Dust mite exposure of >10 μg/g was associated with a decreased risk of current atopic asthma among children with a parental history (OR, 0.39; CI, 0.05-3.13; P < .376), but with increased risk if without a parental history (OR, 1.52; CI, 0.22-10.6; P < .673). ConclusionParental history is an important independent variable in the relationship between early dust mite exposure and atopic outcomes. Increased exposure during infancy is associated with a higher risk for sensitization in the presence of a positive parental history, but is protective among children of parents without a history of atopic disease.

Parent-Reported Predictors of Adolescent Panic Attacks

To identify parent-reported risk factors for adolescent panic attacks. Structured diagnostic interviews were obtained from 770 parents of participants in a school-based risk factor study for adolescent panic. Parent-reported risk factors assessed included characteristics of the child (negative affect, separation anxiety disorder [SAD], childhood chronic illness, and childhood loss) as well as characteristics of the parent (parental panic disorder or agoraphobia [PDA], parental major depression, and parental chronic illness). Bivariate predictors of adolescent panic attacks included parent history of PDA, parent history of chronic illness, child negative affect, and child SAD. Using signal detection methods, three subgroups of participants at risk for panic attacks were identified. Fifty-eight percent of adolescents with panic attacks belonged to one of these high-risk groups. Adolescents with a positive parental history of PDA were at highest risk: 24% of this group experienced panic attacks. Among those without a positive parental history of PDA, those with high childhood negative affect or history of SAD were at increased risk for panic attacks (14% and 20%, respectively). The use of parent-reported data provides cross-validation for previously identified risk factors of adolescent panic attacks. Signal detection results suggest there are multiple paths (equifinality) to the development of adolescent panic attacks.

Family History of Hypertension and Diabetes in Relation to Preeclampsia Risk in Peruvian Women

In a case-control study of 169 preeclamptics and 201 controls, we assessed maternal parental history of chronic hypertension and diabetes in relation to preeclampsia risk among Peruvian women. Participants provided information on parental history of the two conditions and other covariates during postpartum interviews. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for confounding by age, parity and prepregnancy adiposity. In this population, women were more likely to know the diabetes status of their parents than their hypertension status. Compared with women without a parental history of hypertension, women with a parental history of hypertension experienced a 20% increased risk of preeclampsia (OR = 1.2; 95% CI 0.7–2.2) that did not reach statistical significance. Women with a positive parental history for diabetes had a 3.4-fold increased risk of preeclampsia (95% CI 1.4–8.4). Women with a positive parental history of both hypertension and diabetes, as compared with those whose parents had neither condition, experienced a 4.6- fold increased risk of preeclampsia (OR = 4.6; 95% CI 0.9–23.0). Our results are generally consistent with the thesis that parental history of hypertension and diabetes reflects genetic and behavioral factors whereby women may be predisposed to an increased risk of preeclampsia.

Awareness of hypertension and dyslipidemia in a semirural population of young adults: the bogalusa heart study

Background To assess the awareness of hypertension and dyslipidemia in a semirural population of young adults. Methods A cohort of 5,707 individuals was surveyed by a questionnaire. The awareness analysis was done on 1,454 subjects screened for cardiovascular risk factors 5 years earlier. Results Among the respondents ( n = 3,699, 65%), the prevalence of hypertension among blacks and whites was 11% and 7.3% ( P < 0.0001), respectively; dyslipidemia, 4.7% and 5.8% ( P = 0.27). Results from the screening showed a prevalence of 11.4% in blacks versus 6.0% in whites ( P < 0.0001) for hypertension; 14.2% versus 17.9% ( P = 0.12) for dyslipidemia. Males had a higher prevalence of dyslipidemia than females (24% vs. 12%, P = 0.001). Five years later, among those informed of their hypertension, males were more likely to be aware of their hypertension than females [odds ratio (95% confidence interval) = 5.0 (1.4–17.5)]. Increasing age [1.04 (1.0–1.1)], positive parental history of coronary heart disease [2.6 (1.5–4.3)], and higher education level [2.1 (1.2–33.6)] were associated with the awareness of dyslipidemia. Awareness of the condition increased the proportion of subjects receiving treatment for hypertension, but did not change the proportion receiving treatment for dyslipidemia. Conclusions These results underscore the need for cardiovascular health education efforts in this population group.

Parental history and early-onset type 2 diabetes in African Americans and Latinos in Chicago

Objective: To examine the role of parental diabetes mellitus (DM) in the development of type 2 DM among children and adolescents from high-risk ethnic groups. Study design: A population-based dataset of insulin-treated diabetes among African American and Latino children <18 years old yielded 243 cases who completed an interview. A subset with features of type 2 DM was identified (n = 44) using one or more criteria: stopping insulin therapy; using oral hypoglycemic agents; acanthosis nigricans; polycystic ovary syndrome; denoted “atypical” or “type 2” by a physician. Results: Of all the patients, 76% had no known diabetic parent; 7% had father only; 15% had mother only; and 2.5% had two diabetic parents. Parental DM was more likely in type 2 than in type 1 children (only paternal, 15.9% vs 5.5%, P <.02; only maternal, 38.6% vs 9.5%, P <.01; or both, 6.8% vs 1.5%, P <.01). Conclusion: A positive parental history of DM appears to be more strongly related to childhood type 2 than to type 1 DM. Whether this is a reflection of genetic or behavioral factors is yet unclear. (J Pediatr 2002;141:825-29)

Time-course of adiposity and fasting insulin from childhood to young adulthood in offspring of parents with coronary artery disease: the Bogalusa Heart Study.

Obesity and the attendant insulin resistance/hyperinsulinemia related to coronary artery disease (CAD) morbidity and mortality are well documented. However, information is lacking on the time-course relation of adiposity and fasting insulin from childhood to young adulthood in offspring of parents with CAD, a surrogate measure of future risk. Longitudinal analysis was performed on data collected from the Bogalusa Heart Study cohort with (n = 271) and without (n = 805) a parental history of CAD followed since childhood by repeated surveys from 1973 to 1991. Lowess smoothing and multivariate analyses using Generalized Estimating Equations revealed that body mass index, triceps, and subscapular skinfolds were consistently higher from childhood to adulthood in offspring of parents with CAD history. Insulin levels during childhood and adolescence were lower in the offspring with affected parents. On the other hand, higher levels of fasting insulin from offspring were associated with positive parental history of CAD after age 20 and this association remained significant even after adjusting for body mass index. There was no significant interaction with race or sex in these relationships. These results indicate that the offspring at high risk for CAD develop excess body fatness beginning in childhood and then later manifest hyperinsulinemia in young adulthood. These observations have important implications for prevention.

Auditory event-related brain potentials in parents of children with specific language impairment

Auditory event-related brain potentials evoked in response to tone stimuli and to speech stimuli were recorded in a group of parents of children with specific language-impairment and a group of parents of normally speaking children. The parents of the language-impaired children showed longer P3 latencies than the parental control group in the speech task requiring a phonological discrimination, but did not differ from the controls in the linguistically non-demanding tone discrimination task. The longer P3 latency was associated with a positive parental history of language delay. There were no group differences concerning the N1 component in any of the tasks. The findings indicate that parents of children with specific language impairment show signs of deficient late-stage perceptual higher order linguistic processing, whereas the earlier central sensory detection stage of the phonological information is no different from the controls. Our observations are particularly interesting with regard to a study of the children of these two parental groups, where the language-impaired children showed longer P3 latencies than controls in both a tone task and a speech task, whereas there were no differences between the children concerning the N1 component. We propose that deficient late-stage auditory higher order perceptual processing as indexed by the longer P3 latency to speech stimuli observed both in children with specific language-impairment and in their parents may represent a constitutional trait, contributing to the language acquisition difficulties in these children.

The Pattern of Atopic Sensitization is Associated with the Development of Asthma in Childhood

Purpose of the Study. Asthma eventually develops in only one third of atopic children. The aim of this study was to prospectively investigate the pattern of atopic sensitization typically associated with the development of asthma in childhood.Study Population. A cohort of 1314 children followed from birth to the age of 7 years in the German Multicenter Allergy Study.Methods. Parental questionnaires on asthma and asthmatic symptoms were completed 6 times up to the age of 2 years and from then on yearly. Determination of specific immunoglobulin E to 9 food and inhalant allergens was performed yearly, and at the age of 7 years, a bronchial histamine challenge was conducted.Results. Onset of atopic sensitization in children with current asthma at the age of 7 years was significantly earlier than in children without current asthma (39.4% before age 1 year vs 21.0%; P = .015). Early atopic sensitization without any sensitization to inhalant allergens at the age of 7 years conferred no increased risk for asthma at this age. Only those children sensitized to inhalant allergens by the age of 7 years were at a significantly increased risk of being asthmatic at this age (odds ratio 10.12; 95% confidence interval [CI]: 3.81–26.88). However, even in this group of persistently sensitized children, the risk of being asthmatic at the age of 7 years was only increased if a positive parental history of asthma or atopy was present (OR: 15.56; 95% CI: 5.78–41.83), with the effect being strongest for maternal asthma.Conclusion. The results indicate that an underlying factor pertaining to asthma and maternal transmission may determine both a certain pattern of sensitization and the expression of asthma.Reviewer’s Comments. This study challenges our current understanding of the natural history of childhood asthma. The notion of a progressive atopic march assumes that early atopic sensitization to food allergens is a risk factor for subsequent inhalant sensitization, which, in turn, is regarded as a risk factor for the development of asthma. However, recent epidemiologic studies showed no consistent protective effect of reduced food or inhalant allergens, as well as no positive effect of increased inhalant allergen levels on the development of asthma. This study supports the hypothesis that the development of childhood asthma and atopy run in parallel if certain perinatal or hereditary influences prevail, rather than being subsequent stepping stones in a progressive atopic march.

Sex differences in risk factors for incident type 2 diabetes mellitus: the MONICA Augsburg cohort study.

To examine sex-specific associations between cardiovascular risk factors, a parental history of diabetes, and type 2 diabetes mellitus (DM). The study is based on 3052 men and 3114 women (aged 35 to 74 years) who participated in one of the 3 MONICA (Monitoring of Trends and Determinants in Cardiovascular Disease) Augsburg surveys between 1984 and 1995, who were free of DM at baseline and returned a follow-up questionnaire in 1998. Sex-specific hazard ratios (HRs) were estimated from Cox proportional hazard models. A total of 128 cases of incident DM among men and 85 cases among women were registered during the follow-up period. The age-standardized incidence rate was 5.8 per 1000 person-years for men and 4.0 per 1000 person-years for women. In multivariable survival analyses, age, body mass index, and a positive parental history of diabetes were important independent risk factors for DM in both sexes. High-density lipoprotein cholesterol level was inversely associated with DM in men and women. For other risk factors, sex-related differences were observed. Systolic blood pressure (HR per 10 mm Hg increase, 1.16), regular smoking (HR, 1.75), and high daily alcohol intake (HR, 1.95) predicted the development of DM in men only, whereas uric acid (HR per 1 mmol/L increase, 2.05) and physical inactivity during leisure time (HR, 1.80) were associated with diabetes development in women only. In men and women, most variables predicting future diabetes in the present study are also known to be important risk factors for cardiovascular disease and arteriosclerosis. However, there are sex-related dissimilarities that seem to be involved in disease development.

Distribution and correlates of lipoproteins and their subclasses in black and white young adults. The Bogalusa Heart Study

Lipoprotein subclasses vary in CAD risk potential, but their distribution and correlates are not well documented in black and white young adults. A subsample of 449 (32%) young adults (67% white, 58% female) aged 20–37 years examined in the Bogalusa Heart Study had lipoprotein subclasses measured in terms of cholesterol by vertical spin density-gradient ultracentrifugation. LDL subclass pattern was characterized as either predominantly LDL 1 (large, buoyant), LDL 2 (intermediate) or LDL 3 (small, dense). Whites had significantly higher levels of VLDL, VLDL 3, and LDL and lower levels of HDL 2 and HDL 3 than blacks. White females had significantly higher levels of HDL 2 than white males. Visceral fatness, measured as waist circumference, and race were the major contributors to the explained variance (6–22%) of these lipoproteins, with adverse trends seen among whites and persons with large waist circumferences. Sex (males>females), waist circumference (positive), HDL 2 (negative), and HDL 3 (positive) were the predictor variables for the likelihood of having the LDL 3 pattern. When glucose and insulin were included in the multivariate analysis, insulin (positive), sex (males>females), HDL 2 (negative) and HDL 3 (positive) became significant predictors of LDL 3 pattern. Positive parental history of CAD was associated with LDL ( P=0.009) in white males, and HDL 2 ( P=0.008) and LDL 3 subclass pattern ( P=0.038) in white females; whereas none in blacks. The observed correlates of lipoprotein subclasses and patterns need to be considered in estimating CAD risk in young adults.

The pattern of atopic sensitization is associated with the development of asthma in childhood

Background: Even though atopic sensitization has been shown to be strongly associated with childhood asthma, asthma eventually develops in only one third of atopic children. Objective: The aim of this study was to prospectively investigate the pattern of atopic sensitization typically associated with the development of asthma in childhood. Methods: The German Multicenter Allergy Study followed 1314 children from birth to the age of 7 years. Parental questionnaires on asthma and asthmatic symptoms were completed 6 times up to the age of 2 years and from then on yearly. Determination of specific IgE to 9 food and inhalant allergens was performed yearly, and at the age of 7 years, a bronchial histamine challenge was conducted. Results: Onset of atopic sensitization in atopic children with current asthma at the age of 7 years was significantly earlier than in atopic children without current asthma (39.4% before age 1 year vs 21.0%, P = .015). Early atopic sensitization without any sensitization to inhalant allergens at the age of 7 years conferred no increased risk for asthma at this age. Only those children sensitized to any allergen early in life and sensitized to inhalant allergens by the age of 7 years were at a significantly increased risk of being asthmatic at this age (odds ratio, 10.12; 95% CI, 3.81-26.88). However, even in this group of persistently sensitized children, the risk of being asthmatic at the age of 7 years was only increased if a positive parental history of asthma or atopy was present (odds ratio, 15.56; 95% CI, 5.78-41.83), with the effect being strongest for maternal asthma. Conclusion: Our results indicate that an underlying factor pertaining to asthma and maternal transmission may determine both a certain pattern of sensitization and the expression of asthma. (J Allergy Clin Immunol 2001;108:709-14.)

Acute appendicitis in children: The importance of family history

Background/Purpose: Acute appendicitis is common, frequently atypical, challenging, and still associated with significant morbidity. Despite major technologic advances, appendicitis remains a primarily clinical diagnosis. Therefore, no relevant anamnestic information should be overlooked. Surprisingly, the relationship between heredity and appendicitis is seldom considered. Because of the potential clinical importance of the family history, the authors addressed this question prospectively over a 52-month period in a practice that includes the majority of pediatric patients with appendicitis in the region. Methods: Family histories were obtained in a standardized manner, focusing on first-degree relatives. Children with incomplete family information were excluded. Patients (ages 2½ to 19 years) were divided into 3 groups: group A, children who underwent an appendectomy (n = 166); group B (first control), children who presented with an acute abdomen and suspected appendicitis but did not undergo an appendectomy (n = 117); group C (second control), children who were seen in the practice for unrelated conditions (n = 141). Results: A positive parental history was obtained from 59 patients (36%) in group A, 24 patients (21%) in group B, and 20 patients (14%) in group C, and the odds ratios (ORs) were 2.0 (P =.035) and 2.9 (P <.001) for groups A versus B and A versus C, respectively. Of the 13 patients whose sibling had had acute appendicitis, 9 were in group A versus 2 each in groups B and C, and the OR for any family history (siblings, parents) in groups A versus B was 1.9 (P =.028) and for groups A versus C was 2.9 (P < 0.001). Appendicitis was histologically confirmed in 93% of children in group A. Conclusions: Heredity is a significant factor in pediatric patients who have appendicitis. Children who have appendicitis are twice as likely to have a positive family history than are those with right lower quadrant pain (but no appendicitis) and almost 3 times as likely to have a positive family history than are surgical controls (without abdominal pain). Because of its potential value in changing the threshold for intervention, a careful family history should be obtained for every child in whom acute appendicitis is suspected. J Pediatr Surg 36:1214-1217. Copyright © 2001 by W.B. Saunders Company.

Blood pressure but not parental history for hypertension predicts pain perception in women

Previous work has suggested an attenuated sensitivity to painful stimulation in hypertensive men. We recently reported that, compared with persons with negative parental history, men, but not women, with a positive history for hypertension showed attenuated pain perception. This study specifically addressed factors that predict pain perception in women, including blood pressure, parental history and mood states. Fifty-four normotensive women with positive (PH+; n=20) or negative parental history (PH−; n=34) for hypertension and high or low casual systolic blood pressure (BP) performed the cold pressor (CP) test. Participants rated their pain every 15 s during a 90-s hand CP (0–4°C) and a 90-s post-CP rest period. Detailed mood ratings were obtained immediately before the CP test. Data were evaluated using multivariate repeated measure analyses of variance and regression analyses. PH+ and PH− women did not differ in age, height, weight, education, resting BP, or heart rate. PH+ and PH− women did not differ in pain ratings during or after the CP, or pain ratings using the McGill Pain Questionnaire (MPQ), and they did not differ in their cardiovascular responses to the CP, confirming our earlier study in a separate sample. Women with high casual systolic BP reported significantly less pain, especially after the CP ( P<0.01). MPQ total scores confirmed this finding with high BP women reporting less pain than low BP women ( P<0.05). Regression analyses confirmed these effects. Controlling for potential confounding variables did not alter these relationships. These findings suggest that in women, phenotype systolic BP may be a better predictor of hypoalgesia than parental history of hypertension.

Risk of Type 2 Diabetes Mellitus in Young Adults from a Biracial Community: The Bogalusa Heart Study

Background. Since type 2 diabetes has a strong familial component, characteristics of young adult offspring of type 2 diabetics were examined in a community sample to determine early abnormalities in black and white persons at risk.Methods. The sample consisted of 1,338 fasting young adults (72% white, 28% black) aged 19 to 37 years from a biracial community, including those with positive parental history of type 2 diabetes (one offspring per family, n = 230) or conditions of impaired fasting glucose and type 2 diabetes (n = 22).Results. Positive family history of diabetes or impaired fasting glucose and type 2 diabetes in young adults of both races were significantly associated with adverse profiles of measures of obesity and abdominal fat (body mass index, triceps and subscapular skinfolds, waist circumference, and abdominal height), systolic and diastolic blood pressures, serum total cholesterol, triglycerides, VLDL cholesterol, and HDL cholesterol, and indicators of glucose homeostasis (plasma glucose and insulin and insulin resistance index). The magnitude of the differences in obesity and abdominal fat measures and plasma glucose between individuals with and without parental diabetes was greater among blacks versus whites (P = 0.047–0.004). Further, black offspring of both diabetics and non-diabetics had unfavorable profiles of obesity and abdominal fat measures, blood pressure, insulin, and insulin resistance index (P = 0.0001). In a multivariate analysis, adiposity measured as body mass index (P = 0.03) and plasma glucose (P = 0.003) emerged as the two independent characteristics that distinguished those with parental diabetes from those without parental disease. Insulin (P = 0.0001) and the insulin resistance index (P = 0.0001) were independently associated with conditions of impaired fasting glucose or type 2 diabetes.Conclusions. The risk factors of young adults with parental type 2 diabetes or conditions of impaired fasting glucose and type 2 diabetes can be detected early. These observations have implications for early prevention and intervention, especially for blacks.

Additive pressor effects of caffeine and stress in male medical students at risk for hypertension

The effects of caffeine on blood pressure (BP) and cortisol secretion were examined during elevated work stress in medical students at high versus low risk for hypertension. Among 31 male medical students who were regular consumers of caffeine, 20 were considered at low risk for hypertension (negative parental history and all screening BP < 125/78 mm Hg) and 11 at high risk based on epidemiologic criteria (positive parental history and average screening BPs between 125/78 and 139/89 mm Hg). Cortisol levels and ambulatory BP were measured with and without caffeine during two lectures (low work stress) and two exams (high work stress) in a randomized, double-blind, crossover trial. Caffeine consumption and exam stress increased cortisol secretion in both groups ( P < .05). BP increased with caffeine or exam stress in both groups, low versus high risk, respectively (Caffeine: + 5/4 vs + 3/3 mm Hg; Stress: + 4/1 vs + 7/3 mm Hg; P < .05). The combination of stress and caffeine caused additive increases in BP (Low Risk + 9/5 mm Hg, High Risk + 10/6 mm Hg) such that 46% of high-risk participants had average systolic BP ≥ 140 mm Hg. This combined effect of stress and caffeine on BP suggests that it may be beneficial for individuals at high risk for hypertension to refrain from the use of caffeinated beverages, particularly at times when work demands and attendant stressors are high. For the same reasons, recent intake of caffeine should be controlled in patients undergoing BP measurement for the diagnosis of hypertension.

Sex differences in pain perception and cardiovascular responses in persons with parental history for hypertension

We investigated gender differences in cardiovascular and pain responses to the cold pressor (CP) test in persons with positive (PH+) or negative parental history (PH−) for hypertension. Previous work has suggested an attenuated sensitivity to painful stimulation in hypertensive men and more recently in men with parental disposition for hypertension. It is not known whether this hypoalgesic effect is present in PH+ women. In this study, we evaluated differences in pain perception between men and women with PH+ or PH− using an assessment method to measure current as well as delayed pain. Participants rated their pain every 15 s during a 90-s hand CP (0–4°C) and a 90-s post-CP rest period. Systolic and diastolic blood pressures (SBP, DBP) and heart rate (HR) were measured before, during, and after the CP. PH+ and PH− groups did not differ in age, height, weight, education, resting SBP, DBP, or HR. PH+ men showed greater DBP responses to the CP than PH− men, while female groups did not differ in cardiovascular responses to the CP. Although pain ratings during the CP did not differ between groups, post-CP reported pain receded faster in the PH+ men than in the PH− men. PH+ women, on the other hand, tended to report greater pain than PH− women. These findings question the generalizability of the hypoalgesic effects in hypertension-prone women.

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.

Lipid reactivity among men with a parental history of myocardial infarction.

In the current study, we examined lipid and cardiovascular responses to an acute stressor among men with and without a parental history of myocardial infarction. 37 men were selected from a large group who completed medical history questionnaires and interviews. Twenty-two men who denied parental history of heart disease (negative parental history) were compared with 15 men with one or both parents who had suffered a myocardial infarction (positive parental history). Total cholesterol, high- and low-density lipoprotein cholesterol, triglycerides, heart rate, and blood pressure were measured at rest and during a videotaped speech stressor. Positive parental history men had significantly higher low-density lipoprotein cholesterol levels and blood pressure at baseline, significantly lower high-density lipoprotein cholesterol levels at baseline, and significantly larger total cholesterol and low-density lipoprotein cholesterol reactivity, relative to negative parental history men. Because parental history is a risk factor for subsequent cardiovascular morbidity and mortality, these data suggest that lipid reactivity to stress may be biologically important.