Evaluation of Insulin Resistance and Sodium Sensitivity in Normotensive Offspring of Hypertensive Individuals

Influence of family history of hypertension on blood pressure and heart rate variability in young adults: a meta-analysis

PURPOUSE

This meta-analysis evaluates the impact of family history of hypertension (FHH + ) on blood pressure (BP) and heart rate variability (HRV) in young adults.

METHODS

Observational studies that evaluated adults (aged between 18 and 40 years) of both sexes, are without cardiometabolic disease diagnosis, are published in English, and are reporting on the influence of FHH + (father, mother, or both) on BP and HRV were included. In June 2021, we made a search of the electronic database MEDLINE (accessed by PubMed). Random-effects models were used, and data are reported as standardized mean difference and 95% confidence limits.

RESULTS

Thirty-eight studies with a total of 2025 individuals were included. Clinic systolic [3.13 mmHg (1.75-4.51)] and diastolic [2.85 mmHg (1.65-4.04)] BPs were higher ( P < 0.001) in individuals with an FHH + . Only 24-h systolic BP was higher [1.76 mmHg (0.05-3.47); P = 0.04] in individuals with an FHH + . As for HRV indices in time-domain, RMSSD: -7.00 ms (-10.75 to -3.26), SDNN: -13.93 ms (-23.56 to -4.30), and HF [-6.82 n. u. (-9.76 to -3.89)] were lower ( P < 0.05), and LF [4.78 ms (2.52-7.03)] and LF/HF ratio [0.32 (0.14-0.50)] were higher ( P < 0.001) in individuals with an FHH + .

CONCLUSION

FHH + negatively impacts BP and HRV in young adults.

Familial burden of hypertension and its effect on blood pressure levels, insulin resistance, and intracellular ions in Greek offspring

We examined the effect of familial burden of hypertension on blood pressure (BP) levels, insulin resistance (IR), and intracellular ions in healthy offspring of Greek families with one, two, or no hypertensive parents. A total of 118 adolescents and young adults were recruited. Three groups were formed: Group A, both parents were normotensive (N-N); Group B, one parent normotensive and one hypertensive (N-H); and Group C, both parents hypertensive (H-H). BP levels, homeostasis assessment model-IR (HOMA-IR) index, and intracellular Na(+), K(+), Ca(2+), and Mg(2+) were compared in the three groups. Also, multiple regression analyses were used to create models with BP parameters and HOMA-IR as dependent variables. Offspring of H-H parents had higher body mass index (BMI) (mean difference, 4.3 +/- 0.9 kg/m(2); 95% confidence interval [CI], 2.0-6.5), higher systolic blood pressure (SBP) (mean difference, 13.2 +/- 3.1 mm Hg; 95% CI, 5.8-20.7), increased levels of intraerythrocyte Ca(2+) (mean difference, 0.02 +/- 0.01 mmol/l; 95% CI, 0.05-0.1), and fasting blood glucose (mean difference, 0.31 +/- 0.10 mmol/l; 95% CI, 0.05-0.56) when compared with those with no parental history of hypertension. In the regression model, SBP was found to be significantly affected by BMI (beta = 0.43; P < .001), iK(+) (beta = -0.224; P < .01), and gender (beta = -0.298; P < .001). The addition of the parental history showed a significant independent association of H-H parental history with SBP (beta = 0.27; P < .05). HOMA-IR was significantly determined by BMI (beta = 0.511; P < .05), iNa(+) (beta = 0.211; P < .05), and iMg(2+) (beta = -0.205; P < .05). Parental history of hypertension did not influence the HOMA-IR index. This study highlights the relative importance and contribution of environmental and genetic influences on the development of high BP. Both these influences possibly alter the intracellular ionic environment. However, nurture rather than familial hypertension burden is the key factor of IR in Greek offspring.

Association between insulin, leptin, adiponectin and blood pressure in youth

OBJECTIVE

To examine whether insulin, leptin and adiponectin are independent correlates of blood pressure (BP) in a large population-based sample of children and adolescents.

METHODS

We studied 655 boys and 667 girls aged 9, 13 and 16 years who participated in the Quebec Child and Adolescent Health and Social Survey, a province-wide school-based survey conducted in 1999.

RESULTS

Strong, positive univariate associations between BMI, insulin and leptin Z-scores, and both systolic and diastolic BP were found in both sexes. Adiponectin Z-scores were negatively associated with systolic BP in girls only. In multivariate analyses only BMI and insulin Z-scores were significantly associated with systolic BP. In boys, each 1 SD increase in BMI was associated with a 4 mmHg increase in mean systolic BP; each 1 SD increase in insulin was associated with a 1 mmHg increase in mean systolic BP. Only insulin Z-scores were independently associated with diastolic BP in both sexes. For each 1 SD increase in insulin, there was a 1 mmHg increase in mean diastolic BP in boys. Similar to systolic BP, the magnitude of the effect of insulin Z-scores on diastolic BP increased as a function of BMI Z-scores in girls.

CONCLUSION

Independently of BMI, insulin is a strong correlate of systolic and diastolic BP in youth. Although animal studies support a role for leptin and adiponectin in controlling BP, they are not independently associated with BP in youth.