Parental History of Hypertension: A Risk for Autonomic Dysfunction and Metabolic and Vascular Derangement in Normotensive Male Offspring

BACKGROUND

Children of hypertensive parents have an increased propensity of developing hypertension, at an age very much prior to their parents. Understanding the pathophysiology of hypertension in such young individuals, especially baroreflex sensitivity (BRS), is necessary. Reduced heart rate variability (HRV), insulin resistance (IR), dyslipidemia, and decreased vasodilatory adipokines, namely, apelin and relaxin, in normotensives may predispose to the onset of hypertension. Thus, this study compared autonomic functions, vascular markers, and metabolic profiles between normotensive male offspring with and without parental hypertension.

METHODS

This analytical cross-sectional study comprised 40 male normotensive offspring of hypertensive parents, aged 18-35 years, recruited as the study group and 40 age- and body mass index (BMI)-matched normotensive male offspring with non-hypertensive parents enrolled as controls. Cardiovascular autonomic functions, including BRS, HRV, diastolic blood pressure response to isometric handgrip test (ΔDBPIHG), Valsalva ratio, and metabolic and vascular markers, were assessed.

RESULTS

The study group exhibited reduced BRS, HRV, and Valsalva ratio and higher ΔDBPIHG compared to controls, indicating impaired autonomic functions. The study group had higher IR and triglyceride levels and reduced apelin and relaxin levels. BRS showed significant correlations with HRV, Valsalva ratio, ΔDBPIHG, and metabolic and vascular markers.

CONCLUSIONS

Normotensive male offspring of hypertensive parents exhibit impaired autonomic functions, as evidenced by reduced BRS, HRV, and Valsalva ratio. Additionally, they have higher IR, dyslipidemia, and decreased levels of vasodilatory adipokines, indicating an increased risk for future hypertension development. These findings signify that early identification of hypertensive potential in this high-risk population is warranted, which would enable taking necessary preventive measures.

The Association Between Body Mass Index and Parental History of Hypertension Among Young Indian Adults

BACKGROUND

Hypertension is a disease of multifactorial etiology. Individuals with parental history of hypertension (PHH) have also been observed to be at an increased risk of developing hypertension in their adult life. However, there is a dearth of studies among youth. Obesity is one of the risk factors, and studies conducted among adults of all age groups have observed that there is a highly significant correlation between hypertension and body mass index (BMI). Hence, the association between the two factors, viz., parental history of hypertension and BMI, among the young Indian male and female population was analyzed in this study.

METHOD

This cross-sectional study conducted in Central India comprised 100 young adults between 18 and 25 years of age. On the basis of parental history of hypertension, the subjects were divided into two groups: group 1 comprised youth with parental history of hypertension and group 2 comprised youth without parental history of hypertension, involving 32 and 68 subjects in each of these groups, respectively. Anthropometric measurements were done using standard methods, and BMI was calculated. Statistical analysis was done using Epi Info software.

RESULTS

The study subjects in both groups were comparable in age. The mean age of the study participants was 19.32 years and 19.45 years in group 1 and group 2, respectively. The study did not find any association between BMI and parental history of hypertension.

CONCLUSION

The association between parental history of hypertension and BMI, the non-modifiable and modifiable independent risk factors, respectively, needs to be further explored in light of the iceberg phenomenon, multifactorial causation, and natural history of disease. It is worth mentioning that parental history of hypertension and other risk factors should be considered even if the BMI is normal as per Asian Indian cutoff levels.

Elevated blood pressure and its predictors among secondary school students in Sarawak: a cross-sectional study

OBJECTIVES

Hypertension is a health issue affecting adolescents. Accumulating evidence affirms that elevated blood pressure begins in childhood and tracks into adulthood. This cross-sectional study was conducted to determine the prevalence of elevated blood pressure and its predictors among secondary school students in Sarawak, Malaysia.

METHODS

A total of 2,461 secondary school students aged 12-17 years from 19 schools in Sarawak participated in the study. Questionnaire was used to obtain socio-demographic data, parental history of hypertension, and self-reported physical activity. Anthropometric and blood pressure measurements were taken. Data was entered and analysed using SPSS version 23.0.

RESULTS

The prevalence of adolescents with elevated blood pressure, overweight, central obesity, and overfat were 30.1%, 24.3%, 13.5%, and 6.7%, respectively. Multivariate logistic regression demonstrated the predictors significantly associated with elevated blood pressure among respondents: overweight (adjusted odds ratio=3.144), being male (adjusted odds ratio=3.073), being Chinese (adjusted odds ratio=2.321) or Iban (adjusted odds ratio=1.578), central obesity (adjusted odds ratio=2.145), being overfat (adjusted odds ratio=1.885), and being an older adolescent (adjusted odds ratio=1.109). Parental history of hypertension, locality, and physical activity showed no significant associations.

CONCLUSION

The obesity epidemic must be tackled at community and school levels by health education and regulation of school canteen foods.