Differential influence of family history of hypertension and premature myocardial infarction on systolic blood pressure and left ventricular mass trajectories in youth
Differential influence of family history of hypertension and premature myocardial infarction on systolic blood pressure and left ventricular mass trajectories in youth
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DOI：
10.1542/peds.111.6.1387
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发表时间：
2003-06-01
期刊：
影响因子：
8
通讯作者：
Snieder, H
中科院分区：
文献类型：
--
作者：
Dekkers, JC;Treiber, FA;Snieder, H
Objective.探讨原发性高血压（EH）遗传易感性和早发心肌梗死（MI）遗传易感性对青年人收缩压（SBP）和左室质量（LVM）纵向发展的影响。分别为745例受试者（年龄范围：4.9-27.5岁）和687例受试者（年龄范围：8.2-27.5岁）的样本创建了个体SBP和LVM随年龄的增长曲线。每个样本的非洲裔美国人和欧洲裔美国人男性和女性比例大致相等，每年评估10年。EH家族史（FH）和早发MI家族史分别作为EH和早发MI遗传易感性的指标。EH和早发MI的FH阳性（FH+）分别定义为亲生父母一方或双方证实EH，亲生父母或祖父母中任何一方证实MI，年龄在55岁之前。EH FH+受试者的SBP水平高于EH FH阴性（FH-）受试者，且随时间推移SBP增加更强。EH FH+受试者的LVM水平也高于EH FH-受试者。此外，EH的FH+对左心室质量的影响在女性中比男性更强。高血压FH对SBP和LVM的影响不能用社会经济地位的差异来解释，但调整BMI后对LVM的影响不再显著。心肌梗死FH对收缩压、左室质量无明显影响。在儿童期观察到EH的遗传易感性对SBP和LVM轨迹的影响，而在MI的FH中没有发现这种影响。高血压的遗传标记可能有助于了解高血压和左室肥厚易感性的个体差异。
Objective. To examine the influence of genetic susceptibility to essential hypertension (EH) and the genetic susceptibility to premature myocardial infarction (MI) on longitudinal development of systolic blood pressure (SBP) and left ventricular mass (LVM) in youth.Methods. Individual SBP and LVM growth curves across age were created for a sample of 745 subjects (age range: 4.9-27.5 years) and a sample of 687 subjects (age range: 8.2-27.5 years), respectively. Each sample had an approximately equal proportion of African American and European American males and females, with annual assessments over a 10-year period. Family history (FH) of EH and FH of premature MI were used as measures of genetic susceptibility to EH and to premature MI, respectively. Positive FH (FH+) of EH and of premature MI were defined, respectively, as verified EH in 1 or both biological parents, and verified MI in any biological parent or grandparent before 55 years of age.Results. Subjects with an FH+ of EH had higher SBP levels and stronger increases in SBP over time than subjects with a negative FH (FH-) of EH. Subjects with an FH+ of EH also showed higher LVM levels than subjects with an FH- of EH. In addition, the effect of an FH+ of EH on LVM was stronger in females than males. The effects of FH of EH on SBP and LVM could not be explained by differences in socioeconomic status, but the effect on LVM was no longer significant after adjustment for BMI. FH of MI had no significant effects on SBP or LVM.Conclusions. Effects of genetic susceptibility to EH on SBP and LVM trajectories were observed in childhood, whereas no such effects were found for FH of MI. Genetic markers of EH may improve the understanding of individual differences in susceptibility to develop hypertension and LV hypertrophy.