How family history and risk factors for hypertension relate to ambulatory blood pressure in healthy adults
How family history and risk factors for hypertension relate to ambulatory blood pressure in healthy adults
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DOI：
10.1097/hjh.0b013e3282f15c27
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发表时间：
2008-02-01
影响因子：
4.9
通讯作者：
Weiss, Robert E.
中科院分区：
文献类型：
--
作者：
Goldstein, Iris B.;Shapiro, David;Weiss, Robert E.
虽然家族史是高血压的主要预测因素，但其他危险因素也与血压升高有关。本研究探讨去甲肾上腺素（NE）、胰岛素抵抗和血脂与高血压家族史的关系，并试图确定家族史与这些因素对BP的共同影响。方法220例健康男女，年龄22-50岁，完成2次24 h动态血压监测。根据父母的家族史信息，分为父母双高血压组、父母单高血压组和父母血压正常组。获得血浆样本以获得空腹儿茶酚胺水平、胰岛素、葡萄糖和脂质。结果双亲高血压患者胰岛素水平高、胰岛素抵抗、低密度脂蛋白胆固醇水平高。虽然NE与家族史没有直接联系，但在控制家族史和体重指数后，高NE水平与血压升高有关。父母双方都患有高血压且NE水平升高的女性在清醒和睡眠期间的收缩压和舒张压均较高。在男性中，双亲同时患有高血压和高NE仅与清醒时的舒张压有关。结论NE结果提供了交感神经激活在高血压危险个体识别中的证据。在健康个体中研究高血压家族史和其他危险因素提供了一个独特的机会，可以在高血压确诊之前就探索导致血压升高的因素。
Background Although family history is a major predictor of hypertension, other risk factors have been linked to elevated blood pressure ( BP). This study explored the relationship of norepinephrine ( NE), insulin resistance and lipids to family history of hypertension, and attempted to determine the combined effects of family history and these factors on BP.Methods A total of 220 healthy men and women, aged 22-50 years, completed two 24 h ambulatory BP sessions. Based on family history information obtained from parents, three groups were formed: subjects with two hypertensive parents, one hypertensive parent or normotensive parents. Plasma samples were obtained to derive fasting catecholamine levels, insulin, glucose and lipids.Results Individuals with two hypertensive parents had high insulin, insulin resistance and low-density lipoprotein cholesterol. Although NE was not directly linked to family history, high NE levels were associated with increased BP, after controlling for family history and body mass index. Women with two hypertensive parents and elevated NE levels had higher systolic BP and diastolic BP during waking and sleep periods. In men the combination of two hypertensive parents and high NE was related only to diastolic BP during waking.Conclusions NE results provide evidence of sympathetic activation in the identification of individuals at risk for hypertension. Studying family history of hypertension and other risk factors in healthy individuals provides a unique opportunity to explore factors leading to elevated BP long before a diagnosis of hypertension is made.