FAMILIAL HYPERTENSION & BIRACIAL CV REACTIVITY IN YOUTH

原发性高血压（EH）的发病率和死亡率 代表了美国主要的医疗保健成本和关注点。 由于EH的前体起源于儿童时期， 在青春期，我们试图确定EH的危险因素， 高遗传风险人群，即，黑人 和父母患有高血压的孩子。一个风险因素表明， 很好的承诺是心血管（CV）反应性， 血流动力学变量的变化，如收缩期和舒张期血液 血压和心率对实验室或自然生活的反应 压力源这些压力源包括：身体压力（锻炼）， 心理压力（电子游戏挑战、星星追踪）和“日常 生活压力（24小时动态血压）。其他标记，如 心脏指数，特别是左心室质量（LVM）和红细胞 细胞钠转运，已被证明与 心血管疾病的发展，如冠状动脉疾病和高血压。在 我们继续的研究，我们寻求扩大我们的初步调查， 在遗传风险方面存在差异的健康儿童的出生率人群， EH，父母高血压的儿童和血压正常的儿童 父母我们寻求：I）扩展我们对24小时动态血压的初步研究 模式; 2）建立CV反应性与 心脏尺寸和性能指数的回声测定测量， 重点是LVM -目前已知的最强大的风险因素; 3） 研究遗传因素对上述指标的重要性（CV 反应性和LV质量）通过对兄弟姐妹和无关对的研究; 4） 确定CV反应性的前瞻性预后价值，24小时 ABPM和红细胞钠转运预测血压和LV 2年随访后发现肿块， 应用研究应该：一）提高设计的可能性 前瞻性筛查和干预计划， 预防成年期高血压; 2）扩大现有的知识， 高血压的危险因素，以便进一步剖析高血压的机制 EH在美国白色和黑人中均存在。

The morbidity and mortality caused by essential hypertension (EH) represent major health care costs and concerns in the United States. Because the precursors of EH have their origins in childhood and adolescence, we have sought to identify risk factors for EH in populations at high genetic risk for the development of EH, i.e., blacks and children of hypertensive parents. A risk factor which has shown excellent promise is cardiovascular (CV) reactivity, the measures of the changes of hemodynamic variables, such as systolic and diastolic blood pressure, and heart rate in response to laboratory or natural life stressors. These stressors include: physical stress (exercise), psychological stress (video game challenge, star tracing), and "everyday life" stress (24 hour ambulatory blood pressure). Other markers, such as cardiac indices, especially left ventricular mass (LVM) and red blood cell sodium transport, have been shown to be linked directly with the development of CV diseases, such as coronary artery disease and EH. In our continued studies we seek to expand our initial investigations in a biracial population of healthy children who differ in genetic risk for EH, children of a hypertensive parent and children of normotensive parents. We seek to: I ) extend our preliminary study of 24 hour ABPM patterns; 2) establish the potential link between CV reactivity and echo-determined measures of cardiac dimensions and performance Indices, with emphasis on LVM - the most powerful risk factor presently known; 3) examine the importance of genetic influences on the above indices (CV reactivity and LV mass) by the study of siblings and unrelated pairs; 4) determine the prospective prognostic value of CV reactivity, 24 hour ABPM, and red cell sodium transport to predict blood pressure and LV mass after a 2 year follow-up, Findings from this continuation application studies should: I ) enhance the probability of designing a prospective screening and intervention program for the primary prevention of EH in adulthood; 2) expand current knowledge concerning risk factors for EH to allow further dissection into the mechanisms of EH in both white and black Americans.