FAMILIAL HYPERTENSION & BIRACIAL CV REACTIVITY IN YOUTH

高血压病患者的发病率和死亡率 代表了美国的主要医疗保健成本和担忧。 因为EH的先驱者起源于童年和 在青春期，我们试图确定高血压的危险因素 易患高血压的高遗传风险人群，即黑人 以及父母患有高血压的孩子。一个已经表明的风险因素 心血管(CV)反应性是极有希望的，衡量 血流动力学变量的变化，如收缩和舒张期血液 压力和心率对实验室或自然生活的反应 压力源。这些应激源包括：身体压力(运动)， 心理压力(电子游戏挑战、追星)，以及“每天 生活“压力(24小时动态血压)。其他指标，如 心脏指数，特别是左心室重量和红血球 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……里面 我们的继续研究，我们寻求扩大我们的初步调查 遗传风险不同的健康儿童的混血群体 呃，父母高血压的孩子和血压正常的孩子 父母。我们寻求：i)扩展我们对24小时ABPM的初步研究 模式；2)建立CV反应性和 心脏大小和性能指数的回声测量， 重点关注LVM--目前已知的最强大的风险因素；3) 检验遗传影响对上述指标(CV)的重要性 反应性和LV质量)通过兄弟姐妹和无关对的研究；4) 测定24小时心血管反应性的前瞻性预后价值 ABPM和红细胞钠转运预测血压和左心室 随访2年后的肿块，这是继续的结果 应用研究应该：i)提高设计一种 针对小学儿童的前瞻性筛查和干预计划 成人高血压的预防；2)扩大现有知识，包括 高血压的危险因素允许进一步剖析其发病机制 呃，美国白人和黑人都是如此。

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.