Key result
Prehypertension with familial hypertension links to higher resting forearm vascular conductance and altered autonomic modulation.
Why the study?
Does prehypertension alter autonomic and vascular function in young individuals with a family history of systemic arterial hypertension compared to normotensive individuals with the same risk factor?
Cross-Sectional (n=25)
No
Does prehypertension alter autonomic and vascular function in young individuals with a family history of systemic arterial hypertension compared to normotensive individuals with the same risk factor?
Absolute Event Rate: 3.48% vs 2.67%
p-value: p=0.05
Prehypertensive individuals with a family history of hypertension already manifest peripheral autonomic dysfunction and increased vascular conductance, indicating early cardiovascular regulatory alterations prior to the onset of established clinical hypertension.
Early vascular-autonomic changes appear in prehypertensive youth with family history; hypothesis-generating and requires longitudinal validation before clinical use.
BACKGROUND: Individuals with a family history of systemic arterial hypertension (FHSAH) and / or prehypertension have a higher risk of developing this pathology. OBJECTIVE: To evaluate the autonomic and vascular functions of prehypertensive patients with FHSAH. METHODS: Twenty-five young volunteers with FHSAH, 14 normotensive and 11 prehypertensive subjects were submitted to vascular function evaluation by forearm vascular conductance(VC) during resting and reactive hyperemia (Hokanson®) and cardiac and peripheral autonomic modulation, quantified, respectively, by spectral analysis of heart rate (ECG) and systolic blood pressure (SBP) (FinometerPRO®). The transfer function analysis was used to measure the gain and response time of baroreflex. The statistical significance adopted was p ≤ 0.05. RESULTS: Pre-hypertensive individuals, in relation to normotensive individuals, have higher VC both at rest (3.48 ± 1.26 vs. 2.67 ± 0.72 units, p = 0.05) and peak reactive hyperemia (25, 02 ± 8.18 vs. 18.66 ± 6.07 units, p = 0.04). The indices of cardiac autonomic modulation were similar between the groups. However, in the peripheral autonomic modulation, greater variability was observed in prehypertensive patients compared to normotensive individuals (9.4 [4.9-12.7] vs. 18.3 [14.8-26.7] mmHg2; p < 0.01) and higher spectral components of very low (6.9 [2.0-11.1] vs. 13.5 [10.7-22.4] mmHg2, p = 0.01) and low frequencies (1.7 [1.0-3.0] vs. 3.0 [2.0-4.0] mmHg2, p = 0.04) of SBP. Additionally, we observed a lower gain of baroreflex control in prehypertensive patients compared to normotensive patients (12.16 ± 4.18 vs. 18.23 ± 7.11 ms/mmHg, p = 0.03), but similar delay time (-1.55 ± 0.66 vs. -1.58 ± 0.72 s, p = 0.90). CONCLUSION: Prehypertensive patients with FHSAH have autonomic dysfunction and increased vascular conductance when compared to normotensive patients with the same risk factor.
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Amaral et al. (2017) conducted a cross-sectional in Prehypertension with family history of systemic arterial hypertension (n=25). Prehypertension vs. Normotension was evaluated on Resting forearm vascular conductance (p=0.05). Prehypertensive individuals with a family history of hypertension demonstrated higher resting forearm vascular conductance (3.48 vs 2.67 units, p=0.05) and greater peripheral autonomic modulation variability compared to normotensive peers.
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