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The study of cardiovascular sympathetic reactivity in unmasking hypertension in offsprings of hypertensive parents

Mitesh Sinha, Santosh Verma.




Abstract

Background: Hypertension is one of the major public health challenge in the world. Early detection of hypertension may enable an individual to enjoy a healthy life by lifestyle modifications. It is well established that genes, environment and its interactions are important in the pathogenesis and risk of hypertension. Studies have shown an association between excessive blood pressure (BP) reactivity to cardiovascular sympathetic tests and incidence of subsequent hypertension. Cold Pressor test (CPT) and isometric handgrip test (IHG) are commonly used test for cardiovascular sympathetic reactivity.

Aims and Objectives: The aim is to explore the cardiovascular reactivity to stress (CPT and IHG) and the recovery time after the withdrawal of the stressor in normotensive offspring of hypertensive parents.

Materials and Methods: The study is an observation case–control study with a total of 40 normotensive subjects of age 17–25 years who have a family history of hypertension and age and sex-matched 40 normotensive subjects with no family history of hypertension were taken as control. Systolic BP (SBP), diastolic BP (DBP), and mean BP (MBP) were measured during rest, during IHG test, 5 min after IHG in the recovery phase, during CPT and 4 min after CPT in the recovery phase.

Result: In our study, the SBP, DBP, and the MBP during resting stage were significantly higher in the normotensive offspring’s of hypertensive parents as compared to control group. There were significant increases in the systolic, diastolic, and the MBPs during the isometric exercise and CPT in both the groups. Recovery to the baseline after cardiac sympathetic reflex tests such as IHG and CPT also was slow among the positive family history groups compared to participants with a negative family history of hypertension.

Conclusion: Hypertension has a genetic disposition. The subjects from the hypertensive families showed greater and prolonged responsiveness to sympathetic stimulation in comparison to the subjects from the non-hypertensive families, indicating the hyperresponsiveness of the sympathetic nervous system to stressor stimuli in the offspring of hypertensive adults.

Key words: Cold Pressor Test; Hypertension; Isometric Hand Grip Test; Offspring’s






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