Arterial stiffness and peripheral vascular resistance in offspring of hypertensive parents: influence of sex and other confounders

Aim:Established essential hypertension is associated with increased arterial stiffness and peripheral resistance, but the extent of vascular changes in persons genetically predisposed for essential hypertension is uncertain.Methods:Participants from the Danish Hypertension Prevention Project (DHyPP) (both parents hypertensive) (n=95, 411 years, 53% men) were compared with available spouses (n=45, 411 years) using measurements of ambulatory blood pressure (BP), left ventricular mass index (LVMI), pulse wave velocity, central BP and augmentation index (AIx) in addition to forearm resting and minimal resistance [forearm resting vascular resistance (R-rest) and forearm minimal vascular resistance (R-min)].Results:DHyPP patients with participating spouses had higher 24-h mean BP (94 +/- 1 vs. 88 +/- 1mmHg, P<0.01), LVMI (94 +/- 3 vs. 80 +/- 2g/m(2), P<0.01), central SBP (121 +/- 2 vs. 111 +/- 2mmHg, P<0.01) and AIx (16.0 +/- 1.2 vs. 10.5 +/- 1.7%, P<0.01), but similar carotid-femoral pulse wave velocity (7.5 +/- 0.2 vs. 7.1 +/- 0.2m/s), R-rest (53 +/- 3 vs. 51 +/- 3mmHg/ml/min/100ml) and log R-min (0.58 +/- 0.02 vs. 0.55 +/- 0.02mmHg/ml/min/100ml) when compared with spouses. Using multiple linear regression analysis (adjusting for sex, age, BMI, creatinine clearance and 24-h BP, heart rate and sodium excretion) AIx and LVMI remained elevated in DHyPP patients [4.2% (0.7; 7.7), P=0.02 and 6.3g/m(2) (0.7; 11.9), P=0.03]. For the entire DHyPP cohort AIx, R-rest and R-min were higher in women than men (P<0.01), and the same was true for AIx and R-min among spouses (P<0.05). Furthermore, AIx was linearly associated with R-rest and R-min.Conclusion:Young to middle-aged individuals genetically predisposed for essential hypertension display increased AIx and LVMI, although vascular stiffness and peripheral resistance are still normal.