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, 41±1 years, 53%men) were compared with available spouses (n=45, 41±1 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±1 mmHg, P<0.01), LVMI (94±3 vs. 80±2 g/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±0.2 m/s), R _rest (53±3 vs. 51±3 mmHg/ml/min/100 ml) and log R _min (0.58±0.02 vs. 0.55±0.02 mmHg/ml/min/100 ml) 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 6.3 g/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.