Influence of gender and family history of hypertension on autonomic control of heart rate, diastolic function and brain natriuretic peptide.
OBJECTIVE
To verify in a unitary view whether autonomic control of heart rate and cardiac structure and function are modified early in offspring of hypertensive families.


RESULTS
We selected 87 age- and sex-matched young normotensive subjects with (n = 45) and without (n = 42) a family history of hypertension who underwent evaluations of arterial pressure, time-domain parameters of autonomic heart rate control (24-h ECG monitoring), spectral baroreflex sensitivity, left ventricular geometry and function (echo-Doppler) and plasma brain natriuretic peptide levels (BNP). The group with a family history of hypertension significantly differed from their counterparts for systolic pressure (119 +/- 11 versus 114 +/- 9 mmHg, P< 0.05), heart rate (RR interval, 766 +/- 64 versus 810 +/- 93 ms, P< 0.05), heart rate variability [the standard deviation of normal RR intervals (SDNN), 147 +/- 29 versus 171 +/- 33 ms, P < 0.051, diastolic function (isovolumetric relaxation time, 65 +/- 9 versus 60 +/- 8 ms, P< 0.05) and BNP (23 +/- 13 versus 37 +/- 10 pg/ml, P< 0.05). Baroreflex sensitivity values did not differ between the two groups. When gender was considered, all the above-mentioned measures, as well as baroreflex sensitivity, were significantly different between males with and without a family history of hypertension but not between females, except for BNP, which was lower in males and females with a history of hypertension (males, 24 +/- 11 versus 38 +/- 8 pg/ml, P< 0.01; females 21 +/- 14 versus 36 +/- 13 pg/ml, P < 0.05).


CONCLUSIONS
Male, but not female, hypertensive offspring have modified diastolic function and autonomic control of heart rate; BNP is the only parameter able to characterize hypertensive offspring independently from the influence of gender. This provides the hypothesis that the impaired production of this hormone could play a primary role in the pre-hypertensive state.
Pitzalis
M V
MV
Institute of Cardiology, University of Bari, Italy. mariavittoria.pitzalis@cardio.uniba.it
Iacoviello
M
M
Massari
F
F
Guida
P
P
Romito
R
R
Forleo
C
C
Vulpis
V
V
Rizzon
P
P
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001341:Autonomic Nervous System / Q000503:physiopathology*; D017704:Baroreflex; D003971:Diastole; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D020022:Genetic Predisposition to Disease; D006339:Heart Rate / Q000502:physiology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000294:innervation / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000235:genetics / Q000503:physiopathology*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012737:Sex Factors; D016277:Ventricular Function, Left / Q000502:physiology
D020097:Natriuretic Peptide, Brain