Blood pressure change and risk of hypertension associated with parental hypertension: the Johns Hopkins Precursors Study.
BACKGROUND
Parental hypertension is used to classify hypertension risk in young adults, but the long-term association of parental hypertension with blood pressure (BP) change and risk of hypertension over the adult life span has not been well studied.


METHODS
We examined the association of parental hypertension with BP change and hypertension risk from young adulthood through the ninth decade of life in a longitudinal cohort of 1160 male former medical students with 54 years of follow-up.


RESULTS
In mixed-effects models using 29 867 BP measurements, mean systolic and diastolic BP readings were significantly higher at baseline among participants with parental hypertension. The rate of annual increase was slightly higher for systolic (0.03 mm Hg, P= .04), but not diastolic, BP in those with parental hypertension. After adjustment for baseline systolic and diastolic BP and time-dependent covariates--body mass index, alcohol consumption, coffee drinking, physical activity, and cigarette smoking--the hazard ratio (95% confidence interval [CI]) of hypertension development was 1.5 (1.2-2.0) for men with maternal hypertension only, 1.8 (1.4-2.4) for men with paternal hypertension only, and 2.4 (1.8-3.2) for men with hypertension in both parents compared with men whose parents never developed hypertension. Early-onset (at age <or=55 years) hypertension in both parents imparted a 6.2-fold higher adjusted risk (95% CI, 3.6-10.7) for the development of hypertension throughout adult life and a 20.0-fold higher adjusted risk (95% CI, 8.4-47.9) at the age of 35 years.


CONCLUSIONS
Hypertension in both mothers and fathers has a strong independent association with elevated BP levels and incident hypertension over the course of adult life.
Wang
Nae-Yuh
NY
Department of Medicine, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA. naeyuh@jhmi.edu
Young
J Hunter
JH
Meoni
Lucy A
LA
Ford
Daniel E
DE
Erlinger
Thomas P
TP
Klag
Michael J
MJ
D000328:Adult; D001794:Blood Pressure; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics*; D008137:Longitudinal Studies; D008297:Male; D010290:Parents; D018570:Risk Assessment; D012307:Risk Factors