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Circulation, Vol 85, 497-503, Copyright © 1992 by American Heart Association
RJ Parmer, JH Cervenka and RA Stone
BACKGROUND. Abnormalities in baroreflex control of heart rate may be
important in the pathogenesis of essential hypertension. METHODS AND
RESULTS. To investigate the influence of heredity on baroreflex function,
we measured baroreflex sensitivity in 40 untreated patients with essential
hypertension grouped by the presence (FH+) or absence (FH-) of a family
history of hypertension and in 24 normotensive counterparts. Baroreflex
sensitivity was assessed by both high-pressure (phenylephrine bolus) and
low-pressure (amyl nitrite inhalation) stimuli. Subject groups were matched
for age, blood pressure, body weight, and race. Baroreflex sensitivity (in
milliseconds per millimeter of mercury) assessed by amyl nitrite inhalation
was 24.3 +/- 2.8 in FH- normotensives, 12.3 +/- 1.7 in FH+ normotensives,
15.4 +/- 3.3 in FH- hypertensives, and 8.1 +/- 1.2 in FH+ hypertensives.
Baroreflex sensitivity assessed by phenylephrine bolus was 28.8 +/- 5.6 in
FH- normotensives, 19.3 +/- 2.8 in FH+ normotensives, 19.1 +/- 2.0 in FH-
hypertensives, and 13.6 +/- 1.3 in FH+ hypertensives. Two-factor analysis
of variance showed significant effects on baroreflex sensitivity for blood
pressure status (normotensive versus hypertensive) and for family history
of hypertension. After control line (controlling) for the effects of
several variables, including age, mean arterial pressure, body weight, and
race through multiple linear regression analysis, the effect of family
history of hypertension on baroreflex sensitivity was still highly
significant. Indeed, of all variables investigated, family history of
hypertension was the strongest unique baroreflex sensitivity predictor.
CONCLUSIONS. These data suggest that the impairment in baroreflex
sensitivity in hypertension is in part genetically determined and may be an
important hereditary component in the pathogenesis of essential
hypertension.
ARTICLES
Baroreflex sensitivity and heredity in essential hypertension
Department of Medicine, University of California, San Diego.
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