Autonomic and Vascular Control in Prehypertensive Subjects with a Family History of Arterial Hypertension

作者：Amaral Josaria Ferraz^*; Andrade Borsato Diana de Medeiros; Guedes Freitas Isabelle Magalhaes; Toschi-Dias Edgar; Martinez Daniel Godoy; Laterza Mateus Camaroti

来源：Arquivos Brasileiros de Cardiologia, 2018, 110(2): 166-174.

DOI：10.5935/abc.20180006

• Hypertension / genetic
• Autonomic Nervous System
• Risk Factors
• Endothelium
• Vascular / physiopathology

Background: Individuals with a family history of systemic arterial hypertension (FHSAH) and/or prehypertension have a higher risk of developing this pathology.
Objective: To evaluate the autonomic and vascular functions of prehypertensive patients with FHSAH.
Methods: Twenty-five young volunteers with FHSAH, 14 normotensive and 11 prehypertensive subjects were submitted to vascular function evaluation by forearm vascular conductance(VC) during resting and reactive hyperemia (Hokanson (R)) and cardiac and peripheral autonomic modulation, quantified, respectively, by spectral analysis of heart rate (ECG) and systolic blood pressure (SBP) (FinometerPRO (R)). The transfer function analysis was used to measure the gain and response time of baroreflex. The statistical significance adopted was p <= 0.05.
Results: Pre-hypertensive individuals, in relation to normotensive individuals, have higher VC both at rest (3.48 +/- 1.26 vs. 2.67 +/- 0.72 units, p = 0.05) and peak reactive hyperemia (25, 02 +/- 8.18 vs. 18.66 +/- 6.07 units, p = 0.04). The indices of cardiac autonomic modulation were similar between the groups. However, in the peripheral autonomic modulation, greater variability was observed in prehypertensive patients compared to normotensive individuals (9.4 [4.9-12.7] vs. 18.3 [14.8-26.7] mmHg(2); p < 0.01) and higher spectral components of very low (6.9 [2.0-11.1] vs. 13.5 [10.7-22.4] mmHg(2), p = 0.01) and low frequencies (1.7 [1.0-3.0] vs. 3.0 [2.0-4.0] mmHg(2), p = 0.04) of SBP. Additionally, we observed a lower gain of baroreflex control in prehypertensive patients compared to normotensive patients (12.16 +/- 4.18 vs. 18.23 +/- 7.11 ms/mmHg, p = 0.03), but similar delay time (-1.55 +/- 0.66 vs. -1.58 +/- 0.72 s, p = 0.90).
Conclusion: Prehypertensive patients with FHSAH have autonomic dysfunction and increased vascular conductance when compared to normotensive patients with the same risk factor.

• 出版日期2018-2