P revious studies have shown that cardiovascular disease clusters within families, 1,2 and a family history of atherosclerotic disease is an established risk factor for cardiovascular events. There have been several studies on the impact of a family history of hypertension on cardiovascular events in offspring, and associations of parental hypertension with blood pressure (BP) elevation and insulin resistance in offspring have been indicated by cross-sectional studies.3-6 However, because BP level and some metabolic parameters (eg, plasma glucose and insulin level) are age dependent, the results of crosssectional analyses may have been biased depending on the age distribution of the study subjects. In addition, the effect of parental hypertension on the time course of BP during aging cannot be assessed by cross-sectional analysis. Although there have been a few longitudinal studies in which children or adolescents (ie, university students) were recruited, 7-11 the number of subjects in those studies was relatively small or the subjects were restricted to white men. More importantly, the relationship between effects of parental history of hypertension on longitudinal changes in metabolic risk factors and effects on longitudinal BP changes has not been clarified.In the present study, we examined the effects of parental hypertension on time courses of both BP and metabolic risk factors during the third to eighth decades of life. We retrieved data from the Tanno-Sobetsu Study and used a mixed-effects model for analyses of longitudinal changes in parameters. The results of the present study indicated that parental hypertension has additive effects not only on age-dependent elevation of BP but also on fasting blood glucose (fasting blood sugar [FBS]) and triglyceride (TG) levels in both men and women. These effects of parental hypertension on the risk factors may contribute to the increase in atherosclerotic cardiovascular events in subjects with a family history of hypertension. MethodsThe protocol of this study was approved by the ethics committee of Sapporo Medical University. Detailed methods are described in the online-only Data Supplement.Abstract-The mechanism underlying the association of parental hypertension with cardiovascular events in offspring remains unclear. In this study, the effects of parental hypertension on longitudinal trends of blood pressure and metabolic parameters were examined by mixed-effects model analysis. From 1977 to 2006, 5198 subjects participated in the Tanno-Sobetsu Study, and we selected 2607 subjects (1095 men and 1512 women) for whom data on parental history of hypertension were available. In both men and women with and without parental hypertension, systolic blood pressure and fasting blood glucose levels consistently increased from the third to eighth decades of life, whereas diastolic blood pressure and serum triglyceride levels followed biphasic (inverted U shape) time courses during that period. However, the relationships between the parameters and age were significantly shi...

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Here we examined whether the Matsuda-DeFronzo insulin sensitivity index (ISI-M) is more efficient than the homeostasis model assessment of insulin resistance (HOMA-IR) for assessing risk of hypertension. Cross-sectional and longitudinal analyses were conducted using normotensive subjects who were selected among 1399 subjects in the Tanno-Sobetsu cohort. In the cross-sectional analysis (n ¼ 740), blood pressure (BP) level was correlated with HOMA-IR and with ISI-M, but correlation coefficients indicate a tighter correlation with ISI-M. Multiple linear regression analysis adjusted by age, sex, body mass index (BMI) and serum triglyceride level (TG) showed contribution of ISI-M and fasting plasma glucose, but not of HOMA-IR. In the longitudinal analysis (n ¼ 607), 241 subjects (39.7%) developed hypertension during a 10-year follow-up period, and multiple logistic regression indicated that age, TG, systolic BP and ISI-M, but not HOMA-IR, were associated with development of hypertension. In subjects o60 years old, odds ratio of new-onset hypertension was higher in the low ISI-M group (ISI-M, less than the median) than in the high ISI-M group for any tertile of BMI. In conclusion, ISI-M is a better predictor of hypertension than is HOMA-IR. Non-hepatic IR may be a determinant, which is independent of TG, BP level and BMI, of the development of hypertension.

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The use of an ARB, but not a CCB, is associated with reduced all-cause and cardiovascular mortalities in patients on HD.