Cardiac Autonomic Dysfunction in Offspring of Hypertensive Parents During Exercise

Abstract

Offspring of hypertensive parents present autonomic dysfunction at rest and during physiological maneuvers. However, the cardiac autonomic modulation during exercise remains unknown. This study tested whether the cardiac autonomic modulation would be reduced in offspring of hypertensive parents during exercise. Fourteen offspring of hypertensive and 14 offspring of normotensive individuals were evaluated. The groups were matched by age (24.5±1.0 vs. 26.6±1.5 years; p=0.25) and BMI (22.8±0.6 vs. 24.2±1.0 kg/m; p=0.30). Blood pressure and heart rate were assessed simultaneously during 3 min at baseline followed by 3-min isometric handgrip at 30% of maximal voluntary contraction. Cardiac autonomic modulation was evaluated using heart rate variability. Primary variables were subjected to two-way ANOVA (group vs. time). P value<0.05 was considered statistically significant. Blood pressure and heart rate were similar between groups during exercise protocol. In contrast, offspring of hypertensive subjects showed a reduction of SDNN (Basal=34.8±3.5 vs. 45.2±3.7 ms; Exercise=30.8±3.3 vs. 41.5±3.9 ms; p group=0.01), RMSSD (Basal=37.1±3.7 vs. 52.0±6.0 ms; Exercise=28.6±3.4 vs. 41.9±5.3 ms; p group=0.02) and pNN50 (Basal=15.7±4.0 vs. 29.5±5.5%; Exercise=7.7±2.4 vs. 18.0±4.3%; p group=0.03) during the exercise protocol in comparison with offspring of normotensive parents. We concluded that normotensive offspring of hypertensive parents exhibit impaired cardiac autonomic modulation during exercise.

Influence of family history of hypertension on blood pressure and heart rate variability in young adults: a meta-analysis

“…Twenty [8,15–20,22,27,31,33,35,37–39,41] and 34 studies [8–28,31–33,36,37,39–42] reported body mass and BMI data, respectively. Some studies were matched according to body mass or BMI to a control group FHH − [12,40].…”

“…Figure 1 shows a flowchart of selected studies. Among the 38 studies included in the quantitative analysis, with 2025 participants with ~25 years old, 21 included only men [11,12,[15][16][17][20][21][22][23][24][25]27,[31][32][33][34][35][36], five included only women [18,28,37,38], and 12 both sexes [8][9][10]13,14,19,26,[39][40][41][42]. Of these studies, 37 assessed clinic BP, 18 HRV indices, and five ambulatory BP.…”

“…Of these studies, 37 assessed clinic BP, 18 HRV indices, and five ambulatory BP. Of the HRV studies, 14 included only men [15][16][17]20,[22][23][24][25]27,32,33], four included both sexes [9,14,26], and no HRV study included only women. HRV was measured through ECG [9,17,20,[23][24][25][26]32,33] or heart rate monitor [14][15][16]22,27], with 5-min [17,20,23,24] to 30-min [33] analyses.…”

“…not necessarily accompanied by increased BP in young adults [14][15][16][17]27]. It remains to be studied whether the adrenergic activation precedes and promotes the elevation of BP.…”

“…Although BP and HRV concordance within families can be attributed to genetic susceptibility and shared environmental exposures, a large family study [55] showed that the contribution of genetic factors to the variance of diastolic BP (24.4%), RMSSD (17.9%), and SDNN (15.6%) in the general population is substantial, and the genes for BP and HRV partially overlap. However, the autonomic dysfunctions are not necessarily accompanied by increased BP in young adults [14–17,27]. It remains to be studied whether the adrenergic activation precedes and promotes the elevation of BP.…”