Family history of essential hypertension versus obesity as risk factors for hypertension in adolescents

Abstract

Family history of hypertension and obesity are both risk factors for hypertension. Hypertension and obesity share several physiopathologic abnormalities and are frequently associated. However, not all obese people are hypertensive. Renal handling of sodium has been proposed as a physiopathogenic mechanism of essential hypertension and obesity. This study was conducted in obese adolescents to evaluate the role of a family history of hypertension versus obesity in the renal handling of sodium. .5% ؎ 1.3%, in ON it was 22.4% ؎ 2.3%, and in LH it was 14.4% ؎ 1.2% (P < .05). FEUA in OH was 8.5% ؎ 0.8%, in ON it was 14.8% ؎ 3.6%, and in LH it was 7.9% ؎ 0.8% (P < .01). Plasma renin activity (PRA) and aldosterone (PA) were measured in OH and LH; PRA was 5.3 ؎ 0.4 and 4.5 ؎ 0.4 ng/mL/h, respectively (P ‫؍‬ NS), and PA was 366 ؎ 36 and 242 ؎ 32 pg/mL, respectively (P < .05). In summary, adolescents with a family history of hypertension, regardless of their body mass, have a diminished FELi and FEUA. Obese adolescents also have higher plasma levels of aldosterone than lean ones. In conclusion, the family history of hypertension would be related to the increased renal proximal sodium reabsorption whereas obesity would be related to increased distal sodium reabsorption mechanisms, such as aldosterone. Both mechanisms could explain the higher prevalence of hypertension in obese offspring of hypertensive parents. Am J Hypertens 1999;12:260 -263

Relationship among Systolic Blood Pressure, Serum Insulin and Leptin, and Visceral Fat Accumulation in Obese Children

“…These findings are consistent with previous reports of a linkage between hypertension and obesity in children and adults (5,25,28). For the primary prevention of hypertension, a strategy to checkup on obese children with hyperinsulinemia, that is visceral fat accumulation, is required.…”

“…SNS hyperactivity via hyperleptinemia probably affected SBP elevation in OF subjects rather than in ON subjects. Previous studies have demonstrated that hyperinsulinemia, hyperleptinemia, SNS hyperactivity and hyperactivity of the renin-angiotensin system caused renal and hemodynamic alterations associated with renal sodium retention, and consequential hypertension (5,26,28). In the present study, this linkage may have affected children in the OF rather than those in the ON group.…”

Obesity-related hypertension: Role of the sympathetic nervous system, insulin, and leptin

“…Given the important effects of gender on leptin levels, the genetic contribution to leptin may differ between men and women [28,49,50]. Several studies have noted abnormal glucose and insulin metabolism in normotensive offspring of families with hypertension [28,[50][51][52][53]. In those studies, a positive family history of hypertension also predicted other risk factors, such as higher levels of plasma norepinephrine [29], body weight [54], insulin [53], and abnormal lipid metabolism.…”

An epidemiological study on prevalence of hypertension and its risk factors among school boys of Burdwan municipal area

“…This observation agreed with the finding of Simsolo et al and Muratova et al that overweight positively related with hypertension. 20, 21 Sundar et al found, an overwhelming evidence in his study that the prevalence of hypertension was high among obese individuals (p=0.000), which was highly significant. Similar observation was seen by Buch et al 8,15 The prevalence of hypertension was much higher among those students (8%) with positive family history, compared to 5.2%, where family history of hypertension was absent, which was statistically significant (p<0.05).…”