A critical interpretation of juvenile borderline hypertension

The search for the genetic configuration of essential hypertension and the link with intermediate phenotypes ranks high on the current research agenda. Juvenile borderline hypertension is supposed to contain essential clues to the identification of these phenotypes. According to a large number of investigations, this condition is characterized by a labile type of hypertension and an elevation of the cardiac index, plasma catecholamines and/or renin activity. The 'prehypertensive' offspring from hypertensive parents may be included in these observations. The psychometric profile of the hypertensive patient also enters the equation. It seems likely that external conditions affect the manifestation of borderline hypertension. In particular, the stigma of the term hypertension appears to be carried over into the clinical findings, presenting as components of the pathophysiological and psychological profile. This calls for a reinterpretation of the patterns observed in early human hypertension.