[Cardiovascular reactivity in young people]

Experimental and clinical evidence has emerged which supports the presence of a stress mediated neurogenic component in the development of essential hypertension (EH). To investigate the relationship of genetic risk for EH and the cardiovascular response to centrally mediated stress in the young, we have studied adolescent offspring of hypertensive and normotensive parents. Compared to the normotensive family history negative controls, those adolescents with mildly elevated blood pressure and at least one parent with RH respond to the central stressor of forced mental arithmetic with a greater and more prolonged elevation in blood pressure (p less than 0.01) and heart rate (p less than 0.1). Those adolescents who were normotensive but also had a parent with EH also had a greater response in the cardiovascular parameters (p less than 0.1) than the family history negative controls. However, this group was mixed with high responders and low responders. Preliminary studies on the effect of sodium on the stress response indicated that salt loading augmented the stress response in family history positive subjects, while no effect was observed in the history negative adolescents. Our studies indicate the presence of an identifiable neurogenic component in early EH. Furthermore, a high sodium intake appears to alter the vascular sensitivity to neurogenic stimuli.