The Association Of Low Birth Weight And Physiological Risk Factors Of Hypertension In African American Adolescents

Low birth weight (LBW) has been associated with increased blood pressure and the development of cardiovascular disease including hypertension. Elevated blood pressure, cortisol, and hyperresponsiveness during physiologic stress may function as hypertension biological markers. We examined the association of blood pressure and cortisol levels during induced physiologic stress with LBW in an African American adolescent population (n = 106). METHODS AND RESULTS: Birth weight was obtained from parents. Blood pressure and cortisol levels were measured at rest and in response to an induced physiological stressor. Compared with normal birth weight group (n = 73), the LBW group (n = 33) demonstrated elevated (+4 mm Hg) diastolic pressure (P = .002) and cortisol hyperresponsiveness (P = .05). Seventy-nine percent of LBW adolescents had elevated blood pressure and/or cardiovascular reactivity (P = .04), and 39% had elevated blood pressures. CONCLUSIONS: Low birth weight African American adolescents demonstrated physiological risk factors for hypertension, and these findings add support to the association between LBW and the development of hypertension. © 2007 Lippincott Williams & Wilkins, Inc

Biologic Measures As Epidemiological Indicators Of Risk For The Development Of Hypertension In An African American Adolescent Population

Globally, the health disparity of hypertension is disproportionately greater within the African American population and develops at an earlier age. Elevated and continuous interaction of biologic measures during adolescence may be precursors and indicators of risk for blood pressure changes and the subsequent development of adult essential hypertension. The purpose of this study was to describe (1) the prevalence of biologic measures of risk of hypertension, specifically family history of hypertension, prehypertension, elevated salivary cortisol, and hyperresponsive cortisol and cardiovascular reactivity, and (2) the gender difference in the prevalence of biologic risk factors of hypertension. SUBJECTS AND METHOD: This was an exploratory descriptive design with a nonrandom purposive sample. Participants (N = 106) were high school, African American adolescents, aged 14 to 18 years. Data, including family history of hypertension, resting blood pressure, and blood pressure and cortisol levels before and after induced physiologic stress by cold water hand immersion, were measured. RESULTS: One hundred six African American participants (49 males and 57 females) completed the study. Data described that 71% had a positive family history of hypertension. Overall, the resting blood pressures were 120 mm Hg for systolic and 68 mm Hg for diastolic. Forty-one percent of the patients had prehypertensive blood pressures; 86% had elevated cortisol; 49% had hyperresponsive blood pressure reactivity; and 35% had cortisol hyperresponsivity. Excluding ethnicity, 65% had 3 or more biologic measures of risk of hypertension. Statistically significant gender differences included male systolic pressure and number of males with prehypertension. CONCLUSION: This study provides evidence of the high prevalence of multiple physiologic biologic measures of risk of hypertension factors within a vulnerable population. The continuous interaction of biologic measures over time may increase the susceptibility and risk of essential hypertension development and supports the development of appropriate physiologically based behavioral interventions. Copyright © 2012 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited

Influence of gender and race on hemodynamic response to dobutamine during dobutamine stress echocardiography

This study sought to determine the influence of gender and/or race on the hemodynamic response to dobutamine during dobutamine stress echocardiography. Blood pressure response patterns differed by gender and race, and completion of testing was often limited because of adverse events, namely, hypertension. Gender and racial differences in blood pressure response merit consideration as potential contributors to the suboptimal response in dobutamine stress testing. © 2004 by Excerpta Medica, Inc