Increased central body fat deposition precedes a significant rise in resting blood pressure in male offspring of essential hypertensive parents: a 5 year follow-up study

Objectives As long as offspring of essential hypertensive parents (O-Hyp) a re lean, their blood pressure usually remains within normal limits. The mec hanism(s) transforming this 'genetically dysregulated normotension' into hy pertension are unclear. We hypothesized that O-Hyp are not only genetically prone to develop hypertension, but may also have a particular propensity t o accumulate central body fat. Design A 5-year follow-up cohort study. Setting University Hospital in Switzerland. Participants Seventeen young (2 5 +/- 1 years, mean +/- SD), lean healthy normotensive male O-Hyp and 17 ag e- and sex-matched offspring of normotensive parents (O-Norm) paired for ba seline blood pressure with the O-Hyp. Main outcome measures Resting and exercise blood pressure, body weight body mass index (BMI) and waist-to-hip ratio were assessed at baseline and afte r 5 years. Results At baseline, body weight BMI, waist-to-hip ratio and blood pressure did not differ significantly between O-Hyp and O-Norm. At follow-up, body weight was increased in both groups (from 73.9 +/- 6.0 to 77.7 +/- 8.1 kg i n O-Hyp, P = 0.008, and from 71.5 +/- 6.9 to 73.5 +/- 6.6 kg in O-Norm, P = 0.03). BMI followed a similar pattern. In contrast, waist-to-hip ratio inc reased in O-Hyp (from 0.84 +/- 0.03 to 0.87 +/- 0.03, P = 0.012), but not i n O-Norm (from 0.84 +/- 0.03 to 0.84 +/- 0.04, P = 0.79) and was therefore higher in O-Hyp at follow-up (P = 0.011, O-Hyp versus O-Norm). Peak systoli c blood pressure during dynamic exercise also rose at 5 years in the O-Hyp (from 182 +/- 10 to 214 +/- 17 mmHg, P = 0.0001) while resting systolic blo od pressure only tended to do so (from 121 +/- 7 to 128 +/- 12 mmHg, P = 0. 07). In O-Norm, resting and peak dynamic exercise systolic blood pressure r emained unchanged (119 +/- 11 versus 121 +/- 9 mmHg, baseline versus follow -up, P = 0.40, and 186 +/- 12 versus 196 +/- 22 mmHg, P = 0.10, respectivel y). Thus, systolic peak exercise blood pressure was significantly (P = 0.01 4) elevated at follow-up in O-Hyp compared to O-Norm, while resting systoli c blood pressure only tended (P = 0.06) to do so. Conclusions Initially lean normotensive O-Hyp have a disparate long-term co urse of central body fat as compared to O-Norm. Thus, O-Hyp are not only ge netically prone to develop hypertension, but they also have a particular pr opensity to accumulate central body fat even before a distinct rise in rest ing blood pressure occurs. The exaggerated blood pressure response to exerc ise observed at follow-up in the O-Hyp represents another marker that confe rs them a greater risk of developing future hypertension. J Hypertens 19:21 43-2148 (C) 2001 Lippincott Williams & Wilkins.