Cardiovascular response to physical stress in offspring of hypertensive parents: Dutch hypertension and offspring study

Blood pressure (BP) regulatory mechanisms were studied in youngsters with contrasting risks for hypertension, based on parental history, during physical stress. As a static exercise, an isometric handgrip task (22% of maximal force during 5 min) was used and a dynamic exercise task was performed on a bicycle ergometer. At rest and during stress, BP and heart rate were recorded. In order to study the adaptation of the cardiovascular system to physical stress, cardiac output and total peripheral resistance were measured in addition to indices of vagal and sympathetic influences on the heart. Heart rate and cardiac output declined significantly more in offspring of hypertensive parents during static exercise (diffecence in heart rate: -2.5 ± 1.2 bpm, P = 0.004; difference in cardic output: -9.0 ± 4.6%, P = 0.05). This is most likely the result of a larger increase in the total peripheral resistance in youngsters at risk (difference: 13.2 ± 6.8%, P = 0.06). No differences between the two groups were found in reactivity of BP or in the indices of sympathetic activation or vagal inhibition of the heart. The offspring of hypertensive parents showed an attenuated increase in stroke volume during the dynamic exercise task (difference at the first cycling level: -11.5 ± 5.4%, P= 0.04), while no difference in neural activity or heart rate was found. Youngsters with a parental history of hypertension show an enhanced reactivity of total peripheral resistance during static exercise. This does not lead to a higher BP response in this group, most probably because of a larger decrease of the cardiac output. During dynamic exercise the physiological increase in stroke volume is blunted in offspring of hypertensive parents.