SUSTAINED NIGHT-TIME BLOOD PRESSURE INCREASE IN SONS OF HYPERTENSIVE PARENTS UNDERGOING UNIVERSITY EXAMINATION

Objective: The study was performed to investigate the effect of an acute stressful stimuli occurring in daily life (examination at University level) on 24-hour blood pressure in subjects with and without parental history of hypertension. Methods. Normotensive students (n=18, age 22±2 years, 8 female) with negative (NFH, n=11) or positive family history for hypertension (PFH, n=7, at least one parent treated for hypertension) underwent three sessions of 24-hour ambulatory BP monitoring (ABPM) (SpaceLabs 90207), one month before (basal recording), 1 day before (pre-examination recording) and on the day of final course examination (examination recording) respectively. Results. Age and gender distribution, as well as body mass index (22±3, 22±2 in PHF and in NFH group respectively) were comparable in the two groups. During the baseline session ambulatory day- and night-time systolic and diastolic BP values and heart rate were non significantly different between groups (ns for all). The night before the examination both SBP and DBP were higher than baseline values whereas no changes were detectable during the awake period. In particular systolic and diastolic night-time BP were significantly higher in subjects with PFH than in subjects with NFH (p<0.005). As expected, during the day of the examination PFH subjects experienced an higher acute blood pressure increase during the hours of examination (p<0.002 vs NHF). At ambulatory monitoring day-time SBP was significantly increased in both groups (p<0.05) with no significant changes in DBP. After this acute response both SBP and DBP returned to values non significantly different from baseline values in subjects with NFH. Conversely both SBP and DBP remained at higher levels during all the following night in PFH when compared to both baseline values (p<0.001) and to values measured in NFH (p<0.01). Conclusion. Daily life mental stress is able to induce significant changes of circadian BP profile in young subjects with familiar history of HTN.