Abstract
It has been suggested that a hyperkinetic circulatory state, with high cardiac output, causes high blood pressure in childhood and, secondarily, in adulthood. We studied blood pressure and cardiac output in 319 subjects aged 15 to 19. Blood pressure was measured with an automated device; cardiac output was estimated by M-mode echocardiography and indexed by body surface area. The distribution of cardiac output was stratified using quartiles. Mean arterial pressure was virtually constant over these strata, with boys and girls showing essentially the same pattern. Linear regression of mean arterial pressure on cardiac output yielded a coefficient which was not significantly different from zero. A history of high blood pressure in the parents was positively associated with mean arterial pressure, but unrelated to cardiac output, in the offspring. This evidence does not support the hypothesis that the hyperkinetic circulatory state causes high blood pressure in childhood; rather, raised blood pressure in adolescents appears to relate to increased peripheral vascular resistance. Therefore, our findings lend support to the view that change in blood pressure over time is caused by a gradual increase in peripheral resistance beginning early in life.
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- Brown J. J., Lever A. F., Robertson J. I. Pathogenesis of essential hypertension. Lancet. 1976 Jun 5;1(7971):1217–1219. doi: 10.1016/s0140-6736(76)92164-4. [DOI] [PubMed] [Google Scholar]
- Ellison R. C., Sosenko J. M., Harper G. P., Gibbons L., Pratter F. E., Miettinen O. S. Obesity, sodium intake, and blood pressure in adolescents. Hypertension. 1980 Jul-Aug;2(4 Pt 2):78–82. [PubMed] [Google Scholar]
- Feigenbaum H. Echocardiographic examination of the left ventricle. Circulation. 1975 Jan;51(1):1–7. doi: 10.1161/01.cir.51.1.1. [DOI] [PubMed] [Google Scholar]
- Folkow B. The haemodynamic consequences of adaptive structural changes of the resistance vessels in hypertension. Clin Sci. 1971 Jul;41(1):1–12. doi: 10.1042/cs0410001. [DOI] [PubMed] [Google Scholar]
- Frohlich E. D., Tarazi R. C., Dustan H. P. Re-examination of the hemodynamics of hypertension. Am J Med Sci. 1969 Jan;257(1):9–23. doi: 10.1097/00000441-196901000-00002. [DOI] [PubMed] [Google Scholar]
- GORLIN R. The hyperkinetic heart syndrome. JAMA. 1962 Nov 24;182:823–829. doi: 10.1001/jama.1962.03050470001001. [DOI] [PubMed] [Google Scholar]
- Goldring D., Hernandez A., Choi S., Lee J. Y., Londe S., Lindgren F. T., Burton R. M. Blood pressure in a high school population. II. Clinical profile of the juvenile hypertensive. J Pediatr. 1979 Aug;95(2):298–304. doi: 10.1016/s0022-3476(79)80678-2. [DOI] [PubMed] [Google Scholar]
- Hofman A., Roelandt J. T., Boomsma F., Schalekamp M. A., Valkenburg H. A. Haemodynamics, plasma noradrenaline and plasma renin in hypertensive and normotensive teenagers. Clin Sci (Lond) 1981 Aug;61(2):169–174. doi: 10.1042/cs0610169. [DOI] [PubMed] [Google Scholar]
- Linhart J. W., Mintz G. S., Segal B. L., Kawai N., Kotler M. N. Left ventricular volume measurement by echocardiography: fact or fiction? Am J Cardiol. 1975 Jul;36(1):114–118. doi: 10.1016/0002-9149(75)90877-2. [DOI] [PubMed] [Google Scholar]
- Silverman N. H., Ports T. A., Snider A. R., Schiller N. B., Carlsson E., Heilbron D. C. Determination of left ventricular volume in children: echocardiographic and angiographic comparisons. Circulation. 1980 Sep;62(3):548–557. doi: 10.1161/01.cir.62.3.548. [DOI] [PubMed] [Google Scholar]
- Szklo M. Epidemiologic patterns of blood pressure in children. Epidemiol Rev. 1979;1:143–169. doi: 10.1093/oxfordjournals.epirev.a036207. [DOI] [PubMed] [Google Scholar]
- Teichholz L. E., Kreulen T., Herman M. V., Gorlin R. Problems in echocardiographic volume determinations: echocardiographic-angiographic correlations in the presence of absence of asynergy. Am J Cardiol. 1976 Jan;37(1):7–11. doi: 10.1016/0002-9149(76)90491-4. [DOI] [PubMed] [Google Scholar]
- WIDIMSKY J., FEJFAROVA M. H., FEJFAR Z. Changes of cardiac output in hypertensive disease. Cardiologia. 1957;31(5):381–389. doi: 10.1159/000165747. [DOI] [PubMed] [Google Scholar]
- Zinner S. H., Levy P. S., Kass E. H. Familial aggregation of blood pressure in childhood. N Engl J Med. 1971 Feb 25;284(8):401–404. doi: 10.1056/NEJM197102252840801. [DOI] [PubMed] [Google Scholar]