[Own and parental predictors of arterial prehypertension and hypertension in children of persons with premature coronary heart disease].

OBJECTIVE

to elucidate own and parental predictors of arterial prehypertension (PreHT) and hypertension (HT) in children of patients with premature manifested before 55 years in men or before 60 years in women) coronary heart disease (CHD).

METHODS

We surveyed 276 families: 258 probands parents with premature CHD, their 214 spouses and 362 native probands children aged 5-37 years. In persons aged 17 years we used criteria of 4 th Report National Education Program Working Group on High BP in Children and Adolescents, in persons 18 years - 7 th Report Joint National Committee (USA). Predictors were selected by logistical regression with adjustment for sex and age.

RESULTS

PreHT/HT was revealed in 26/143 (18.2%) children aged 5-17 years. Their own (body mass index [BMI], waist circumference, glucose) and parental (diastolic BP of proband) predictors related to the presence of PreHT/HT with <0.1 in univariate analysis were included in stepwise regression procedure. PreHT/HT was independently associated only with higher own BMI: odds ratio (OR) of top vs bottom tertile 10.2 (95% confidence interval [CI] 1.99-52.8; p=0.005). PreHT and HT were found in 75/219 (34.2%) and 40/219 (18.3%) children aged 18-37 years, respectively. Their own (BMI, waist circumference, glucose, triglycerides and total cholesterol) and parental (waist circumference, BMI, diabetes mellitus, PreHT/HT and triglycerides of proband; education level, alcohol consumption and oral hormonal contraceptive drugs use of spouse) predictors selected in univariate analysis with <0.1, were included in stepwise regression procedure. HT was independently associated with higher BMI (OR top vs bottom tertile 19.9 [95% CI 4.34-90.8]; <0.0001) and glucose (OR top vs bottom tertile 7.85 [95% CI 2.73-22.6]; <0.0001) of children, and PreHT/HT of probands (OR 2.80 [95% CI 1.13-6.94]; =0.026).

CONCLUSIONS

PreHT and HT (age group 5-17 years) and HT (age group 18-37 years) in children of persons with premature CHD were independently related to own "metabolic" risk factors (BMI in both age groups and basal glucose in adult children). Association of preHT/HT of proband with HT in their children became manifested later in childrens life (18-37 years).