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6743457 
Journal Article 
Epidemiological study on the effect of pre-hypertension and family history of hypertension on cardiac autonomic function 
Wu, JS; Lu, FH; Yang, YC; Lin, TS; Chen, JJ; Wu, CH; Huang, YH; Chang, CJ 
2008 
Yes 
Journal of the American College of Cardiology
ISSN: 0735-1097
EISSN: 1558-3597 
51 
19 
1896-1901 
English 
OBJECTIVES: This study sought to examine the hypothesis that cardiac autonomic function (CAF) is altered in pre-hypertensive subjects and normotensive subjects with a family history of hypertension (FHH).

BACKGROUND: The findings on the FHH effect in CAF have been inconsistent, and little is known about altered CAF in pre-hypertensive subjects under The Seventh Report of the Joint National Commission on High Blood Pressure criteria of normotension and pre-hypertension.

METHODS: A total of 1,436 community dwellers were classified as having normotension without FHH (NT[-]), normotension with FHH (NT[+]), pre-hypertension, and hypertension. Cardiac autonomic function was determined by standard deviation of RR intervals (SDNN), power spectrum in low frequencies (LF) and high frequencies (HF) and LF/HF ratio in supine position for 5 min, the ratio between the longest RR interval at approximately the 30th beat and the shortest RR interval at approximately the 15th beat after standing (30 max/15 min ratio), and the ratio between the longest RR interval during expiration and the shortest RR interval during inspiration (E/I ratio).

RESULTS: There was a significant difference in all CAF indexes among subjects with NT(-), NT(+), pre-hypertension, and hypertension. Multivariate analyses with an analysis of covariance model showed that 30 max/15 min ratio, E/I ratio, and HF power decreased in subjects with NT(+), pre-hypertension, and hypertension when compared with NT(-) subjects. Pre-hypertensive and hypertensive subjects displayed higher square roots of LF/HF ratios. Only pre-hypertensive subjects had higher LF power.

CONCLUSIONS: Our study provides evidence that CAF plays a role in pre-hypertension and that altered autonomic function is already present in subjects with FHH. An autonomic imbalance shifting with augmented sympathetic tone was more enhanced in pre-hypertension.