Determinants of the Magnitude of Blood Pressure in Essential Hypertension.
- Author:
Jeong Bae PARK
1
;
Hyun Ho SHIN
Author Information
1. Department of Medicine, Samsung Cheil Hospital, Sung Kyun Kwan University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Genes;
environment;
hypertension
- MeSH:
Aldosterone;
Angiotensinogen;
Blood Pressure Monitoring, Ambulatory;
Blood Pressure*;
Body Mass Index;
Fasting;
Female;
Gene Frequency;
Humans;
Hypertension*;
Insulin;
Phenotype;
Plasma;
Renin;
Smoke;
Smoking;
Sodium
- From:Korean Journal of Medicine
1998;55(5):832-839
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The cause of blood pressure (BP) variation is difficult to identify because genes and environment interact to produce the BP phenotype. Different genetic background and culture in a population make different gene frequency and environment for hypertension. Therefore, we studied the determinants of BP with reference to genes, metabolic factors and environmental factors in Korean population. METHODS: A study was carried out in two hundred fifty- eight patients (mean age 49, females 74%) with newly detected hypertension. Twenty-four hour ambulatory blood pressure monitoring (Accutracter II, Suntecr) was performed as an index of the magnitude of BP. The contributory factors studied were angiotensin-converting enzyme (ACE), angiotensinogen (AGT ; T174M and M235T) gene as a genetic factor, alcohol and smoking habitus, exercise, sodium intake as an environmental factor, and body mass index (BMI), insulin, lipid, renin, and aldosterone as a intermediate phenotype. RESULTS: 1) Genetic factors : There were no significant associations between ACE and AGT polymorphisms and the magnitude of BP. 2) Environmental factors : Alcohol and weight were significantly correlated with daytime systolic BP (r=.13, p=.04 and r=.15, p=.02), diastolic BP (r=.17, p=.01 and r=.12, p=.05), and nighttime diastolic BP (r=.15, p=.02 and r=.11, p=.01). Sodium intake, as assessed by fasting spot urine Na/K ratio in the morning, was not related to the magnitude of BP. 3) Intermediate phenotype : Plasma aldosterone level was significantly correlated to daytime diastolic BP (r=.16, p=.03), nighttime systolic BP (r=.17, p=.03), and nighttime diastolic BP (r=.16, p=.04). In women, plasma aldosterone was reversely correlated to urine Na/K ratio (r=-.42, p=.001). CONCLUSIONS: The magnitude of blood pressure in essential hypertension seems to be mainly determined by weight, alcohol intake, and plasma aldosterone level.
