Aims: 

To evaluate putative alterations in the autonomic regulation of the cardiovascular system in normotensive young adults with family history for hypertension (H+) and/or obesity (Ob+) as compared to age matched controls without family history (C).

Methods: 

Heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity (BRS) were used as markers of the autonomic status. Our protocol consisted of a 5-minute orthostatic test as a sympathetic challenge with a concomitant continuous electrocardiogram recording. HRV indices in the frequency domain were assessed by means of our iCardio software using simultaneously fast Fourier and Wavelet transform. In addition we performed 5-minute non-invasive recording of blood pressure using the Finapress device and we evaluated the parameters of BPV. BRS was measured based on the 4^th phase of Valsalva maneuver.

Results: 

Both (H+) and (OB+) showed elevated HRV in the low frequency range as well as higher indices of autonomic balance as compared to the (C) individuals at rest. Those differences were more pronounced during orthostatic testing. They were supported by an increased BPV as well as by a decreased BRS in the subjects with family history for hypertension and obesity. The evaluated HRV alterations persisted during the follow up performed 1 year later.

Conclusion: 

Our data evidence the existence of sympathetic predominance in young normotensive adults with family history for hypertension and/or obesity. The unequivocal changes in HRV, BPV and BRS prove that this battery of non-invasive methods is a reliable option for screening and could be used in primary prevention.