BACKGROUND:

This study was funded in response to a Request for Application issued in 1975 on High Blood Pressure in the Young. The program on High Blood Pressure in the Young grew out of an awareness that adult hypertension might have its origins in adolescence or even in childhood or infancy. In 1975 NHLBI was supporting little research, except for the Specialized Centers of Research, in identifying the precursors of high blood pressure operating at an early age. Sixteen grants were funded through the program. The program was concluded in 1978 but Dr. Kotchen's grant was renewed as a regular research grant. A second population group was followed in the grant period. From an original population of 409 pregnant, nulliparous adolescents aged 12-18 who had enrolled in the University of Kentucky Young Mothers Program between 1971-1974, 70 were diagnosed as having hypertension during the third trimester of pregnancy. These 70 women plus a control group of 54 normotensive women from the same population were studied as were their children.

Blood pressures were measured in young mothers at 3-6 years and at 6-9 years after their first pregnancy. Women with a history of hypertension during pregnancy were heavier, maintained higher blood pressure and had a greater incidence of hypertension in subsequent pregnancies. At the second follow-up, systolic blood pressure and body weight of male children born to hypertensive women were greater than those in males born to normotensive women. Blood pressures of female children of the two groups of mothers did not differ.

DESIGN NARRATIVE:

In 1973 standardized blood pressure, height, and weight were measured in all 14-19 year old students of Bourbon County High School in Kentucky.

Additional information collected included age, date of birth, sex, and race. In 1978 a five year follow-up study was undertaken of all adolescents 14-15 years old at the time of the initial survey and of selected 16-19 year olds who were in the high, intermediate, and low ranges of the blood pressure distributions. Follow-up measurements included weight, height, and blood pressure in all subjects, and sodium excretion, serum cholesterol, glucose, triglycerides, exercise, and uric acid concentrations, electrocardiograms, and echocardiograms in the older group. In 1984 the follow-up also included information on socioeconomic variables, medical and family histories, smoking, exercise, life events, coronary-prone behavior, and anxiety.

Plasma renin activity and plasma aldosterone were measured before and after treadmill exercise in those young adults with relatively high and relatively low blood pressures to determine if the renin-aldosterone axis is suppressed before the appearance of hypertension. Studies were continued on physiologic, psychosocial, and behavioral risk factors for hypertension, age-related trends in cardiovascular risk factors over time, correlates of elevated blood pressure, and the early cardiac consequences of high blood pressure.