PARENTAL CARDIOMETABOLIC BURDEN AND EARLY VASCULAR RISK PHENOTYPE IN YOUNG ADULTS WITH PREHYPERTENSION

Abstract

Background: Prehypertension in young adults may represent an early stage of cardiovascular risk rather than a benign intermediate blood pressure category. Familial cardiometabolic predisposition, adiposity, cardiac workload, autonomic modulation, and vascular biomarkers may contribute to this early risk phenotype. The present study was designed to characterize the early vascular risk phenotype of young adults with prehypertension compared with age-matched normotensive controls, and to examine whether parental history of type 2 diabetes mellitus and hypertension is associated with prehypertensive status and selected cardiometabolic risk markers.

Methods: This age-matched case–control study included 113 young adults, comprising 66 prehypertensive subjects and 47 normotensive controls. Anthropometric indices, body composition, haemodynamic parameters, heart rate variability, endothelial/angiogenic and oxidative stress biomarkers, lipid profile, and parental history of type 2 diabetes mellitus and hypertension were assessed. Between-group comparisons were performed using appropriate parametric or non-parametric tests. Age- and sex-adjusted regression models were used to evaluate independent associations. Logistic regression was performed to assess the association of parental cardiometabolic history with prehypertension.

Results: Prehypertensive subjects had significantly higher BMI, waist circumference, waist–hip ratio, body fat percentage, visceral fat, heart rate, mean arterial pressure, and rate pressure product compared with normotensive controls. VEGF and resistin concentrations were also higher among prehypertensive subjects. VEGF remained significantly associated with prehypertension after adjustment for age, sex, and BMI. Heart rate variability and lipid parameters did not show robust group differences after correction for multiple testing. Any parental history of type 2 diabetes mellitus was associated with approximately four-fold higher odds of prehypertension after adjustment for age and sex. Parental cardiometabolic burden score was also independently associated with prehypertensive status, while parental hypertension showed a positive but borderline association.

Conclusion: Young adults with prehypertension demonstrate an adverse early cardiovascular risk phenotype characterized by increased adiposity, higher cardiac workload, elevated VEGF and resistin, and greater familial cardiometabolic burden. Parental type 2 diabetes mellitus and cumulative parental cardiometabolic burden may help identify young individuals at increased risk for early blood pressure dysregulation.