Hypertension Clinical Trial
Official title:
Genetics of Cardiovascular Reactivity in Black Youth
To evaluate individual differences in cardiovascular responses to acute stress in Black adolescents.
BACKGROUND:
The prevalence and severity of essential hypertension (EH) are greater among Black Americans
than other ethnic groups in the U.S. Blacks are at increased risk for target organ damage
from elevated blood pressure, including heart disease, stroke, and endstage renal failure.
There are significant ethnic differences in cardiovascular reactivity (CVR) to stress, which
is a risk factor for elevated blood pressure. Studies have shown that CVR to stress is
stable over time, heritable, and predictive of future elevations in blood pressure and the
development of essential hypertension. These properties make measures of CVR a valuable
intermediate for genetic studies of hypertensive risk.
DESIGN NARRATIVE:
The genetic epidemiology study will test the hypothesis that individual differences in CVR
to acute stress in Black youth are associated with well defined polymorphisms in candidate
genes related to blood pressure including: 1) alpha- and beta-adrenergic receptor genes; 2)
genes involved in catecholamine metabolism; 3) genes involved in endocrine function; 4)
genes involved in the renin angiotensin system. By focusing on normotensive youth at risk
for developing essential hypertension, the investigators hope to identify genes associated
with the onset, rather than the sequelae, of hypertension. Moreover, given that CVR to acute
stress is defined as a change in cardiovascular function evoked by an environmental
manipulation of stress, the research is inherently a study of gene-environment interactions.
A total of 500 unrelated Black adolescents and young adults (equal numbers of males and
females), 15-21 years of age will be studied. Buccal cell samples will be collected for DNA
extraction from all subjects for genetic association analyses. Impedance cardiography and
blood pressure monitoring will be used to assess components of CVR to stress during video
game, mental arithmetic, cold pressor, and whole body cold exposure tasks, all of which have
been utilized or developed in the laboratory. Various methods will be used to evaluate
genetic associations with CVR to acute stress, including analyses of single nucleotide
polymorphisms and haplotypes. Supplementary analyses will evaluate potential gene-gene
interactions and additional gene-environment interactions involving chronic environmental
stress.
;
Observational Model: Cohort, Time Perspective: Cross-Sectional
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