Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov;72(5):1103-1108.
doi: 10.1161/HYPERTENSIONAHA.118.11925.

Elevated Blood Pressure in Adolescence Is Attributable to a Combination of Elevated Cardiac Output and Total Peripheral Resistance

Chloe Park  1 , Abigail Fraser  2   3 , Laura D Howe  2   3 , Siana Jones  1 , George Davey Smith  2   3 , Debbie A Lawlor  2   3 , Nish Chaturvedi  1   4 , Alun D Hughes  1   4
Affiliations

Elevated Blood Pressure in Adolescence Is Attributable to a Combination of Elevated Cardiac Output and Total Peripheral Resistance

Chloe Park et al. Hypertension. 2018 Nov.

Abstract

Unlike in older people, it has been suggested that elevated blood pressure (BP) in young people is because of high cardiac output accompanied by normal total peripheral resistance (TPR)-a hyperkinetic/hyperdynamic circulation. We investigated this in a large, United Kingdom-based birth cohort of adolescents. The study was conducted on 2091 17-year-old participants in the ALSPAC (Avon Longitudinal Study of Parents and Children)-a prospective population-based birth cohort study. BP measurement and echocardiography were performed, and heart rate (HR), stroke volume (SV), and TPR were calculated. Data are means (SD). Higher quintiles of systolic BP were associated with higher SV, higher HR, and higher TPR. The proportional contribution made by SV, HR, and TPR to mean arterial pressure differed little by systolic BP quintile (SV [32%-34%], HR [25%-29%], and TPR [39%-41%]). Higher BP is attributable to a combination of higher cardiac output (ie, SV×HR) and higher TPR in a population-based sample of adolescents. There is no evidence of a disproportionate contribution from elevated cardiac output at higher BP levels.

Keywords: blood pressure; cardiac output; heart rate; stroke volume; vascular resistance.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Box and whisker plots of (A) stroke volume (white), (B) heart rate, (red) and (C) total peripheral resistance (TPR; green) by quintiles of mean blood pressure.
Figure 2.
Figure 2.
Proportionate contribution of stroke volume (white), heart rate (red), and total peripheral resistance (green) to mean arterial pressure in each quintile of systolic blood pressure.
See this image and copyright information in PMC

Comment in

References

    1. Lawes CM, Hoorn SV, Law MR, Elliott P, MacMahon S, Rodgers A. Blood pressure and the global burden of disease 2000. Part II: estimates of attributable burden. J Hypertens. 2006;24:423–430. 10.1097/01.hjh.0000209973.67746.f0. - PubMed
    1. Rosner B, Hennekens CH, Kass EH, Miall WE. Age-specific correlation analysis of longitudinal blood pressure data. Am J Epidemiol. 1977;106:306–313. - PubMed
    1. Lawlor DA, Smith GD. Early life determinants of adult blood pressure. Curr Opin Nephrol Hypertens. 2005;14:259–264. - PubMed
    1. McCarron P, Smith GD, Okasha M, McEwen J. Blood pressure in young adulthood and mortality from cardiovascular disease. Lancet. 2000;355:1430–1431. doi: 10.1016/S0140-6736(00)02146-2. - PubMed
    1. Leiba A, Twig G, Vivante A, Skorecki K, Golan E, Derazne E, Tzur D, Grossman E, Dichtiar R, Kark JD, Shohat T. Prehypertension among 2.19 million adolescents and future risk for end-stage renal disease. J Hypertens. 2017;35:1290–1296. doi: 10.1097/HJH.0000000000001295. - PubMed

Publication types