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Hypertension. 2002 Apr;39(4):844-7.

Impaired stress-induced pressure natriuresis is related to left ventricle structure in blacks.

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Georgia Prevention Institute in the Department of Pediatrics, Medical College of Georgia, Augusta 30912-4534, USA.


The mechanisms through which stress may contribute to the racial difference in the prevalence of essential hypertension and associated target organ damage remain unclear. This study examined differences in stress-induced pressure natriuresis in 69 black and 52 white normotensives age 14 to 27 years, all with a positive family history of hypertension. Urine samples for sodium excretion were collected before and after a series of tasks (video game challenge, forehead cold stimulation). The average blood pressure across the 2 tasks and the average increase in blood pressure to the 2 tasks were calculated. Blacks had higher mean systolic (131+/-12 versus 126+/-12 mm Hg, P<0.02) and diastolic (77+/-8 versus 72+/-9 mm Hg, P<0.001) blood pressure and a greater average change in systolic blood pressure (15+/-9 versus 11+/-7 mm Hg, P<0.04). This was associated with a smaller change in sodium excretion (2+/-6 versus 7+/-10 mEq/h, P<0.002). The change in sodium excretion was related to the change in systolic (r=0.31, P<0.03) and diastolic (r=0.27, P<0.05) blood pressure in whites but not in blacks. Relative wall thickness was greater in blacks (0.31+/-0.04 versus 0.29+/-0.03, P<0.002). In conclusion, impaired stress-induced pressure natriuresis in blacks may contribute to racial differences in essential hypertension and its sequelae.

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