Autonomic nervous system and microvascular alterations in normotensives with a family history of hypertension.

Autonomic nervous system and microvascular alterations at pre-hypertensive stage of hypertension have still not been fully elucidated. We aimed at addressing central and local influences on microvascular reactivity at pre-hypertensive stage of hypertension. To that end, we studied microvascular reactivity in 59 normotensives with a family history of hypertension and 46 controls. We measured laser-Doppler flow on the finger nailfold skin in the resting condition, after an 8-min occlusion of digital arteries and during local nitroglycerin application. Finger pressure, pulse and ECG were monitored by a Finapres device. Heart rate power spectral analysis was performed using Fast Fourier transformation. Baroreflex sensitivity was estimated by the sequence method. Normotensives with a family history of hypertension showed higher systolic pressure, decreased high-frequency power of the heart rate variability spectrum and reduced baroreflex sensitivity in the resting condition as well as decreased fundamental frequency of laser-Doppler flow oscillations during nitroglycerin application. We conclude that normotensives with a family history of hypertension exhibit altered sympathovagal balance with decreased parasympathetic activity at the cardiac level as well as increased myogenic microvascular reactivity.