Journal of Clinical and Diagnostic Research. 2017 Nov, Vol-11(11): CC05-CC08 5 5 DOI: 10.7860/JCDR/2017/31792.10867 Original Article Physiology Section Hypertension in Asymptomatic, Young Medical Students with Parental History of Hypertension INTRODUCTION Hypertension was one of the three most important risk factors for global disease burden in 2010 [1]. In India, about 1/3 rd of the urban population and 1/4 th of the rural population are hypertensive and most of them are unaware of their hypertension [2]. Reports state that 57% of all stroke deaths and 24% of all coronary heart disease related death in India are directly related to hypertension [3]. Although, hypertension is more prevalent in older populations, young adults (including the active young athletes) are not free from the disease [4]. Special attention must be given to the young adult hypertension as in most of the cases, it remains undiagnosed and needs early treatment [5]. Epidemiological data from India reported that approximately 12.7% hypertensive population [6] with varying prevalence of hypertension with vascular disease occurred below 40 years of age [7]. Presence of family history of hypertension in medical students is an important non-modifiable risk factor for hypertension in future since about 30% of the Blood Pressure (BP) variance can be attributed to genetic factors [8-11], and was found to vary from 25% in pedigree studies to 65% in twin studies. Hence, screening young adults with parental history of hypertension can lead to early detection of hypertension and treatment before possible end-organ damage. In our study, we aim to determine the prevalence of sustained hypertension in young asymptomatic adults with parental history of hypertension. MATERIALS AND METHODS This cross-sectional study was carried out in the Department of Physiology, Himalayan Institute of Medical Sciences (HIMS), Dehradun, from 21 st July 2016 to 21 st September 2016. The study was approved by the Institutional Ethical Committee. A total of 104 healthy asymptomatic, medical students between 18- 22 years of age (42 males and 62 females), who had a family history (mother and/or father) of HTN were chosen as cases (Group A). Another 100 healthy, asymptomatic age-matched medical students (39 males and 61 females), without a family history of hypertension were taken as controls (Group B). Exclusion criteria for both groups were: a) students with a history of known medical or surgical disorders, b) history of corticosteroid usage in the past year, c) history of antidepressant medication usage. A preformed questionnaire was given to the subject before inclusion into the study. The preformed questionnaire included medical history of his/her parents mainly focusing on hypertension and cardiovascular disease (CVD) events. The subjects were enrolled after obtaining an informed written consent. Height (HT) and body weight (BW) were measured for all subjects. BMI was calculated as BW in kg divided by square root of HT in meter. Blood pressure and heart rate (HR) were measured once a day using an electronic sphygmomanometer (LotFancy FDA Approved Digital Upper Arm Blood Pressure Monitor and Heart Rate Monitor: Medium and Large Cuffs). Blood pressure was measured in the sitting position, after a minimum five minutes of rest. The readings were taken from both right and left arms of the subject. The higher BP reading was taken as the reference. First reading (Day 0): One reading was taken at baseline and another reading was taken after one minute. An average of the two BP readings was calculated and recorded to represent the patient’s blood pressure (SBP-1 and DBP-1) on day 0. Similarly, an average of two readings of heart rate was also taken (HR-1). Second reading (15 th day): After 15 days, the same procedure was followed to record the blood pressure (SBP-2 and DBP-2) and heart rate (HR-2) from the same subject. All other precautions for BP recording were taken according to the guidelines [12-14]. An overall average BP reading was then calculated as the arithmetic mean of day 0 BP and day 15 th BP readings. This value was used to classify the subject into normal or prehypertensive or hypertensive category, based on Joint National Committe (JNC) VII guidelines SIMRAN SIDHU 1 , ARUSHIE SADHWANI 2 , MALAVIKA MITTAL 3 , VEDDANT SHARMA 4 , HANJABAM BARUN SHARMA 5 , SOUMEN MANNA 6 Keywords: Future risk, Medical undergraduates, Raised resting blood pressure ABSTRACT Introduction: Family history of hypertension in medical students is an important, non-modifiable risk factor for Hypertension (HTN) in future. Aim: To determine the prevalence of sustained hypertension in young asymptomatic medical students with a parental history of hypertension. Materials and Methods: A cross-sectional study was conducted in a medical college of Dehradun. A total of 104 medical students with parental history of hypertension (Group A) and 100 medical students without a parental history of hypertension (Group B) were included. Electronically blood pressures were recorded on two separate occasions at an interval of 15 days. Comparison was done using Chi-square test/Likelihood ratio, Un-paired t-test and ANCOVA. Results: Overall, Group A had significantly higher percentage of prehypertensive (56.7%) and hypertensive (17.3%) students as compared to Group B which were 19% and 1%, respectively. Group A students had significantly higher Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) as compared to Group B, even after controlling for the differences in Body Mass Index (BMI) and gender (p<0.001). Conclusion: Hypertension was significantly higher in asymptomatic, healthy medical students with parental history of hypertension as compared to those with normotensive parents. We need to orient medical students to improve their knowledge, attitude and lifestyle practices early in life to prevent, treat hypertension and prevent its subsequent morbidity and mortality.