ABC | Volume 115, Nº1, July 2020

Original Article Vargas & Rigatto Parents’ BP and young men autonomic impairment Arq Bras Cardiol. 2020; 115(1):52-58 There is also consistent evidence showing that enhanced parasympathetic modulation is associated with an increase in VO2max in healthy young subjects. 10 However, in the present study we have found no differences in VO 2max , BP and EF between all groups. This is probably due to the fact that, being composed of young athletes who had similar diets and nutrients intake, our groups had a high physical performance, which attenuated the differences. Although we have found a significant difference in cardiac autonomic modulation between the FM-H and FM-N groups, we have not found significant differences in VO 2max and EF which, ultimately, kept BP in normal values despite the family history of hypertension. In agreement with Lucini et al., 9 our results demonstrated that the autonomic changes possibly precede endothelial dysfunction. They showed that, in subjects with BP in the upper normotensive range, the HRV was impaired. These authors also reported that these changes might suggest that the disturbance in the autonomic regulation precedes the hypertensive state,9 as seen in neurogenic hypertension. A point of criticism to our method is the fact that we did not separate the groups according to the parents’ type of hypertension. On the other hand, we know that the probability to have only parents with neurogenic hypertension in the FM-H group is very low. Thus, it is reasonable to believe that, regardless of the cause of hypertension, the EF was preserved. According to our results, strengthened by previous studies that also looked for answers concerning the beginning of the arterial hypertensive process, 9,12,17 it appears that the autonomic dysfunction precedes the endothelial dysfunction. Thus, it is a challenge to discover a treatment for sympathovagal imbalance and reduce cardiovascular risk. Conclusion Although our study has the limitation of a small sample size, it suggests that HRV, in the time and frequency domains, may provide a useful functional outcome to assess the cardiovascular system control earlier. This advantage is useful for healthy young people, as young soccer players, and is probably more important for sedentary people at risk. Doing exercise, more than treating borderline hypertension, represents an alternative to prevent the increase in BP through strategies that treat the mechanisms by which normal BP, eventually, becomes hypertension. However, further studies are needed to confirm these conclusions. Author contributions Conception and design of the research, Analysis and interpretation of the data, Statistical analysis, Obtaining financing, Writing of the manuscript and Critical revision of the manuscript for intellectual content: Vargas W, Rigatto K; Acquisition of data: Rigatto K. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding There were no external funding sources for this study. Study Association This article is part of the thesis of Doctoral submitted by Walter Oliveira de Vargas, from Universidade Federal de Ciências da Saúde de Porto Alegre. 1. World Health Organization. Joint WHO/FAO Expert Consultation on Diet, Nutrition and the Prevention of Chronic. Geneva; 2002. (WHO Technical Report Series; 916). 2. Cardoso CR, Leite NC, Muxfeldt ES, Salles GF. Thresholds of ambulatory blood pressure associated with chronic complications in type 2 diabetes. Am J Hypertens. 2012;25(1):82-8. 3. ManciaG,FagardR,NarkiewiczK,Redón J,ZanchettiA,BöhmM,etal.2013 ESH/ESCGuidelines for themanagement of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). 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