Casual, basal and supplemental blood pressures in 519 first-degree relatives of substantial hypertensive patients and in 350 population controls.

1. The casual blood pressure is the sum of the relatively stable basal pressure taken under defined conditions of rest and the labile supplemental pressure (casual minus basal), which represents the response to the current degree of physical, mental and probably metabolic stimulation. 2. The basal and supplemental blood pressures behave differently and it seems likely that different factors are involved in their pathogenesis. 3. The 5 and 8 years follow-up mortality is closely related to the basal pressure but not to the supplemental pressure. 4. The rise with age in the basal blood pressure is greater in the relatives of substantial hypertensive patients than in population control subjects. 5. Above the age group 30-39 years there is an increase in the rate of rise of the mean basal blood pressure with age among the first-degree relatives of hypertensive patients. In a population control group an acceleration in the rate of rise of the mean basal blood pressure with age also occurs but a decade or more later than in the relatives of hypertensive patients. 6. In males the mean supplemental pressures (systolic and diastolic) do not rise appreciably with age and the mean supplemental pressures of first-degree relatives and control subjects do not differ appreciably. 7. In females the mean supplemental pressures rise with age but, except after age 60 years, the pressure rise in first-degree relatives is only a little greater than in control subjects. 8. When hypertensive patients with similar casual blood pressures are compared the basal blood pressures are higher in patients with glomerulonephritis than in essential hypertensive patients. 9. In the first-degree relatives of substantial hypertensive patients high-ranking basal blood pressures occur much more frequently than in general population control subjects. 10. The close resemblance of the blood pressures in like twins indicates that genetic or familial factors have an important influence on blood pressure, and on the occurrence of frank hypertension.