1
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Ananthamohan K, Brady TM, Arif M, Daniels S, Falkner B, Ferguson M, Flynn JT, Hanevold C, Hooper SR, Ingelfinger J, Lande M, Martin LJ, Meyers KE, Mitsnefes M, Rosner B, Samuels JA, Kuffel G, Zilliox MJ, Becker RC, Urbina EM, Sadayappan S. A Multi-Omics Approach to Defining Target Organ Injury in Youth with Primary Hypertension. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.17.599125. [PMID: 38948714 PMCID: PMC11212900 DOI: 10.1101/2024.06.17.599125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
BACKGROUND Primary hypertension in childhood tracks into adulthood and may be associated with increased cardiovascular risk. Studies conducted in children and adolescents provide an opportunity to explore the early cardiovascular target organ injury (CV-TOI) in a population free from many of the comorbid cardiovascular disease risk factors that confound studies in adults. METHODS Youths (n=132, mean age 15.8 years) were stratified by blood pressure (BP) as low, elevated, and high-BP and by left ventricular mass index (LVMI) as low- and high-LVMI. Systemic circulating RNA, miRNA, and methylation profiles in peripheral blood mononuclear cells and deep proteome profiles in serum were determined using high-throughput sequencing techniques. RESULTS VASH1 gene expression was elevated in youths with high-BP with and without high-LVMI. VASH1 expression levels positively correlated with systolic BP (r=0.3143, p=0.0034). The expression of hsa-miR-335-5p, one of the VASH1-predicted miRNAs, was downregulated in high-BP with high-LVMI youths and was inversely correlated with systolic BP (r=-0.1891, p=0.0489). GSE1 hypermethylation, circulating PROZ upregulation (log2FC=0.61, p=0.0049 and log2FC=0.62, p=0.0064), and SOD3 downregulation (log2FC=-0.70, p=0.0042 and log2FC=-0.64, p=0.010) were observed in youths with elevated BP and high-BP with high-LVMI. Comparing the transcriptomic and proteomic profiles revealed elevated HYAL1 levels in youths displaying high-BP and high-LVMI. CONCLUSIONS The findings are compatible with a novel blood pressure-associated mechanism that may occur through impaired angiogenesis and extracellular matrix degradation through dysregulation of Vasohibin-1 and Hyaluronidase1 was identified as a possible mediator of CV-TOI in youth with high-BP and suggests strategies for ameliorating TOI in adult-onset primary hypertension.
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Affiliation(s)
- Kalyani Ananthamohan
- Department of Internal Medicine, Division of Cardiovascular Health and Diseases, Center for Cardiovascular Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Tammy M. Brady
- Division of Pediatric Nephrology, Johns Hopkins University, Baltimore, MD
| | - Mohammed Arif
- Department of Internal Medicine, Division of Cardiovascular Health and Diseases, Center for Cardiovascular Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Stephen Daniels
- Department of Pediatrics, Denver Children’s Hospital, Aurora, CO
| | - Bonita Falkner
- Departments of Medicine and Pediatrics, Thomas Jefferson University, Philadelphia, PA
| | | | - Joseph T. Flynn
- Department of Pediatrics, University of Washington School of Medicine, Division of Nephrology, Seattle Children’s Hospital, Seattle, WA
| | - Coral Hanevold
- Department of Pediatrics, University of Washington School of Medicine, Division of Nephrology, Seattle Children’s Hospital, Seattle, WA
| | - Stephen R. Hooper
- School of Medicine, Department of Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Julie Ingelfinger
- Department of Pediatrics, Harvard Medical School, Mass General Hospital for Children at Massachusetts General Brigham, Boston, MA
| | - Marc Lande
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY
| | - Lisa J. Martin
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Kevin E. Meyers
- Division of Nephrology and Hypertension, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Mark Mitsnefes
- Division of Nephrology and Hypertension, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Bernard Rosner
- Channing Division of Network Medicine, Harvard University, Cambridge, MA
| | - Joshua A. Samuels
- Pediatric Nephrology & Hypertension, McGovern Medical School, University of Texas, Houston, TX
| | - Gina Kuffel
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL
| | - Michael J. Zilliox
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL
| | - Richard C. Becker
- Department of Internal Medicine, Division of Cardiovascular Health and Diseases, Center for Cardiovascular Research, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Elaine M. Urbina
- Division of Cardiology, Heart Institute, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Sakthivel Sadayappan
- Department of Internal Medicine, Division of Cardiovascular Health and Diseases, Center for Cardiovascular Research, University of Cincinnati College of Medicine, Cincinnati, OH
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2
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Koch VHK, Furusawa EA. Pediatric hypertension as an early manifestation of cardiovascular disease in children. J Bras Nefrol 2024; 46:e20230159. [PMID: 38700500 PMCID: PMC11197939 DOI: 10.1590/2175-8239-jbn-2023-0159en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/05/2024] [Indexed: 05/05/2024] Open
Abstract
In adults, cardiovascular events associated with arterial hypertension (AH) have a major impact on morbidity and mortality. In light of recent findings, AH in children has been interpreted as early cardiovascular disease (CVD), while exposure to CV risk factors in children proves to be a predictor of subclinical CVD in adults. The American College of Cardiology/American Heart Association has recently updated the classifications for measuring blood pressure (BP) in adults and children. Primary AH in children is generally asymptomatic, and it is associated with a family history of AH, overweight/obesity, and normal morphofunctional characteristics of the urinary system. The younger the child and the higher the BP, the greater the likelihood of secondary AH. The investigation into the etiology of AH begins with a detailed anamnesis, which should include clinical information and details on the use of medication, smoking, and alcohol consumption from the perinatal period to the time of consultation. Modifying risk factors by reducing weight, decreasing alcohol consumption and increasing vegetable intake from childhood to adulthood has been associated with the resolution of AH in the childhood-adulthood transition, and with the reversal of cardiometabolic adverse effects in non-obese adult individuals. Pharmacological therapy should be initiated in cases of symptomatic AH, AH secondary to chronic kidney disease or diabetes mellitus, presence of target organ lesions, stage 2 AH with no modifiable cause and resistant AH unresponsive to lifestyle changes.
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Affiliation(s)
- Vera Hermina Kalika Koch
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Pediatria, São Paulo, SP, Brazil
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3
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Goulding M, Ryan G, Frisard C, Stevens E, Person S, Goldberg R, Garg A, Lemon SC. Pediatric High Blood Pressure Follow-Up Guideline Adherence in a Massachusetts Health Care System. Acad Pediatr 2024; 24:506-513. [PMID: 37487799 PMCID: PMC10803632 DOI: 10.1016/j.acap.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/10/2023] [Accepted: 07/15/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVES To describe adherence to the American Academy of Pediatrics' (AAP) 2017 clinical practice guidelines for follow-up after high blood pressure (BP) screening by pediatric and family medicine providers in a Massachusetts health care system and to assess differences in receipt of follow-up according to child- and clinic-level factors. METHODS Electronic health record data were analyzed for children aged 3 to 17years who had an outpatient primary care visit during 2018 with a high BP screening (according to AAP guidelines). We classified AAP guideline adherent follow-up as BP follow-up within 6months after an elevated finding (+2-week buffer) and within 2weeks after a hypertensive finding (+2-week buffer). Differences in receipt of guideline adherent follow-up by child- and clinic-level factors were assessed via multilevel mixed effects logistic regression models. RESULTS The median age of the 4563 included children was 12years and 43% were female. Overall, guideline adherent follow-up was received by 17.7% of children within the recommended time interval; 27.4% for those whose index BP was elevated and 5.4% for those whose index BP was hypertensive. Modeling revealed older children and those belonging to clinics with more providers, smaller patient panels, and smaller proportion of Medicaid patients were more likely to receive adherent follow-up. CONCLUSIONS Few children received guideline adherent BP follow-up and most differences in adherence were related to clinic resources. System-level interventions are needed to improve BP follow-up.
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Affiliation(s)
- Melissa Goulding
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences (M Goulding, G Ryan, C Frisard, E Stevens, A Garg, and SC Lemon), University of Massachusetts Chan Medical School, Worcester, Mass.
| | - Grace Ryan
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences (M Goulding, G Ryan, C Frisard, E Stevens, A Garg, and SC Lemon), University of Massachusetts Chan Medical School, Worcester, Mass.
| | - Christine Frisard
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences (M Goulding, G Ryan, C Frisard, E Stevens, A Garg, and SC Lemon), University of Massachusetts Chan Medical School, Worcester, Mass.
| | - Elise Stevens
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences (M Goulding, G Ryan, C Frisard, E Stevens, A Garg, and SC Lemon), University of Massachusetts Chan Medical School, Worcester, Mass.
| | - Sharina Person
- Division of Biostatistics and Health Services Research, Department of Population and Quantitative Health Sciences (S Person), University of Massachusetts Chan Medical School, Worcester, Mass.
| | - Robert Goldberg
- Division of Epidemiology, Department of Population and Quantitative Health Sciences (R Goldberg), University of Massachusetts Chan Medical School, Worcester, Mass.
| | - Arvin Garg
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences (M Goulding, G Ryan, C Frisard, E Stevens, A Garg, and SC Lemon), University of Massachusetts Chan Medical School, Worcester, Mass; Child Health Equity Center, Department of Pediatrics (A Garg), University of Massachusetts Chan Medical School, Worcester, Mass.
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences (M Goulding, G Ryan, C Frisard, E Stevens, A Garg, and SC Lemon), University of Massachusetts Chan Medical School, Worcester, Mass.
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4
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Waterworth SP, Kerr CJ, McManus CJ, Chung HC, Shaw BS, Shaw I, Sandercock GR. Four-year longitudinal associations of physical activity, waist circumference, and blood pressure in UK adolescents. Pediatr Res 2024; 95:736-743. [PMID: 37833532 PMCID: PMC10899106 DOI: 10.1038/s41390-023-02837-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 08/22/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND This study assessed the specific influence of physical activity (PA) and waist circumference (WC) on the 4-year growth trajectory of blood pressure in UK high-school students. METHODS Four-year longitudinal monitoring of 1501 adolescents was conducted as part of the EoEHHS. Measurements were taken in Grades (G)7, 9, and 11. RESULTS Systolic (SBP) and diastolic blood pressure (DBP) increased over the 4-year period (SBP G7 114.6 ± 8.9 mmHg, G9 118.1 ± 9.7 mmHg, G11 122.8 ± 7.8 mmHg; DBP G7 66.7 ± 6.6 mmHg, G9 68.0 ± 6.4 mmHg, G11 70.0 ± 5.2 mmHg). Baseline WC predicted baseline and growth in SBP, but the strongest contribution to SBP came from changes in WC (β = 0.084, p = 0.002). Baseline PAQ-A score (β = -0.822, p = 0.020) and changes in PAQ-A score (β = -0.650, p = 0.019) were associated with smaller increases in DBP over the 4-year measurement period. CONCLUSIONS Baseline and change in WC predicted the growth trajectory of SBP, while baseline and change in PA predicted the growth trajectory of DBP. PA and WC have a prognostic value in predicting changes in blood pressure in adolescents. Increasing PA during adolescence could slow the rise in DBP over time. This is meaningful for future hypertension and CVD risk reduction into adulthood. IMPACT Hypertension in adolescents is a growing health problem that is often overlooked. Baseline and changes in waist circumference over a 4-year period predicted development of systolic blood pressure, while baseline and changes in physical activity predicted development of diastolic blood pressure. Physical activity and waist circumference have a prognostic value in predicting changes in blood pressure in adolescents and could be valuable in planning programmes to prevent hypertension in similar communities and reduce the risk of future adult hypertension.
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Affiliation(s)
- Sally P Waterworth
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK.
| | - Catherine J Kerr
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Christopher J McManus
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Henry C Chung
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Brandon S Shaw
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Ina Shaw
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
| | - Gavin R Sandercock
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Wivenhoe Park, Colchester, Essex, CO4 3SQ, UK
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5
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Guo J, Fraser BJ, Blizzard L, Schmidt MD, Dwyer T, Venn AJ, Magnussen CG. Tracking of Cardiorespiratory Fitness from Childhood to Mid-adulthood. J Pediatr 2024; 264:113778. [PMID: 37848085 DOI: 10.1016/j.jpeds.2023.113778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/22/2023] [Accepted: 10/11/2023] [Indexed: 10/19/2023]
Abstract
High cardiorespiratory fitness (CRF) in adulthood is important for survival from major chronic diseases and preserving good health. We examined how childhood CRF tracks, or persists, into adulthood. Among a cohort of 748 school children followed over 34 years, we found child CRF correlated with young- (r = 0.30) and mid-adulthood (r = 0.16) CRF.
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Affiliation(s)
- Jia Guo
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Brooklyn J Fraser
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Leigh Blizzard
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | | | - Terence Dwyer
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; The Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Murdoch Children's Research Institute, Melbourne, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Alison J Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Costan G Magnussen
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
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6
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Goulding M, Ryan G, Frisard C, Stevens EM, Person S, Goldberg R, Garg A, Lemon SC. Disparities in Receipt of Guideline-adherent Blood Pressure Screening: An Observational Examination of Electronic Health Record Data from a Massachusetts Healthcare System. J Pediatr 2023; 261:113592. [PMID: 37399919 PMCID: PMC10530438 DOI: 10.1016/j.jpeds.2023.113592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE To describe the prevalence of blood pressure (BP) screening according to the 2017 American Academy of Pediatrics (AAP) guidelines and differences according to social vulnerability indicators. STUDY DESIGN We extracted electronic health record data from January 1, 2018, through December 31, 2018, from the largest healthcare system in Central Massachusetts. Outpatient visits for children aged 3-17 years without a prior hypertension diagnosis were included. Adherence was defined by the American Academy of Pediatrics guideline (≥1 BP screening for children with a body mass index [BMI] of <95th percentile) and at every encounter for children with a BMI of ≥95th percentile). Independent variables included social vulnerability indicators at the patient level (insurance type, language, Child Opportunity Index, race/ethnicity) and clinic level (location, Medicaid population). Covariates included child's age, sex, and BMI status, and clinic specialty, patient panel size, and number of healthcare providers. We used direct estimation to calculate prevalence estimates and multivariable mixed effects logistic regression to determine the odds of receiving guideline-adherent BP screening. RESULTS Our sample comprised 19 695 children (median age, 11 years; 48% female) from 7 pediatric and 20 family medicine clinics. The prevalence of guideline-adherent BP screening was 89%. In our adjusted model, children with a BMI of ≥95th percentile, with public insurance, and who were patients at clinics with larger Medicaid populations and larger patient panels had a lower odds of receiving guideline-adherent BP screening. CONCLUSIONS Despite overall high adherence to BP screening guidelines, patient- and clinic-level disparities were identified.
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Affiliation(s)
- Melissa Goulding
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA.
| | - Grace Ryan
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA
| | - Christine Frisard
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA
| | - Elise M Stevens
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA
| | - Sharina Person
- Division of Biostatistics and Health Service Research, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA
| | - Robert Goldberg
- Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA
| | - Arvin Garg
- Department of Pediatrics, Child Health Equity Center, University of Massachusetts Chan Medical School, UMass Memorial Children's Medical Center, Worcester, MA
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA
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7
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Hauser C, Lichtenstein E, Nebiker L, Streese L, Köchli S, Infanger D, Faude O, Hanssen H. Cardiorespiratory fitness and development of childhood cardiovascular risk: The EXAMIN YOUTH follow-up study. Front Physiol 2023; 14:1243434. [PMID: 37680774 PMCID: PMC10482095 DOI: 10.3389/fphys.2023.1243434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/14/2023] [Indexed: 09/09/2023] Open
Abstract
Background: Obesity- and hypertension-related cardiovascular (CV) risk has been shown to originate in childhood. Higher body mass index (BMI) and blood pressure (BP) have been associated with increased large artery stiffness and a lower microvascular arteriolar-to-venular diameter ratio (AVR) in children. This study aimed to investigate the association of cardiorespiratory fitness (CRF) with development of BMI, BP and vascular health during childhood. Methods: In our prospective cohort study, 1,171 children aged 6-8 years were screened for CRF, BMI, BP, retinal vessel diameters and pulse wave velocity using standardized protocols. Endurance capacity was assessed by 20 m shuttle run test. After 4 years, all parameters were assessed in 664 children using the same protocols. Results: Children with a higher CRF at baseline developed a significantly lower BMI (β [95% CI] -0.09 [-0.11 to -0.06] kg/m2, p < 0.001), a lower systolic BP (β [95% CI] -0.09 [-0.15 to -0.03] mmHg, p = 0.004) and a higher AVR (β [95% CI] 0.0004 [0.00004 to 0.0007] units, p = 0.027) after 4 years. The indirect association of CRF with development of retinal arteriolar diameters was mediated by changes in BMI. Conclusion: Our results identify CRF as a key modulator for the risk trajectories of BMI, BP and microvascular health in children. Obesity-related CV risk has been shown to track into adulthood, and achieving higher CRF levels in children may help counteract the development of CV risk and disease not only in pediatric populations, but may also help reduce the burden of CVD in adulthood. Registration: http://www.clinicaltrials.gov/ (NCT02853747).
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Affiliation(s)
| | | | | | | | | | | | | | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
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8
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Yang Y, Li J, Zhou Z, Wu S, Zhao J, Jia W, Liu M, Shen X, He F, Cheng R. Gut Microbiota Perturbation in Early Life Could Influence Pediatric Blood Pressure Regulation in a Sex-Dependent Manner in Juvenile Rats. Nutrients 2023; 15:2661. [PMID: 37375565 DOI: 10.3390/nu15122661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
The present study aimed to investigate whether gut dysbiosis induced by ceftriaxone in early life could influence pediatric blood pressure regulation in childhood with or without exposure to a high-fat diet (HFD). Sixty-three newborn pups of Sprague-Dawley rats were administered ceftriaxone sodium or saline solution until weaning at 3 weeks, and the rats were fed a HFD or regular diet from 3 to 6 weeks. Tail-cuff blood pressure, the expression levels of genes of the renin-angiotensin system (RAS), the concentrations of IL-1β, IL-6, and TNF-α in the colon and prefrontal cortex, and the composition of fecal microbiota were analyzed. Ceftriaxone treatment significantly increased the diastolic blood pressure of male rats at 3 weeks. At 6 weeks, systolic blood pressure (SBP) was significantly increased only in ceftriaxone treated male rats fed with HFD. The RAS showed increased activation in the kidney, heart, hypothalamus, and thoracic and abdominal aorta of male rats, but only in the kidney, heart, and hypothalamus of female rats. HFD-fed female rats showed a decreased level of IL-6 in the colon. α diversity of gut microbiota decreased and the Firmicutes to Bacteroidetes ratio increased in both male and female rats at 3 weeks; however, these parameters recovered to various degrees in female rats at 6 weeks. These results revealed that early-life gut dysbiosis induced by antibiotics combined with a HFD in childhood could be involved in pediatric blood pressure regulation and an increase in SBP in juvenile rats, and these effects occurred in a sex-dependent manner.
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Affiliation(s)
- Yang Yang
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Jinxing Li
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Zhimo Zhou
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Simou Wu
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Jincheng Zhao
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Wen Jia
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Meixun Liu
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Xi Shen
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Fang He
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Ruyue Cheng
- Department of Nutrition and Food Hygiene, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China
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9
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Cauzzo C, Chiavaroli V, Di Valerio S, Chiarelli F. Birth size, growth trajectory and later cardio-metabolic risk. Front Endocrinol (Lausanne) 2023; 14:1187261. [PMID: 37342257 PMCID: PMC10277632 DOI: 10.3389/fendo.2023.1187261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/19/2023] [Indexed: 06/22/2023] Open
Abstract
There is increasing evidence of a strong association between intrauterine growth and subsequent development of chronic disease in adult life. Birth size and growth trajectory have been demonstrated to have an impact on cardio-metabolic health, both in childhood and adult life. Hence, careful observation of the children's growth pattern, starting from the intrauterine period and the first years of life, should be emphasized to detect the possible onset of cardio-metabolic sequelae. This allows to intervene on them as soon as they are detected, first of all through lifestyle interventions, whose efficacy seems to be higher when they are started early. Recent papers suggest that prematurity may constitute an independent risk factor for the development of cardiovascular disease and metabolic syndrome, regardless of birth weight. The purpose of the present review is to examine and summarize the available knowledge about the dynamic association between intrauterine and postnatal growth and cardio-metabolic risk, from childhood to adulthood.
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Affiliation(s)
- Chiara Cauzzo
- Department of Pediatrics, University of Chieti, Chieti, Italy
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10
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Wu Y, Li Z, Du B, Ye Y, Wang H, Niu Y, Chen S, Wu Y, Jin H, Zhang X, Wang J, Sun K. Different Associations of Systolic Blood Pressure and Body Mass Index With Cardiac Structure and Function in Young Children. Hypertension 2022; 79:2583-2592. [DOI: 10.1161/hypertensionaha.122.19396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Both elevated systolic blood pressure (SBP) and excess weight can lead to early cardiovascular organ damage in children. In this study, we investigated whether there is a difference in the associations of SBP and body mass index (BMI) with cardiovascular structure and function in 4-year-old children.
Methods:
In 1474 children (52.3% males) from the Shanghai Birth Cohort, physical examination and echocardiography were performed. Standardized linear regression models were used to evaluate the associations of BMI
Z
score and SBP
Z
score with cardiovascular parameters and to compare the strengths of these associations.
Results:
The incidence of SBP elevation significantly increased in overweight children. SBP was positively related to heart rate, left ventricular (LV) ejection fraction and fraction shortening (β=1.824 [95% CI, 1.014–2.634], 0.579 [0.294–0.864], and 0.480 [0.257–0.704], respectively). BMI
Z
score was positively associated with LV mass index (β=1.225 [0.863–1.587]) and the risk of LV hypertrophy (odds ratio=1.428 [1.157–1.761]) but negatively related to measures of systolic function, including LV ejection fraction, LV fraction short, and global longitudinal strain (β=−0.417 [−0.735 to −0.099], −0.302 [−0.551 to −0.053], and −0.392 [−0.621 to −0.163], respectively). No noteworthy additive or multiplicative interactions between BMI and SBP were detected.
Conclusions:
Elevations in both BMI and SBP were related to cardiac structure and function in children as young as 4 years old. Elevated SBP was associated with increased heart rate and LV ejection at the early stage of BP elevation. BMI showed a closer relationship with left heart diameters and geometry than SBP.
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Affiliation(s)
- Yujian Wu
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Zhuoyan Li
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Bowen Du
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Yujiao Ye
- Children's Heart Center, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, China (Y.Y.)
| | - Hualin Wang
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Yiwei Niu
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Sun Chen
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Yurong Wu
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Hong Jin
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health (H.J.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Xi Zhang
- Clinical Research Unit (X.Z.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Jian Wang
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
| | - Kun Sun
- Department of Pediatric Cardiology (Yujian Wu, Z.L., B.D., H.W., Y.N., S.C., Yurong Wu, J.W., K.S.), Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, China
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11
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Glenn TW, Eaton CK, Psoter KJ, Eakin MN, Pruette CS, Riekert KA, Brady TM. Agreement between attended home and ambulatory blood pressure measurements in adolescents with chronic kidney disease. Pediatr Nephrol 2022; 37:2405-2413. [PMID: 35166919 PMCID: PMC9376201 DOI: 10.1007/s00467-022-05479-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 12/20/2021] [Accepted: 01/24/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND This study aimed to compare attended home blood pressure (BP) measurements (HBPM) with ambulatory BP monitor (ABPM) readings and examine if level of agreement between measurement modalities differs overall and by subgroup. METHODS This was a secondary analysis of data from a 2-year, multicenter observational study of children 11-19 years (mean 15, SD = 2.7) with chronic kidney disease. Participants had 3 standardized resting oscillometric home BPs taken by staff followed by 24-h ABPM within 2 weeks of home BP. BP indices (measured BP/95%ile BP) were calculated for mean triplicate attended HBPM and mean ABPM measurements. Paired HBPM and ABPM measurements taken during any of 5 study visits were compared using linear regression with robust standard errors. Generalized estimating equation-based logistic regression determined sensitivity, specificity, negative, and positive predictive values with ABPM as the gold standard. Analyses were conducted for the group overall and by subgroup. RESULTS A total of 103 participants contributed 251 paired measurements. Indexed systolic BP did not differ between HBPM and daytime APBM (mean difference - 0.002; 95% CI: - 0.006, 0.003); the difference in indexed diastolic BP was minimal (mean difference - 0.033; 95% CI: - 0.040, - 0.025). Overall agreement between HBPM and 24-h ABPM in identifying abnormal BP was high (81.8%). HBPM had higher sensitivity (87.5%) than specificity (77.4%) and greater negative (89.8%) than positive (73.3%) predictive value, and findings were consistent in subgroups. CONCLUSIONS Attended HBPM may be reasonable for monitoring BP when ABPM is unavailable. The greater accessibility and feasibility of attended HBPM may potentially help improve BP control among at-risk youth. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Trevor W Glenn
- Johns Hopkins University School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD, 21224, USA.
| | - Cyd K Eaton
- Johns Hopkins University School of Medicine, Baltimore MD - 733 N Broadway, Baltimore, MD, 21205, USA
| | - Kevin J Psoter
- Johns Hopkins University School of Medicine, Baltimore MD - 733 N Broadway, Baltimore, MD, 21205, USA
| | - Michelle N Eakin
- Johns Hopkins University School of Medicine, Baltimore MD - 733 N Broadway, Baltimore, MD, 21205, USA
| | - Cozumel S Pruette
- Johns Hopkins University School of Medicine, Baltimore MD - 733 N Broadway, Baltimore, MD, 21205, USA
| | - Kristin A Riekert
- Johns Hopkins University School of Medicine, Baltimore MD - 733 N Broadway, Baltimore, MD, 21205, USA
| | - Tammy M Brady
- Johns Hopkins University School of Medicine, Baltimore MD - 733 N Broadway, Baltimore, MD, 21205, USA
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12
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Hessey E, Paun A, Benisty K, McMahon K, Palijan A, Pizzi M, Morgan C, Zappitelli M. 24-Hour ambulatory blood pressure monitoring 7 years after intensive care unit admission. Pediatr Nephrol 2022; 37:1877-1887. [PMID: 35039930 DOI: 10.1007/s00467-021-05392-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Children who develop acute kidney injury (AKI) in the pediatric intensive care unit (PICU) may be at higher risk of long-term chronic kidney disease and hypertension. The objectives of this study were to determine the prevalence of post-discharge hypertension and albuminuria using reference-standard measurements in children admitted to the PICU, and evaluate their association with AKI. METHODS Single-center longitudinal cohort study of children admitted to the PICU from 2005 to 2010 with 7-8 years of follow-up (n = 207). Patients were excluded if they had pre-existing chronic kidney disease, were deceased, lived > 3.5-h drive away, were unwilling/unable to provide consent/assent, or had a clotting disorder. AKI was defined by the Kidney Disease: Improving Global Outcomes creatinine definition. Office blood pressure was evaluated using age, sex, and height-based percentiles. Hypertension was defined using 24-h ambulatory blood pressure monitoring (ABPM). Albuminuria was defined as first morning urine albumin:creatinine ratio ≥ 30 mg/g. Prevalence of blood pressure outcomes was calculated. The association between AKI and outcomes was evaluated using multivariable regression. RESULTS Sixty of 207 (29%) children developed AKI during PICU admission. Overall, 6% had albuminuria and 21% had elevated office blood pressure or worse. One-hundred-and-seventy-seven (86%) patients had successful ABPM data. Of these, 10 (6%) had white coat, 18 (10%) had masked, and 5 (3%) had ambulatory hypertension. There was no statistically significant difference in outcomes across AKI stages. CONCLUSIONS Blood pressure abnormalities are common in children 7 years after PICU admission. Future studies with longer follow-up are needed to further evaluate the association between AKI and hypertension. A higher-resolution version of the graphical abstract is available as Supplementary information.
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Affiliation(s)
- Erin Hessey
- Department of Pediatrics, Division of Nephrology, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
- Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | - Alex Paun
- McGill University Health Centre Research Institute, McGill University Health Centre, Montreal, QC, Canada
| | - Kelly Benisty
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Kelly McMahon
- Department of Pediatrics, Division of Nephrology, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - Ana Palijan
- Department of Pediatrics, Division of Nephrology, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - Michael Pizzi
- Department of Pediatrics, Division of Nephrology, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
| | - Catherine Morgan
- Department of Pediatrics, Division of Nephrology, Stollery Children's Hospital, University of Alberta, Edmonton, AB, Canada
| | - Michael Zappitelli
- Department of Pediatrics, Division of Nephrology, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, 6th floor, Room 06.9708, Toronto, ON, M5G 0A4, Canada.
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13
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Kim SH, Song YH, An HS, Shin JI, Oh JH, Lee JW, Kim SH, Kim HS, Shin HJ, Ha IS. The compatibility of new blood pressure reference values for Korean children and adolescents with the US reference: the Korean Working Group of Pediatric Hypertension. Clin Hypertens 2022; 28:19. [PMID: 35915509 PMCID: PMC9341068 DOI: 10.1186/s40885-022-00200-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 02/08/2022] [Indexed: 11/25/2022] Open
Abstract
Background Childhood hypertension is associated with hypertension and metabolic syndrome in adulthood. Since the definition of childhood hypertension is based on the distribution of normative blood pressure (BP), a reference range is essential to create hypertension guidelines for children. We aimed to investigate the compatibility of the new Korean BP reference with the United States (US) BP reference based on the 2017 Clinical Practice Guideline. Methods We compared the new Korean reference BP values for children and adolescents aged 10 to 17 years with those in the 2017 Clinical Practice Guidelines. We also analyzed the differences in the prevalence of hypertension in Korean children and adolescents when reference value was applied. Considering Korean and US BP references together, linear trend lines were sought. Results Systolic BP (SBP) and diastolic BP (DBP) values in 95th percentiles showed no significant differences between the two BP references. Applying the two reference values, there was no significant difference in the prevalence of elevated BP and a combination of elevated BP and hypertension. Combining the Korean and US BP values and plotting them against age, approximate lines for the 90th and 95th SBP and DBP percentiles were observed. Conclusions The BP values of the new Korean BP reference were similar to those of the US BP reference; they were reliable and interchangeable. Supplementary Information The online version contains supplementary material available at 10.1186/s40885-022-00200-x.
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Affiliation(s)
- Sung Hye Kim
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.,The Korean Working Group of Pediatric Hypertension, Seoul, Republic of Korea
| | - Young Hwan Song
- The Korean Working Group of Pediatric Hypertension, Seoul, Republic of Korea. .,Department of Pediatrics, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, 13620, Seongnam, Republic of Korea.
| | - Hyo Soon An
- The Korean Working Group of Pediatric Hypertension, Seoul, Republic of Korea.,Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - Jae Il Shin
- The Korean Working Group of Pediatric Hypertension, Seoul, Republic of Korea.,Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin-Hee Oh
- The Korean Working Group of Pediatric Hypertension, Seoul, Republic of Korea.,Department of Pediatrics, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Republic of Korea
| | - Jung Won Lee
- The Korean Working Group of Pediatric Hypertension, Seoul, Republic of Korea.,Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Seong Heon Kim
- The Korean Working Group of Pediatric Hypertension, Seoul, Republic of Korea.,Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea
| | - Hae Soon Kim
- The Korean Working Group of Pediatric Hypertension, Seoul, Republic of Korea.,Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Hye-Jung Shin
- The Korean Working Group of Pediatric Hypertension, Seoul, Republic of Korea.,Department of Pediatrics, National Medical Center, Seoul, Republic of Korea
| | - Il-Soo Ha
- The Korean Working Group of Pediatric Hypertension, Seoul, Republic of Korea.,Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea
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14
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Agostinis-Sobrinho C, Kievisiene J, Dubey V, Rauckiene-Michealsson A, Norkiene S, Ramirez-Velez R, Reuter CP, Brand C, Mota J, Santos R. Cardiovascular health behavior and blood pressure in adolescents: A longitudinal analysis. Nutr Metab Cardiovasc Dis 2022; 32:1766-1773. [PMID: 35599087 DOI: 10.1016/j.numecd.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/01/2022] [Accepted: 04/11/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The ideal cardiovascular health behaviors (ICHB) have been associated with a subsequent positive health status in adults. However, evidence regarding blood pressure (BP) and ICHB in adolescents is scarce. The aim of this prospective cohort was to evaluate the impact of accumulation of ICHB on BP values in adolescents over two years. METHODS This is a longitudinal analysis with 445 adolescents (232 girls) aged 12-18 years old. Resting blood pressure was measured at baseline and 2 years later, and ICHBs at baseline according to standard procedures. Based on the American Heart Association definition, the ICHB index was defined as a sum of meeting the ICHBs (from 0 to 4, where 4 would be the healthiest profile of all ICHBs) for a healthy diet, physical activity, smoking status and body mass index. RESULTS Adjusted means values (ANCOVA) of BP parameters through achievement of a greater number of (between 1-4) the ICHBs (adjusting for potential confounders, age, sex, pubertal stage and socioeconomic status) showed that, as increase the number of ICHB accumulated as a lower the BP levels [ICHB and SBP (F3.435) = 4.501, p = 0.004), DBP (F(3.435) = 2.725, p = 0.044), pulse pressure (F(3.435) = 4.004, p = 0.008), and rate pressure product (F(3.435) = 2.866, p = 0.036)] over two years. CONCLUSION A lower number of ICHB (smoking status, body mass index, physical activity, and diet) during adolescence play a key role on blood pressure over two years. A higher number of ICHB is seen to be associated with a lower risk of short-term, hypertension.
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Affiliation(s)
| | | | - Viney Dubey
- Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | | | - Sigute Norkiene
- Faculty of Health Sciences, Klaipeda University, Klaipeda, Lithuania
| | - Robinson Ramirez-Velez
- Navarrabiomed, Hospital Universitario de Navarra (HUN), Navarra Institute for Health, Research (IdiSNA), Universidad Pública de Navarra (UPNA), Pamplona, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Cezane Priscila Reuter
- Graduate Program in Health Promotion, University of Santa Cruz Do Sul, Santa Cruz Do Sul, RS, Brazil
| | - Caroline Brand
- Graduate Program in Health Promotion, University of Santa Cruz Do Sul, Santa Cruz Do Sul, RS, Brazil
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Portugal
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15
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Chu C, Liao YY, He MJ, Ma Q, Zheng WL, Yan Y, Hu JW, Xu XJ, Fan YN, Yang RH, Mu JJ. Blood Pressure Trajectories From Childhood to Youth and Arterial Stiffness in Adulthood: A 30-Year Longitudinal Follow-Up Study. Front Cardiovasc Med 2022; 9:894426. [PMID: 35845038 PMCID: PMC9278647 DOI: 10.3389/fcvm.2022.894426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/06/2022] [Indexed: 11/24/2022] Open
Abstract
Background This study aimed to identify the subgroups of individuals sharing similar blood pressure (BP) trajectories from childhood to youth and explore the associations of these trajectories with arterial stiffness in adulthood. Methods A group-based trajectory model was used to identify BP trajectories among 2,082 individuals in the Hanzhong adolescent hypertension cohort by using BP values repeatedly measured at four visits from childhood (6–15 years) to youth (14–23 years). The brachial–ankle pulse wave velocity (baPWV) was examined 30 years after the baseline survey. Mixed linear regression models were used to examine the associations of these trajectories with adult baPWV. Results Among the 2,082 individuals, three trajectory groups of systolic BP were identified as follows: the low-level group (n = 889), medium-level group (n = 1,021), and high-level group (n = 172). The baPWV in adulthood was higher in medium-level and high-level groups compared with the low-level group (1271.4 ± 224.7 cm/s, 1366.1 ± 249.8 cm/s vs. 1190.1 ± 220.3 cm/s, all p < 0.001). After adjustment for potential confounding factors, the association between baPWV and systolic BP trajectories was statistically significant (adjusted β = 49.4 cm/s; p < 0.001 for the medium-level group and β = 107.6 cm/s; p < 0.001 for the high-level group compared with the low-level group). Similar results were obtained for the association of baPWV with the trajectories of diastolic BP and mean arterial pressure (MAP), except for pulse pressure. Conclusion Our investigation demonstrates different BP trajectories from childhood to youth and shows the trajectories of systolic BP, diastolic BP, and MAP are significant predictors of arterial stiffness in adulthood.
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Affiliation(s)
- Chao Chu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Yue-yuan Liao
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Ming-jun He
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Qiong Ma
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Wen-ling Zheng
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Yu Yan
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Jia-wen Hu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Xian-jing Xu
- Department of Cardiovascular Medicine, Henan Province People’s Hospital, Zhengzhou, China
| | - Ya-ning Fan
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
| | - Rui-hai Yang
- Institute of Cardiovascular Sciences, Hanzhong People’s Hospital, Hanzhong, China
| | - Jian-jun Mu
- Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi’an, China
- *Correspondence: Jian-jun Mu,
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16
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Meng Y, Buscot MJ, Juonala M, Wu F, Armstrong MK, Fraser BJ, Pahkala K, Hutri-Kähönen N, Kähönen M, Laitinen T, Viikari JSA, Raitakari OT, Magnussen CG, Sharman JE. Relative Contribution of Blood Pressure in Childhood, Young- and Mid-Adulthood to Large Artery Stiffness in Mid-Adulthood. J Am Heart Assoc 2022; 11:e024394. [PMID: 35699171 PMCID: PMC9238667 DOI: 10.1161/jaha.121.024394] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Blood pressure associates with arterial stiffness, but the contribution of blood pressure at different life stages is unclear. We examined the relative contribution of childhood, young‐ and mid‐adulthood blood pressure to mid‐adulthood large artery stiffness. Methods and Results The sample comprised 1869 participants from the Cardiovascular Risk in Young Finns Study who had blood pressure measured in childhood (6–18 years), young‐adulthood (21–30 years), and mid‐adulthood (33–45 years). Markers of large artery stiffness were pulse wave velocity and carotid distensibility recorded in mid‐adulthood. Bayesian relevant life course exposure models were used. For each 10‐mm Hg higher cumulative systolic blood pressure across the life stages, pulse wave velocity was 0.56 m/s higher (95% credible interval: 0.49 to 0.63) and carotid distensibility was 0.13%/10 mm Hg lower (95% credible interval: −0.16 to −0.10). Of these total contributions, the highest contribution was attributed to mid‐adulthood systolic blood pressure (relative weights: pulse wave velocity, childhood: 2.6%, young‐adulthood: 5.4%, mid‐adulthood: 92.0%; carotid distensibility, childhood: 5.6%; young‐adulthood: 10.1%; mid‐adulthood: 84.3%), with the greatest individual contribution coming from systolic blood pressure at the time point when pulse wave velocity and carotid distensibility were measured. The results were consistent for diastolic blood pressure, mean arterial pressure, and pulse pressure. Conclusions Although mid‐adulthood blood pressure contributed most to mid‐adulthood large artery stiffness, we observed small contributions from childhood and young‐adulthood blood pressure. These findings suggest that the burden posed by arterial stiffness might be reduced by maintaining normal blood pressure levels at each life stage, with mid‐adulthood a critical period for controlling blood pressure.
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Affiliation(s)
- Yaxing Meng
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Australia
| | - Marie-Jeanne Buscot
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Australia
| | - Markus Juonala
- Department of Medicine University of Turku Turku Finland.,Division of Medicine Turku University Hospital Turku Finland
| | - Feitong Wu
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Australia
| | - Matthew K Armstrong
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Australia
| | - Brooklyn J Fraser
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Australia
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine University of Turku Turku Finland.,Centre for Population Health Research University of TurkuTurku University Hospital Turku Finland.,Paavo Nurmi Centre Sports & Exercise Medicine Unit Department of Physical Activity and Health University of Turku Turku Finland
| | - Nina Hutri-Kähönen
- Tampere Centre for Skills Training and Simulation Tampere University Tampere Finland
| | - Mika Kähönen
- Department of Clinical Physiology Tampere University HospitalFaculty of Medicine and Health TechnologyTampere University Tampere Finland
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine Kuopio University HospitalUniversity of Eastern Finland Kuopio Finland
| | - Jorma S A Viikari
- Department of Medicine University of Turku Turku Finland.,Division of Medicine Turku University Hospital Turku Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine University of Turku Turku Finland.,Centre for Population Health Research University of TurkuTurku University Hospital Turku Finland.,Department of Clinical Physiology and Nuclear Medicine Turku University Hospital Turku Finland
| | - Costan G Magnussen
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Australia.,Research Centre of Applied and Preventive Cardiovascular Medicine University of Turku Turku Finland.,Centre for Population Health Research University of TurkuTurku University Hospital Turku Finland.,Baker Heart and Diabetes Institute Melbourne Victoria Australia
| | - James E Sharman
- Menzies Institute for Medical ResearchUniversity of Tasmania Hobart Australia
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17
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Pedersen JN, Dalgård C, Möller S, Andersen LB, Birukov A, Andersen MS, Christesen HT. Early pregnancy vitamin D status is associated with blood pressure in children: an Odense Child Cohort study. Am J Clin Nutr 2022; 116:470-481. [PMID: 35511609 PMCID: PMC9348989 DOI: 10.1093/ajcn/nqac118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Blood pressure in childhood tracks into later life. Vitamin D status in adults is associated with blood pressure, but the impact of vitamin D status in pregnancy and childhood on blood pressure still needs investigation. OBJECTIVE We investigated whether fetal rather than current vitamin D status is associated with blood pressure in children. METHODS In a prospective observational study within the population-based Odense Child Cohort (OCC), we examined serum 25-hydroxyvitamin D2+3 [s-25(OH)D] in early and late pregnancy, cord blood, and at 5 y age, and the associations with systolic and diastolic blood pressure (SBP/DBP) in the 5-y-old children (n = 1,677). Multiple regression models were adjusted for maternal country of origin, parity, smoking during pregnancy, 5-y height, and weight. Two-stage mixed effect modeling was performed, integrating all s-25(OH)D data from pregnancy and cord blood. RESULTS The median (IQR) s-25(OH)D in early pregnancy, late pregnancy, the umbilical cord, and at 5 y was 65.5 (50.7-78.5), 78.5 (60.3- 95.8), 45.4 (31.1- 60.7), and 71.9 (54.6- 86.5) nmol/L, respectively. The mean ±SD 5-y SBP/DBP was 101.0/63.8 (7.1/5.9) mmHg. In adjusted analyses, a 10 nmol/L increase of s-25(OH)D in early pregnancy associated with a 0.3/0.2 mmHg lower SBP/DBP at 5 y (P < 0.05). Optimal s-25(OH)D (>75 nmol/L) in early pregnancy was associated with lower 5-y SBP and DBP, β (95% CI) -1.45 (-2.6, -0.3), and -0.97 (-1.9, -0.1), compared with reference s-25(OH)D (50-74.9 nmol/L). Two-stage analysis combining early pregnancy, late pregnancy, and cord s-25(OH)D data showed an inverse association with 5-y SBP and DBP for boys (P < 0.025) with significant sex-difference for DBP (Pinteraction = 0.004). No associations were found between s-25(OH)D and 5-y BP above the 90th percentile. CONCLUSION Early pregnancy s-25(OH)D concentrations, especially >75 nmol/L, were inversely associated with 5-y blood pressure in the offspring. A novel identified protective effect of optimal vitamin D levels in early pregnancy on offspring BP is suggested.
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Affiliation(s)
- Josefine N Pedersen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark,Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Christine Dalgård
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark,Clinical Pharmacology, Pharmacy and Environmental Medicine, Dept of Public Health, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark,Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Louise B Andersen
- General Practice, Capital Region, Denmark,Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Anna Birukov
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Marianne Skovsager Andersen
- Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark,Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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Cui Y, Zhang F, Wang H, Zhao L, Song R, Han M, Shen X. Temporal Associations between Tri-Ponderal Mass Index and Blood Pressure in Chinese Children: A Cross-Lag Analysis. Nutrients 2022; 14:nu14091783. [PMID: 35565750 PMCID: PMC9103659 DOI: 10.3390/nu14091783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/20/2022] [Accepted: 04/22/2022] [Indexed: 12/19/2022] Open
Abstract
Background: No longitudinal studies have explored the relationship between tri-ponderal mass index (TMI) and blood pressure (BP) in children. This study is aimed to investigate the temporal associations between TMI and BP among children in China. Methods: A longitudinal study was carried out with Chinese children from 2014 to 2019. Data of the anthropometric examination and blood pressure were collected annually. TMI was calculated by dividing weight by the cube of height. BP was measured using a standard mercury sphygmomanometer. We investigated temporal associations between TMI and BP with a cross-lagged panel model using repeated measure data from 2014 (Wave 1), 2016 (Wave 2), and 2018 (Wave 3). Results: Results of the cross-lagged panel model showed that TMI was associated with subsequent BP. Participants with higher levels of TMI presented higher levels of BP (Wave 1: β = 0.737 for systolic blood pressure (SBP) and β = 0.308 for diastolic blood pressure (DBP), Wave 2: β = 0.422 for SBP and β = 0.165 for DBP, p < 0.01). In addition, children with higher BP could also present higher TMI (Wave 1: β = 0.004 for SBP and β = 0.006 for DBP, Wave 2: β = 0.003 for SBP and β = 0.005 for DBP, p < 0.01), but the cross-lag path coefficient indicated that the influence of TMI on BP was stronger than the influence of BP on TMI. Conclusions: There was a temporal association between TMI and BP in Chinese children. Higher TMI predicted higher subsequent BP rather than the reverse relationship.
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Ludwig-Walz H, Nyasordzi J, Weber KS, Buyken AE, Kroke A. Maternal pregnancy weight or gestational weight gain and offspring's blood pressure: A systematic review. Nutr Metab Cardiovasc Dis 2022; 32:833-852. [PMID: 35078676 DOI: 10.1016/j.numecd.2021.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022]
Abstract
AIMS An increasing number of studies suggest that maternal weight parameters in pregnancy are associated with offspring's blood pressure (BP). The aim of this systematic review - following the updated Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) Statement - was to assess and judge the evidence for an association between maternal pregnancy weight/body mass index (BMI) or gestational weight gain (GWG) with offspring's BP in later life. DATA SYNTHESIS MEDLINE, EMBASE, Cochrane Library, CINAHL and Web of Science were searched without limits. Risk of bias was assessed using the "US National Heart, Lung and Blood Institute"-tool, and an evidence grade was allocated following the "World Cancer Research Fund" criteria. Of 7,124 publications retrieved, 16 studies (all cohort studies) were included in the systematic review. Overall data from 52,606 participants (0 years [newborns] to 32 years) were enclosed. Association between maternal pregnancy BMI and offspring's BP were analyzed in 2 (both "good-quality" rated) studies, without consistent results. GWG and offspring's BP was analyzed in 14 studies (2 "good-quality", 9 "fair-quality", 3 "poor-quality" rated). Of these, 3 "fair-quality" studies described significant positive results for systolic BP and significant results, but partly with varying directions of effect estimates for diastolic BP. Mean arterial pressure (MAP) was analyzed in 1 "poor-quality" congress paper. Overall, based on the small number of "good-quality"-rated studies and the inconsistency of effect direction, no firm conclusion can be drawn. CONCLUSION Evidence for an association of maternal pregnancy weight determinants with offspring's BP was overall graded as "limited - no conclusion".
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Affiliation(s)
- Helena Ludwig-Walz
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany.
| | - Juliana Nyasordzi
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Germany; University of Health and Allied Sciences, Ho, Volta Region, Ghana.
| | | | - Anette E Buyken
- Department of Sports and Health, Institute of Nutrition, Consumption and Health, Paderborn University, Germany.
| | - Anja Kroke
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany.
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20
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Chen C, Lu M, Wu Y, Zhang Z, Hu J, Yin J, Zhou W, Xu JY, Lv H, Qin LQ. The prevalence of hypertension and elevated blood pressure and its correlation with overweight/obesity among students aged 6-17 years in Suzhou. J Pediatr Endocrinol Metab 2022; 35:341-348. [PMID: 34951936 DOI: 10.1515/jpem-2021-0033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 12/01/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Lifestyle changes have led to an increase in the prevalence of hypertension in Chinese children and adolescents. The aim of this study was to analyze the prevalence of hypertension and its association with overweight and obesity among students aged 6-17 years in Suzhou. This retrospective analysis included physical examination data of primary and junior high school students in Suzhou Industrial Park from 2016 to 2019. METHODS Elevated blood pressure and hypertension were defined using blood pressure criteria appropriate for age, sex, and height percentile. Overweight and obesity were defined using the 2007 diagnostic criteria proposed by the World Health Organization for school-age children. Logistic regression analysis was used to evaluate the association between hypertension and overweight and obesity. RESULTS A total of 128,113 students were included. The prevalence of elevated BP and hypertension was 9.92% and 13.56%, respectively. The incidence of high blood pressure was higher in boys than in girls and increased with an increase in body mass index (BMI). The prevalence of hypertension in obese boys and girls (27.07% and 27.49%, respectively) was 2.3-fold and 2.8-fold higher than that in normal-weight boys and girls (11.58% and 9.83%, respectively). CONCLUSIONS Blood pressure was positively correlated with BMI, and the risk of high blood pressure due to overweight/obesity was 10.44%. Overweight and obesity significantly increased the risk of hypertension in students aged 6-17 years in Suzhou. Targeted weight-loss programs during childhood and adolescence may reduce the risk of hypertension in adulthood.
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Affiliation(s)
- Cailong Chen
- Children Health Management Center, Children's Hospital of Soochow University, Suzhou, China
| | - Menglan Lu
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Ying Wu
- Children Health Management Center, Children's Hospital of Soochow University, Suzhou, China
| | - Zheng Zhang
- Children Health Management Center, Children's Hospital of Soochow University, Suzhou, China
| | - Jia Hu
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Jieyun Yin
- Department of Epidemiology and Biostatics, School of Public Health, Soochow University, Suzhou, China
| | - Wanping Zhou
- Children Health Management Center, Children's Hospital of Soochow University, Suzhou, China
| | - Jia-Ying Xu
- State Key Laboratory of Radiation Medicine and Protection, School of Radiation Medicine and Protection, Soochow University, Suzhou, China
| | - Haitao Lv
- Children Health Management Center, Children's Hospital of Soochow University, Suzhou, China
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
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21
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High blood pressure in children and adolescents: current perspectives and strategies to improve future kidney and cardiovascular health. Kidney Int Rep 2022; 7:954-970. [PMID: 35570999 PMCID: PMC9091586 DOI: 10.1016/j.ekir.2022.02.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 02/08/2023] Open
Abstract
Hypertension is one of the most common causes of preventable death worldwide. The prevalence of pediatric hypertension has increased significantly in recent decades. The cause of this is likely multifactorial, related to increasing childhood obesity, high dietary sodium intake, sedentary lifestyles, perinatal factors, familial aggregation, socioeconomic factors, and ethnic blood pressure (BP) differences. Pediatric hypertension represents a major public health threat. Uncontrolled pediatric hypertension is associated with subclinical cardiovascular disease and adult-onset hypertension. In children with chronic kidney disease (CKD), hypertension is also a strong risk factor for progression to kidney failure. Despite these risks, current rates of pediatric BP screening, hypertension detection, treatment, and control remain suboptimal. Contributing to these shortcomings are the challenges of accurately measuring pediatric BP, limited access to validated pediatric equipment and hypertension specialists, complex interpretation of pediatric BP measurements, problematic normative BP data, and conflicting society guidelines for pediatric hypertension. To date, limited pediatric hypertension research has been conducted to help address these challenges. However, there are several promising signs in the field of pediatric hypertension. There is greater attention being drawn on the cardiovascular risks of pediatric hypertension, more emphasis on the need for childhood BP screening and management, new public health initiatives being implemented, and increasing research interest and funding. This article summarizes what is currently known about pediatric hypertension, the existing knowledge-practice gaps, and ongoing research aimed at improving future kidney and cardiovascular health.
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22
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Berube FR, Hoopes EK, D’Agata MN, Patterson F, Ives SJ, Farquhar WB, Witman MA. Subjective sleep score is associated with central and peripheral blood pressure values in children aged 7-12 years. J Sleep Res 2022; 31:e13440. [PMID: 34288196 PMCID: PMC8766862 DOI: 10.1111/jsr.13440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 02/03/2023]
Abstract
Shortened and poor-quality sleep have emerged as non-traditional risk factors for the development of hypertension in adults, and it is likely these relations extend to paediatric populations when evaluating sleep subjectively. Therefore, we aimed to evaluate subjective sleep metrics and their associations with central and peripheral blood pressure (BP) values in children. We hypothesized that poor-quality sleep and short sleep duration would be associated with elevated pressures in healthy children. Subjective sleep habits and sleep duration were evaluated using the Children's Sleep Habits Questionnaire (CSHQ) in 29 children aged 7-12 years (13 male/16 female). A total sleep score was generated by summing subscale scores: a higher score indicates poorer sleep habits. Peripheral BP was measured, and central pressures were estimated using pulse wave analysis. Pearson's r correlations were used to assess relations between total sleep score, sleep duration, and sleep score subscales with BP values. Sleep score was positively associated with central and peripheral systolic pressure (r = 0.43, p = 0.02 and r = 0.41, p = 0.03, respectively), diastolic pressure (r = 0.42, p = 0.02 and r = 0.36, p = 0.05, respectively) and mean arterial pressure (r = 0.40, p = 0.03 and r = 0.36, p = 0.03, respectively). Sleep duration was negatively associated with central and peripheral diastolic pressure (r = -0.40, p = 0.03 and r = -0.41, p = 0.03, respectively). Regarding the CSHQ subscales, daytime sleepiness and parasomnias were consistently positively associated with BP values. These findings support sleep as a primordial prevention target for hypertension and the maintenance of cardiovascular health during childhood. Consideration of a variety of sleep habits using tools such as the CSHQ may provide important insights into early-life cardiovascular risk.
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Affiliation(s)
- Felicia R. Berube
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | - Elissa K. Hoopes
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE
| | - Michele N. D’Agata
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | - Freda Patterson
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE
| | - Stephen J. Ives
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY
| | - William B. Farquhar
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | - Melissa A. Witman
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
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Tao JM, Wei W, Ma XY, Huo YX, Hu MD, Li XF, Chen X. Diagnostic accuracy of anthropometric indices for discriminating elevated blood pressure in pediatric population: a systematic review and a meta-analysis. BMC Pediatr 2022; 22:19. [PMID: 34983442 PMCID: PMC8725266 DOI: 10.1186/s12887-021-03062-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Childhood obesity is more likely to increase the chance of many adult health problems. Numerous studies have shown obese children to be more prone to elevated blood pressure (BP) and hypertension. It is important to identify an obesity anthropometric index with good discriminatory power for them in pediatric population. METHODS MEDLINE/PubMed, Web of Science, and Cochrane databases were retrieved comprehensively for eligible studies on childhood obesity and hypertension/elevated BP through June 2021. The systematic review and meta-analysis of studies used receiver operating characteristics (ROC) curves for evaluating the discriminatory power of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) in distinguishing children with elevated BP and hypertension. RESULTS 21 cross-sectional studies involving 177,943 children and 3-19 years of age were included in our study. Meta-analysis showed that the pooled area under the reporting receiver-operating characteristic curves (AUC) and 95% confidence intervals (CIs) for BMI, WC, and WHtR to detect hypertension of boys were 0.68 (0.64, 0.72), 0.69 (0.64, 0.74), 0.67 (0.63, 0.71), for elevated BP, the pooled AUCs and 95% CIs were 0.67 (0.61, 0.73), 0.65 (0.58, 0.73), 0.65 (0.61, 0.71). The pooled AUCs and 95% CIs for BMI, WC and WHtR of predicting hypertension were 0.70 (0.66, 0.75), 0.69 (0.64, 0.75), 0.67 (0.63, 0.72) in girls, the pooled AUCs and 95% CIs of predicting elevated BP were 0.63 (0.61, 0.65), 0.62 (0.60, 0.65), 0.62 (0.60, 0.64) respectively. There was no anthropometric index was statistically superior in identifying hypertension and elevated BP, however, the accuracy of BMI predicting hypertension was significantly higher than elevated BP in girls (P < 0.05). The subgroup analysis for the comparison of BMI, WC and WHtR was performed, no significant difference in predicting hypertension and elevated BP in pediatric population. CONCLUSIONS This systematic review showed that no anthropometric index was superior in identifying hypertension and elevated BP in pediatric population. While compared with predicting elevated BP, all the indicators showed superiority in predicting hypertension in children, the difference was especially obvious in girls. A better anthropometric index should be explored to predict children's early blood pressure abnormalities.
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Affiliation(s)
- Jun-Min Tao
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9, West Section of Lvshun South Road, Lvshunkou District, Dalian City, 116044, Liaoning Provence, China
| | - Wei Wei
- Department of Neurosurgery, Affiliated Dalian Municipal Central Hospital, Dalian Medical University, Dalian, 116033, China
| | - Xiao-Yang Ma
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9, West Section of Lvshun South Road, Lvshunkou District, Dalian City, 116044, Liaoning Provence, China
| | - Ying-Xiang Huo
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9, West Section of Lvshun South Road, Lvshunkou District, Dalian City, 116044, Liaoning Provence, China
| | - Meng-Die Hu
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9, West Section of Lvshun South Road, Lvshunkou District, Dalian City, 116044, Liaoning Provence, China
| | - Xiao-Feng Li
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9, West Section of Lvshun South Road, Lvshunkou District, Dalian City, 116044, Liaoning Provence, China
| | - Xin Chen
- Department of Epidemiology, School of Public Health, Dalian Medical University, No. 9, West Section of Lvshun South Road, Lvshunkou District, Dalian City, 116044, Liaoning Provence, China.
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24
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Caamaño-Navarrete F, Guzmán-Guzmán IP, Palomino-Devia C, Reyes-Oyola FA, Bustos-Barahona R, Jerez-Mayorga D, Delgado-Floody P. The association between modifiable lifestyle behaviour in Latin-American schoolchildren with abdominal obesity and excess weight. A comparison of Chile and Colombia. ENDOCRINOL DIAB NUTR 2022; 69:4-14. [PMID: 35232558 DOI: 10.1016/j.endien.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/07/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The purpose was to determine the association of lifestyle (i.e., Mediterranean diet [MD] adherence, physical activity [PA], screen time [ST]) and fitness with abdominal obesity (AO) and excess weight in the Chilean and Colombian schoolchildren. RESEARCH METHODS & PROCEDURES This cross-sectional study included 969 schoolchildren, girls (n=441, 5.24±0.80 years old) and boys (n=528, 5.10±0.78 years old) from Chile (n=611) and Colombia (n=358). The body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), MD adherence, PA, ST and cardiorespiratory fitness (CRF) were evaluated. The association of AO and anthropometric variables with lifestyle was estimated through multiple linear regression. To determine the association between AO and lifestyle, a logistic regression and the inclusion of odds ratios (ORs) with 95% confidence intervals (CIs) were used. RESULTS Worse CRF in Chilean children were positively correlated with WC. Excess weight in Chilean and Colombian children was positively associated with an unhealthy lifestyle. In Chilean children unhealthy lifestyle was also associated with AO based on WC≥85th percentile and AO based on WtHR≥85th percentile. In Chilean children, excess weight (BMI≥85th percentile) was positively associated with poor MD adherence. CONCLUSION AO and excess weight were associated with an unhealthy lifestyle in Latin-American schoolchildren. Interventions to reduce the prevalence of AO should include promoting healthier lifestyle choices (i.e., increasing PA after school, reducing ST and improving CRF).
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Affiliation(s)
| | | | | | | | | | | | - Pedro Delgado-Floody
- Department of Physical Education, Sport, and Recreation, Universidad de La Frontera, Temuco, Chile.
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25
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Fishman B, Zloof Y, Orr O, Tsur AM, Furer A, Omer Gilon M, Chodick G, Leiba A, Derazne E, Tzur D, Afek A, Grossman E, Twig G. The opposing trends of body mass index and blood pressure during 1977-2020; nationwide registry of 2.8 million male and female adolescents. Cardiovasc Diabetol 2021; 20:242. [PMID: 34963457 PMCID: PMC8715587 DOI: 10.1186/s12933-021-01433-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/10/2021] [Indexed: 12/30/2022] Open
Abstract
Background Elevated blood pressure among adolescents has been shown to be associated with future adverse cardiovascular outcomes and early onset diabetes. Most data regarding systolic and diastolic blood pressure trends are based on surveys of selected populations within 10–20-year periods. The goal of this study was to characterize the secular trend of blood pressure given the rising prevalence of adolescent obesity. Methods This nationwide population-based study included 2,785,515 Israeli adolescents (41.6% females, mean age 17.4 years) who were medically evaluated and whose weight, height and blood pressure were measured, prior to mandatory military service between 1977 and 2020. The study period was divided into 5-year intervals. Linear regression models were used to describe the P for trend along the time intervals. Analysis of covariance was used to calculate means of blood pressure adjusted for body mass index. Results During the study period, the mean body mass index increased by 2.1 and 1.6 kg/m2 in males and females, respectively (P for trend < 0.001 in both sexes). The mean diastolic blood pressure decreased by 3.6 mmHg in males and by 2.9 mmHg in females (P < 0.001 in both sexes). The mean systolic blood pressure increased by 1.6 mmHg in males and decreased by 1.9 mmHg in females. These trends were also consistent when blood pressure values were adjusted to body mass index. Conclusion Despite the increase in body mass index over the last four decades, diastolic blood pressure decreased in both sexes while systolic blood pressure increased slightly in males and decreased in females. Supplementary Information The online version contains supplementary material available at 10.1186/s12933-021-01433-0.
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Affiliation(s)
- Boris Fishman
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel.,Division of Cardiology, The Leviev Heart Center, The Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Talpiot Sheba Medical Leadership Program, Ramat Gan, Israel
| | - Yair Zloof
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Omri Orr
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel.,Orthopedic Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Avishai M Tsur
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Ramat Gan, Israel
| | - Ariel Furer
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel.,Division of Cardiology, The Leviev Heart Center, The Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ma'ayan Omer Gilon
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gabriel Chodick
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Maccabitech, Maccabi Healthcare Services, Tel Aviv, Israel
| | - Adi Leiba
- Division of Nephrology and Hypertension, Assuta Ashdod Academic Medical Center affiliated to Ben Gurion University, Beer Sheva, Israel.,Harvard Medical School, Boston, MA, USA
| | - Estela Derazne
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorit Tzur
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Central Management, The Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Ehud Grossman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,The Hypertension Unit and the Internal Division, The Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Gilad Twig
- Department of Military Medicine, Hebrew University, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. .,Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
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Nordman H, Jääskeläinen J, Voutilainen R. Birth Size as a Determinant of Cardiometabolic Risk Factors in Children. Horm Res Paediatr 2021; 93:144-153. [PMID: 32846418 DOI: 10.1159/000509932] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 07/06/2020] [Indexed: 11/19/2022] Open
Abstract
The association between birth size and cardiometabolic disease risk may be U-shaped. Being born small for gestational age (SGA) has a definitive association with later cardiovascular risk, but the impact of being born large for gestational age (LGA) on cardiometabolic health is more controversial. In addition to birth size, early postnatal growth pattern and later weight gain affect cardiometabolic risk in adulthood. Most SGA-born children have catch-up and LGA-born children have catch-down growth during the first years of life. The extent of this early compensatory growth may contribute to the adverse health outcomes. Both SGA- and LGA-born children are at an increased risk for overweight and obesity. This may have a long-term impact on cardiometabolic health as overweight tends to track to adulthood. Other cardiometabolic risk factors, including alterations in glucose metabolism, dyslipidemia, hypertension, and low-grade inflammation are associated with birth weight. Many of these risk factors are related to overweight or adverse fat distribution. Since later cardiometabolic risk is often mediated by early growth pattern and later overweight in SGA and LGA children, it is important to focus on staying normal weight throughout life. Hence, effective interventions to reduce cardiometabolic risk in LGA and SGA children should be developed.
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Affiliation(s)
- Henrikki Nordman
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland,
| | - Jarmo Jääskeläinen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Raimo Voutilainen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
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27
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Jones MA, Whitaker KM, Taverno Ross SE, Davis K, Libertus K, Barone Gibbs B. Maternal Sedentary Behavior and Physical Activity across Pregnancy and Early Childhood Motor Development. CHILDREN (BASEL, SWITZERLAND) 2021; 8:549. [PMID: 34201936 PMCID: PMC8304240 DOI: 10.3390/children8070549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 12/05/2022]
Abstract
Early childhood motor development is an important indicator of short- and long-term health. In utero exposures impact offspring health across the lifespan; however, whether maternal activity during pregnancy may impact early childhood motor development remains unknown. This prospective cohort study measured the motor development skills of n = 70 children born to mothers from a previously conducted cohort study which objectively measured activity profile, (sedentary behavior (SED) and moderate-to-vigorous intensity physical activity (MVPA), across pregnancy. Mothers reported the motor development of their child using the Early Motor Questionnaire (EMQ). Linear regression models examined associations between maternal activity profile and EMQ scores. Maternal SED and MVPA were analyzed in two ways: trimester-specific and across pregnancy using trajectory groups. Children were 12-30 months of age, majority white (82%), and 52% male. Maternal SED during pregnancy was not associated with any EMQ domains (gross motor, fine motor, and perception action). Higher maternal MVPA, across pregnancy by trajectory group and in the first and second trimesters, was significantly associated with moderate-sized effects of more advanced fine motor and perception action scores. Higher MVPA in early pregnancy appears to be related to more advanced early childhood motor development. Therefore, maternal MVPA may be a modifiable behavior by which short- and long-term offspring health may be impacted.
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Affiliation(s)
- Melissa A. Jones
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA;
| | - Kara M. Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA;
- Department of Epidemiology, University of Iowa, Iowa City, IA 52241, USA
| | - Sharon E. Taverno Ross
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA 15260, USA; (S.E.T.R.); (K.D.); (B.B.G.)
| | - Kelliann Davis
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA 15260, USA; (S.E.T.R.); (K.D.); (B.B.G.)
| | - Klaus Libertus
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Bethany Barone Gibbs
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA 15260, USA; (S.E.T.R.); (K.D.); (B.B.G.)
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Yang J, May Gwini S, Beilin LJ, Schlaich M, Stowasser M, Young MJ, Fuller PJ, Mori TA. Relationship Between the Aldosterone-to-Renin Ratio and Blood Pressure in Young Adults: A Longitudinal Study. Hypertension 2021; 78:387-396. [PMID: 34120455 DOI: 10.1161/hypertensionaha.121.17336] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Jun Yang
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia (J.Y., P.J.F.).,Department of Medicine (J.Y.), Monash University, Clayton, Victoria, Australia
| | - Stella May Gwini
- Department of Epidemiology, School of Public Health and Preventive Medicine (S.M.G.), Monash University, Clayton, Victoria, Australia.,University Hospital Geelong, Barwon Health, Victoria, Australia (S.M.G.)
| | - Lawrence J Beilin
- Medical School, The University of Western Australia (L.J.B., T.A.M.)
| | - Markus Schlaich
- Dobney Hypertension Centre, Medical School, The University of Western Australia, Royal Perth Hospital Campus (M. Schlaich).,Departments of Cardiology and Nephrology, Royal Perth Hospital, Australia (M. Schlaich).,Neurovascular Hypertension and Kidney Disease Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia (M. Schlaich)
| | - Michael Stowasser
- Endocrine Hypertension Research Centre, University of Queensland Diamantina Institute, Princess Alexandra Hospital, Brisbane, Australia (M. Stowasser)
| | - Morag J Young
- Cardiovascular Endocrinology Laboratory, Baker Heart and Diabetes Institute, Victoria, Australia (M.J. Young)
| | - Peter J Fuller
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia (J.Y., P.J.F.)
| | - Trevor A Mori
- Medical School, The University of Western Australia (L.J.B., T.A.M.)
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Torres CHA, Schultz LF, Veugelers PJ, Mastroeni SSBS, Mastroeni MF. The effect of pre-pregnancy weight and gestational weight gain on blood pressure in children at 6 years of age. J Public Health (Oxf) 2021; 43:e161-e170. [PMID: 32323723 DOI: 10.1093/pubmed/fdaa044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We evaluated the effect of maternal gestational weight gain (GWG) and pre-pregnancy weight on blood pressure (BP) of children 6 years after delivery. METHODS Cross-sectional study that compared the anthropometric measurements of 181 mothers and their children's BP 6 years after delivery. The BP was measured by the auscultatory method. We used log-binomial regression to investigate the association of pre-pregnancy body mass index (BMI) and GWG categories with BP in mid-childhood. RESULTS The prevalence of elevated BP in children was 26.5%. Maternal pre-pregnancy overweight and concurrent excessive GWG were positively associated with elevated BP at 6 years of age. Mothers with pre-pregnancy overweight and excessive GWG were more likely to have children with elevated BP at 6 years of age (OR = 2.05; P = 0.018) compared to mothers who were of normal weight pre-pregnancy and experienced appropriate GWG. We also found that mothers with pre-pregnancy BMI ≥25 kg/m2 and concurrent excessive GWG were more likely to have children with elevated diastolic blood pressure (OR = 2.72; P = 0.005). CONCLUSIONS Pre-pregnancy overweight/obesity had impact on BP in mid-childhood. Interventions aimed at reducing cardiovascular diseases in children should promote weight loss in women of reproductive age rather than in pregnant women.
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Affiliation(s)
- Camila Honorato A Torres
- University Center Tiradentes, Maceió, Alagoas CEP 57.038-000, Brazil.,Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton T6G 2R3, Canada
| | - Lidiane F Schultz
- Post-graduate Program in Health and Environment, University of Joinville Region, Joinville, Santa Catarina CEP 89.219-710, Brazil
| | - Paul J Veugelers
- Population Health Intervention Research Unit, School of Public Health, University of Alberta, Edmonton T6G 2R3, Canada
| | - Silmara S B S Mastroeni
- Department of Health Sciences, University of Joinville Region, Joinville, Santa Catarina CEP 89.219-710, Brazil
| | - Marco F Mastroeni
- Post-graduate Program in Health and Environment, University of Joinville Region, Joinville, Santa Catarina CEP 89.219-710, Brazil.,Department of Health Sciences, University of Joinville Region, Joinville, Santa Catarina CEP 89.219-710, Brazil
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Caamaño-Navarrete F, Guzmán-Guzmán IP, Palomino-Devia C, Reyes-Oyola FA, Bustos-Barahona R, Jerez-Mayorga D, Delgado-Floody P. The association between modifiable lifestyle behaviour in Latin-American schoolchildren with abdominal obesity and excess weight. A comparison of Chile and Colombia. ENDOCRINOL DIAB NUTR 2021; 69:S2530-0164(21)00116-6. [PMID: 34024753 DOI: 10.1016/j.endinu.2021.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/29/2020] [Accepted: 01/07/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose was to determine the association of lifestyle (i.e., Mediterranean diet [MD] adherence, physical activity [PA], screen time [ST]) and fitness with abdominal obesity (AO) and excess weight in the Chilean and Colombian schoolchildren. RESEARCH METHODS & PROCEDURES This cross-sectional study included 969 schoolchildren, girls (n=441, 5.24±0.80 years old) and boys (n=528, 5.10±0.78 years old) from Chile (n=611) and Colombia (n=358). The body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), MD adherence, PA, ST and cardiorespiratory fitness (CRF) were evaluated. The association of AO and anthropometric variables with lifestyle was estimated through multiple linear regression. To determine the association between AO and lifestyle, a logistic regression and the inclusion of odds ratios (ORs) with 95% confidence intervals (CIs) were used. RESULTS Worse CRF in Chilean children were positively correlated with WC. Excess weight in Chilean and Colombian children was positively associated with an unhealthy lifestyle. In Chilean children unhealthy lifestyle was also associated with AO based on WC≥85th percentile and AO based on WtHR≥85th percentile. In Chilean children, excess weight (BMI≥85th percentile) was positively associated with poor MD adherence. CONCLUSION AO and excess weight were associated with an unhealthy lifestyle in Latin-American schoolchildren. Interventions to reduce the prevalence of AO should include promoting healthier lifestyle choices (i.e., increasing PA after school, reducing ST and improving CRF).
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Affiliation(s)
| | | | | | | | | | | | - Pedro Delgado-Floody
- Department of Physical Education, Sport, and Recreation, Universidad de La Frontera, Temuco, Chile.
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31
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Agostinis-Sobrinho CA, Vilan K. Blood Pressure in Children. The Key Role of Physical Activity and Body Fatness. Arq Bras Cardiol 2021; 116:957-958. [PMID: 34008821 PMCID: PMC8121466 DOI: 10.36660/abc.20210117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- César A. Agostinis-Sobrinho
- Klaipeda UniversityFaculty of Health SciencesKlaipedaLituâniaKlaipeda University - Faculty of Health Sciences, Klaipeda – Lituânia
| | - Katiane Vilan
- Klaipeda UniversityFaculty of Health SciencesKlaipedaLituâniaKlaipeda University - Faculty of Health Sciences, Klaipeda – Lituânia
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32
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Within-visit SBP variability from childhood to adulthood and markers of cardiovascular end-organ damage in mid-life. J Hypertens 2021; 39:1865-1875. [PMID: 34397629 DOI: 10.1097/hjh.0000000000002855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Within-visit SBP variability is associated with age and SBP, but its long-term clinical significance is unknown. We examined the association between child, adult, and life-time within-visit SBP variability with markers of end-organ damage using data from a 31-year longitudinal study. METHODS Within-visit SBP variability was calculated as the standard deviation of three sitting SBP readings among up to 3010 participants aged 6-18 years (childhood) who were re-measured up to seven times to mid-adulthood. Markers of cardiovascular end-organ damage in adulthood were carotid intima--media thickness, brachial flow-mediated dilatation, carotid distensibility, pulse wave velocity, left ventricular mass index, carotid plaque, and coronary artery calcification. RESULTS The mean (standard deviation) cumulative within-visit SBP variability was 2.7 (1.5) mmHg in childhood, 3.9 (1.9) mmHg in adulthood and 3.7 (1.5) mmHg across the observed life-time. Childhood within-visit SBP variability was not correlated with its subsequent values measured from 3 to 31 years later. With adjustment for age, sex, cumulative SBP, BMI and serum lipids, neither child, adult, or life-time cumulative within-visit SBP variability associated with markers of cardiovascular end-organ damage. However, higher child, adult, and life-time cumulative SBP significantly associated with higher carotid intima--media thickness, higher pulse wave velocity, lower brachial flow-mediated dilatation, lower carotid distensibility in adulthood. CONCLUSION Within-visit SBP variability from childhood to adulthood does not provide additional predictive utility over SBP over the same period of the life course.
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Beltran-Valls MR, Santos R, Mota J, Moreira C, Lopes L, Agostinis-Sobrinho C. The mediating role of adiposity in the longitudinal association between cardiorespiratory fitness and blood pressure in adolescents: LabMed cohort study. Eur J Clin Invest 2021; 51:e13430. [PMID: 33047322 DOI: 10.1111/eci.13430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/29/2020] [Accepted: 10/06/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The aim of this prospective cohort study was to examine whether the association between the cardiorespiratory fitness (CRF) at baseline and blood pressure (BP) at follow-up is mediated by adiposity in adolescents. MATERIALS AND METHODS The sample comprised 734 adolescents (349 girls) aged 12-18 years from the LabMed Physical Activity Cohort Study. The variables of interest were measured in 2011 (baseline) and in 2013 (2-year follow-up). CRF was assessed by the 20-m shuttle run test. Body mass index, waist circumference, body fat percentage, pubertal status and resting BP were assessed according to standard procedures. Boot-strapped mediation procedures were performed, and indirect effects (IE) with confidence intervals (CI) not including zero were considered statistically significant. RESULTS After adjusting for potential confounders, body mass index acted as a mediator of the relationship between CRF and systolic BP (IE = -0. 023; CI = -0.039; -0.009), pulse pressure (IE = -0.023; CI = -0.034; -0.012) and rate product pressure (IE = -2.839; CI = -5.329; -0.340). Similar results were obtained for waist circumference as mediator for systolic BP (IE = -0.019; CI = -0.033; -0.005), pulse pressure (IE = -0.017; CI = -0.028; -0.007) and rate product pressure (IE = -3.793; CI = -6.097; -1.689). Likewise, body fat percentage mediated the association for: systolic BP (IE = -0.029; CI = -0.048; -0.010), pulse pressure (IE = -0.027; CI = -0.041; -0.013) and rate product pressure (IE = -4.280; CI = -7.488; -1.264). CONCLUSIONS Adiposity mediated the association between CRF and BP in adolescents. Therefore, both optimal CRF and adiposity levels are important to maintain normal BP ranges throughout adolescence.
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Affiliation(s)
- Maria Reyes Beltran-Valls
- LIFE Research Group, University Jaume I, Castellon, Spain.,Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal.,National Physical Activity Promotion Program, Directorate-General of Health, Porto, Portugal
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Carla Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Luís Lopes
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
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Perez-Bey A, Delgado-Alfonso A, Aadland E, Resaland GK, Martinez-Gomez D, Veiga OL, Ponce-Gonzalez JG, Castro-Piñero J. Fitness, waist circumference and their association with future blood pressure in youth: The UP&DOWN Longitudinal Study. J Sci Med Sport 2021; 24:573-579. [PMID: 33674186 DOI: 10.1016/j.jsams.2021.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 11/27/2020] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim was to determine the independent associations of muscular fitness (MF), cardiorespiratory fitness (CRF) and waist circumference (WC) with blood pressure (BP) levels over 2 years in children and adolescents. METHODS 1089 children (517 females) and 787 adolescents (378 females) with complete data on fitness, WC and BP (systolic [SBP] and diastolic [DBP]) were included. Upper MF was assessed through the handgrip strength test, and lower MF using the standing long jump test. The 20-m shuttle run test was used to assess CRF. WC was obtained following standardized methods. Different regression models were fitted by introducing fitness and WC at baseline and their changes as exposures and BP at follow-up and their changes as outcomes. RESULTS WC at baseline was positively and independently associated with each BP variable at follow-up in children and adolescents (β=0.094-0.260; p≤0.05), and CRF was negatively associated with DBP in adolescents (β=-0.096; p=0.034). WC changes were associated with BP variables 2 years later in children (β=0.121-0.142; p<0.01). In adolescents, changes in upper MF (β=-0.116; p=0.001) and WC (β=0.080-0.098; p<0.05) were associated with SBP at follow-up. WC changes were independently associated with changes in each BP variable in children (β=0.111-0.145; all p<0.05) and SBP changes in adolescents (β=0.103 to 0.117; all p<0.01). CONCLUSIONS WC, but neither MF nor CRF, is independently associated with BP and its changes over 2 years. The attainment or maintenance of optimal fatness levels in the pediatric population should be highly encouraged for the prevention of future hypertension.
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Affiliation(s)
- Alejandro Perez-Bey
- GALENO Research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA). Cádiz, Spain.
| | - Alvaro Delgado-Alfonso
- GALENO Research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Spain
| | - Eivind Aadland
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - Geir K Resaland
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
| | - David Martinez-Gomez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz, CIBER of Epidemiology and Public Health (CIBERESP), Spain; IMDEA Food Institute, CEI UAM+CSIC, Spain
| | - Oscar L Veiga
- Department of Physical Education, Sports and Human Movement, Faculty of Teacher Training and Education, Autonomous University of Madrid, Spain
| | - Jesus G Ponce-Gonzalez
- Biomedical Research and Innovation Institute of Cádiz (INiBICA). Cádiz, Spain; MOVE-IT Research group and Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Spain
| | - Jose Castro-Piñero
- GALENO Research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Spain; Biomedical Research and Innovation Institute of Cádiz (INiBICA). Cádiz, Spain
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35
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Batran A, Fashafsheh N, Ayed A, Salameh B. The Predictors of Hypertension in Children: Palestinian Perspective. SAGE Open Nurs 2021; 7:2377960820987424. [PMID: 35198732 PMCID: PMC8859658 DOI: 10.1177/2377960820987424] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/15/2020] [Accepted: 12/19/2020] [Indexed: 11/17/2022] Open
Abstract
Children with high blood pressure are much more likely than children with lower blood pressure to experience hypertension in adulthood. The purpose of this study was to determine the prevalence of hypertension and predictors of hypertension in Palestinian children. Method Cross-sectional study was performed on five hundred and nine (10–13) year old students from governmental schools in Jenin and Tubas. Anthropometric measures consist of body mass index, hip circumference (HC), waist circumference (WC), the ratio of waist to hip (WHR), and the ratio of waist to height (WHtR) were measured. Blood pressure was assessed including systolic (SBP) and diastolic (DBP) utilizing a (Dynamap) vital signs monitor. Results Approximately 38.7% of participants (38.8% females and 38.63% males) were considered pre-hypertensive and 7.3% of the participants (7.4% females and 7.1% males) were hypertensive. Also, there was a weak to moderate relationship between mean blood pressure (systolic and diastolic) and the anthropometric measurements. Additionally, most predictors with significant effects on early childhood hypertension were body mass index (OR 1.16, 95% CI 1.09–1.23). Conclusions Hypertension and prehypertension are present in Palestinian children. Waist hip ratio is the greatest predictor of BP, followed by body mass index. Hence, weight-reduction strategies to at-risk children are crucial to minimizing the prevalence of Palestinian childhood hypertension.
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Affiliation(s)
- Ahmad Batran
- Faculty of Nursing, Arab American University, Jenin, Palestine
| | | | - Ahmad Ayed
- Faculty of Nursing, Arab American University, Jenin, Palestine
| | - Basma Salameh
- Faculty of Nursing, Arab American University, Jenin, Palestine
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36
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Lukomskyj N, Allman-Farinelli M, Shi Y, Rangan A. Dietary exposures in childhood and adulthood and cardiometabolic outcomes: a systematic scoping review. J Hum Nutr Diet 2021; 34:511-523. [PMID: 33406314 DOI: 10.1111/jhn.12841] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/30/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023]
Abstract
Associations between diet and cardiometabolic outcomes are often based on a single measurement of diet in adulthood. Dietary exposures in childhood are thought to influence cardiometabolic disease development and individuals' diets can change over time, therefore dietary exposure in childhood and over long periods are both important to consider. This scoping review aimed to identify and characterise the literature on associations between diet measured in both childhood and adulthood and cardiometabolic outcomes. Seven databases were searched; eligible evidence sources were original analyses published as a journal article in English. Exposures included measures of dietary intake, diet quality and eating behaviours measured in both childhood and adulthood with at least five years between first and last measurements. Cardiometabolic outcomes included measures of anthropometry, biochemistry, vascular structure/function and disease states/scores. We identified 37 eligible articles from nine cohort studies. Dietary exposures were measured between two and eight times and most often assessed by food frequency questionnaire or diet history. The dietary exposures most frequently examined were protein, fat, carbohydrate, fruit, vegetables, sugar-sweetened beverages and breakfast. Cardiometabolic outcomes were predominantly based on risk markers. Authors utilised a variety of analytical approaches to transform and analyse repeated measures of diet, providing insights relevant to different lifespan nutrition concepts. The literature on associations between diet in childhood and adulthood and cardiometabolic outcomes is limited, but such studies have great potential to extend our knowledge in ways only possible with repeated measures of diet over time. Further research is needed to develop the evidence base for diet-disease relationships from a life course perspective, accounting for diet in both childhood and adulthood.
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Affiliation(s)
- Natalya Lukomskyj
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | | | - Yumeng Shi
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Anna Rangan
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
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Moin A, Mohanty N, Tedla YG, Carroll AJ, Padilla R, Langman CB, Smith JD. Under‐recognition of pediatric hypertension diagnosis: Examination of 1 year of visits to community health centers. J Clin Hypertens (Greenwich) 2020; 23:257-264. [PMID: 33373088 PMCID: PMC8030016 DOI: 10.1111/jch.14148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 11/29/2022]
Abstract
Pediatric hypertension is associated with significant target organ damage in children and cardiovascular morbidity in adulthood. Appropriate diagnosis and management per guideline recommendations are inconsistent. In this study, we determined the proportion of missed diagnosis of hypertension and prehypertension and appropriate follow‐up in pediatric patients, stratified by sex, age, race/ethnicity, and weight status. Based on the electronic health record (EHR) data from eight federally qualified health centers, among 62,982 children aged 3 to 18 years, 6233 (10%) had at least one abnormal blood pressure (BP) measurement over twelve months. Among those children whose recorded BPs met the criteria for prehypertension (N = 6178), 14.6% had a diagnosis in the EHR. These children were more likely to be White and have obesity compared with children who met the criteria but were not diagnosed with prehypertension. Among those who met the criteria for hypertension (N = 55), 41.8% had a diagnosis of hypertension in the EHR. Being diagnosed with hypertension was not associated with any examined patient characteristics. Over eleven months, 2837 children had BP ≥ 95th percentile on ≥ 1 visit. Only 13% had guideline‐adherent follow‐up within 1 month and were more likely to be older, female, and of Hispanic ethnicity or “other” race. Over six months, 2902 children had BP ≥ 90th percentile on one visit. 41% had guideline‐adherent follow‐up within 6 months and were more likely to be older, of either White, Hispanic, Asian race, or Hispanic ethnicity. In a community‐based setting, pediatric hypertension and prehypertension were persistently underdiagnosed with low adherence to recommended follow‐up.
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Affiliation(s)
- Anoosh Moin
- Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine Chicago IL USA
| | | | - Yacob G. Tedla
- Department of Medicine Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Allison J. Carroll
- Department of Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine Chicago IL USA
| | | | - Craig B. Langman
- Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Justin D. Smith
- Departments of Psychiatry and Behavioral Sciences Preventive Medicine Medical Social Sciences, and Pediatrics Northwestern University Feinberg School of Medicine Chicago IL USA
- Department of Population Health Sciences University of Utah School of Medicine Salt Lake City UT USA
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Bustos-Barahona R, Delgado-Floody P, Martínez-Salazar C. Lifestyle associated with physical fitness related to health and cardiometabolic risk factors in Chilean schoolchildren. ENDOCRINOL DIAB NUTR 2020; 67:586-593. [DOI: 10.1016/j.endinu.2020.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 01/13/2020] [Accepted: 02/07/2020] [Indexed: 10/24/2022]
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Skapino E, Rupérez AI, Restrepo-Mesa S, Araújo-Moura K, De Moraes AC, Barbosa Carvalho H, Aristizabal JC, Moreno LA. Height-based equations as screening tools for elevated blood pressure in the SAYCARE study. J Clin Hypertens (Greenwich) 2020; 22:2221-2229. [PMID: 33125808 DOI: 10.1111/jch.14087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/22/2020] [Accepted: 10/07/2020] [Indexed: 12/01/2022]
Abstract
This study evaluated the accuracy of four height-based equations: blood pressure to height ratio (BPHR), modified BPHR (MBPHR), new modified BPHR (NMBPHR), and height-based equations (HBE) for screening elevated BP in children and adolescents in the SAYCARE study. We measured height and BP of 829 children and adolescents from seven South American cities. Receiving operating curves were used to assess formula performance to diagnose elevated BP in comparison to the 2017 clinical guideline. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated for the four screening formulas. The diagnostic agreement was evaluated with the kappa coefficient. The HBE equation showed the maximum sensitivity (100%) in children, both for boys and girls, and showed the best performance results, with a very high NPV (>99%) and high PPV (>60%) except for female children (53.8%). In adolescents, the highest sensitivity (100%) was achieved with the NMBPHR for both sexes. Kappa coefficients indicated that HBE had the highest agreement with the gold standard diagnostic method (between 0.70 and 0.75), except for female children (0.57). Simplified methods are friendlier than the percentile gold standard tables. The HBE equation showed better performance than the other formulas in this Latin American pediatric population.
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Affiliation(s)
- Estela Skapino
- Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay.,Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza
| | - Azahara Iris Rupérez
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza.,Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain
| | - Sandra Restrepo-Mesa
- Food and Human Nutrition Research Group, School of Nutrition and Dietetics, University of Antioquia, Medellín, Colombia
| | - Keisyanne Araújo-Moura
- Graduate Program in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil.,Department of Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil.,YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Augusto César De Moraes
- Graduate Program in Public Health, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil.,Department of Epidemiology, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil.,YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Heráclito Barbosa Carvalho
- YCARE (Youth/Child cArdiovascular Risk and Environmental) Research Group Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Juan Carlos Aristizabal
- Grupo de Investigación en Fisiología y Bioquímica (PHYSIS), Escuela de Nutrición y Dietética, Universidad de Antioquia, Medellín, Colombia
| | - Luis Alberto Moreno
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Universidad de Zaragoza, Zaragoza.,Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), University of Zaragoza, Zaragoza, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
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40
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García-Hermoso A, Ramírez-Vélez R, García-Alonso Y, Alonso-Martínez AM, Izquierdo M. Association of Cardiorespiratory Fitness Levels During Youth With Health Risk Later in Life: A Systematic Review and Meta-analysis. JAMA Pediatr 2020; 174:952-960. [PMID: 32870243 PMCID: PMC7489376 DOI: 10.1001/jamapediatrics.2020.2400] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
IMPORTANCE Although the associations between cardiorespiratory fitness (CRF) and health in adults are well understood, to date, no systematic review has quantitatively examined the association between CRF during youth and health parameters later in life. OBJECTIVES To examine the prospective association between CRF in childhood and adolescence and future health status and to assess whether changes in CRF are associated with future health status at least 1 year later. DATA SOURCES For this systematic review and meta-analysis, MEDLINE, Embase, and SPORTDiscus electronic databases were searched for relevant articles published from database inception to January 30, 2020. STUDY SELECTION The following inclusion criteria were used: CRF measured using a validated test and assessed at baseline and/or its change from baseline to the end of follow-up, healthy population with a mean age of 3 to 18 years at baseline, and prospective cohort design with a follow-up period of at least 1 year. DATA EXTRACTION AND SYNTHESIS Data were processed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Random-effects models were used to estimate the pooled effect size. MAIN OUTCOMES AND MEASURES Anthropometric and adiposity measurements and cardiometabolic health parameters. RESULTS Fifty-five studies were included with a total of 37 563 youths (46% female). Weak-moderate associations were found between CRF at baseline and body mass index (r = -0.11; 95% CI, -0.18 to -0.04; I2 = 59.03), waist circumference (r = -0.29; 95% CI, -0.42 to -0.14; I2 = 69.42), skinfold thickness (r = -0.34; 95% CI, -0.41 to -0.26; I2 = 83.87), obesity (r = -0.15; 95% CI, -0.23 to -0.06; I2 = 86.75), total cholesterol level (r = -0.12; 95% CI, -0.19 to -0.05; I2 = 75.81), high-density lipoprotein cholesterol (HDL-C) level (r = 0.11; 95% CI, 0.05-0.18; I2 = 69.06), total cholesterol to HDL-C ratio (r = -0.19; 95% CI, -0.26 to -0.13; I2 = 67.07), triglyceride levels (r = -0.10; 95% CI, -0.18 to -0.02; I2 = 73.43), homeostasis model assessment for insulin resistance (r = -0.12; 95% CI, -0.18 to -0.06; I2 = 68.26), fasting insulin level (r = -0.07; 95% CI, -0.11 to -0.03; I2 = 0), and cardiometabolic risk (r = -0.18; 95% CI, -0.29 to -0.07; I2 = 90.61) at follow-up. Meta-regression analyses found that early associations in waist circumference (β = 0.014; 95% CI, 0.002-0.026), skinfold thickness (β = 0.006; 95% CI, 0.002-0.011), HDL-C level (β = -0.006; 95% CI, -0.011 to -0.001), triglyceride levels (β = 0.009; 95% CI, 0.004-0.014), and cardiometabolic risk (β = 0.007; 95% CI, 0.003-0.011) from baseline to follow-up dissipated over time. Weak-moderate associations were found between change in CRF and body mass index (r = -0.17; 95% CI, -0.24 to -0.11; I2 = 39.65), skinfold thickness (r = -0.36; 95% CI, -0.58 to -0.09; I2 = 96.84), obesity (r = -0.21; 95% CI, -0.35 to -0.06; I2 = 91.08), HDL-C level (r = 0.05; 95% CI, 0.02-0.08; I2 = 0), low-density lipoprotein cholesterol level (r = -0.06; 95% CI, -0.11 to -0.01; I2 = 58.94), and cardiometabolic risk (r = -0.08; 95% CI, -0.15 to -0.02; I2 = 69.53) later in life. CONCLUSIONS AND RELEVANCE This study suggests that early intervention and prevention strategies that target youth CRF may be associated with maintaining health parameters in later life.
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Affiliation(s)
- Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra, Universidad Pública de Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Facultad de Ciencias Médicas, Universidad de Santiago de Chile, Santiago, Chile
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Complejo Hospitalario de Navarra, Universidad Pública de Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Yesenia García-Alonso
- Navarrabiomed, Complejo Hospitalario de Navarra, Universidad Pública de Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Alicia M. Alonso-Martínez
- Navarrabiomed, Complejo Hospitalario de Navarra, Universidad Pública de Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra, Universidad Pública de Navarra, Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
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Patel SS, Daniels SR. Beginning With the End in Mind: The Case for Primordial and Primary Cardiovascular Prevention in Youth. Can J Cardiol 2020; 36:1344-1351. [DOI: 10.1016/j.cjca.2020.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 11/29/2022] Open
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Negative feelings and behaviour are associated with low nutritional level, unhealthy lifestyle, and cardiometabolic risk factors in Chilean schoolchildren. NUTR HOSP 2020; 37:707-714. [PMID: 32720504 DOI: 10.20960/nh.03086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: feelings and behaviours are an important tool that should be considered to prevent early unhealthy lifestyles. Objective: the objective was to determine the association between feelings (i.e., sadness, loneliness, and school behaviour) with lifestyle (i.e., physical activity patterns and nutritional level), and as secondary endpoint to determine the relationship between health-related quality of life (HRQoL) and lifestyle with obesity and cardiometabolic risk (CMR) factors in Latin American schoolchildren. Methods: this cross-sectional study included a sample of 634 schoolchildren (girls, n = 282, 11.86 ± 0.82 years, and boys, n = 352, 12.02 ± 0.87 years) from publics schools in Chile. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), body fat (BF), lifestyle, nutritional level, HRQoL, and CMR (i.e., WtHR > 0.5) were evaluated. Results: schoolchildren who have felt sadness and loneliness presented an association with low nutritional level (OR: 4.26, 95 % CI: 2.0-9.0, p < 0.001, and OR: 4.47, 95 % CI: 2.5-7.9, p < 0.001, respectively), bad lifestyle (OR: 2.14, 95 % CI: 1.0-4.54, p = 0.048, and OR: 1.78, 95 % CI: 1.01-3.1, p = 0.045, respectively), and obesity (OR: 2.0, 95 % CI; 0.89-4.54, p = 0.09, and OR: 2.05, 95 % CI; 1.04-4.0, p = 0.037, respectively). Schoolchildren who have had enough time for themselves reported an association with bad lifestyle (OR: 0.69, 95 % CI: 0.47-1.02, p = 0.06), and those who have could not pay attention presented the highest association with bad lifestyle (OR: 4.64, 95 % CI: 72-12.56, p = 0.002). Conclusion: Latin American schoolchildren who have felt sadness and loneliness reported unhealthy lifestyles (i.e., lower nutritional level, increased screen time, and low physical activity), obesity, and thus a higher CMR burden.
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dos Santos EDSG, de Souza OF. EVIDENCE OF THE ASSOCIATION BETWEEN SLEEP DURATION AND BLOOD PRESSURE IN ADOLESCENTS: A SYSTEMATIC REVIEW. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2020; 39:e2019225. [PMID: 32785432 PMCID: PMC7409100 DOI: 10.1590/1984-0462/2021/39/2019225] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/27/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To review the epidemiological evidence of the association between sleep duration and blood pressure in adolescents. DATA SOURCES We performed a systematic review of observational studies in Medline, Scopus, Lilacs, Web of Science, Science Direct databases and Virtual Libraries in English, Spanish and Portuguese published until September 2018. Studies were selected first by title and abstract, then by complete reading, according to the eligibility criteria. The reference list of selected articles was evaluated in order to retrieve relevant studies. DATA SYNTHESIS Initially, 1,455 articles were retrieved. After exclusion due to duplicity or not meeting the eligibility criteria, 13 articles were included in the review. Studies varied greatly in sample size (143 to 6,940 patients), methods of measuring blood pressure and sleep duration, cutoff points, categorization and adjustment of variables. The main evidence from the studies is that short sleep duration is associated with high blood pressure in adolescence, although the presence of association between high blood pressure and long sleep duration is possible, but not clear in the literature. CONCLUSIONS Sleep duration, especially short duration, is associated with high blood pressure in adolescents. Such evidence draws attention to implications on cardiovascular health in this age group.
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Elevated blood pressure in childhood and hypertension risk in adulthood: a systematic review and meta-analysis. J Hypertens 2020; 38:2346-2355. [DOI: 10.1097/hjh.0000000000002550] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Arango-Paternina CM, Lobelo F, Páez-Rubiano DC, Petro-Petro JA, Llano-Garcia M, Duperly-Sanchez J, Parra D. Association between high blood pressure and fitness and fatness in adolescents. REVISTA DE LA FACULTAD DE MEDICINA 2020. [DOI: 10.15446/revfacmed.v68n3.77559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Excess adiposity is considered the most important risk factor for high blood pressure (HBP) in children and adolescents.Objectives: To explore the association between HBP and overweight (OW) and abdominal obesity (AO), mediated by cardiorespiratory fitness (CRF). To analyze the combined effect of excess adiposity and CRF on HBP among a sample of school-aged children from Montería, Colombia.Materials and methods: Cross-sectional study conducted in a sample of 546 adolescents aged between 11 and 18 years, from 14 randomly selected schools in Montería. Blood pressure, anthropometric, and fitness measures were evaluated by trained personnel using standardized protocols and instrumentation. The association of HBP with fitness and fatness was analyzed using logistic regression models.Results: HBP was associated with OW, AO and low CRF. The inclusion of CRF in this model did not attenuate the association between HBP and OW and between HPB and AO. Adolescents with higher adiposity and low CRF were more likely to have HBP compared with those with lower adiposity and high CRF. Moreover, it was found that excess adiposity and low CRF had an additive effect on the risk of HBP among the sample.Conclusion: HBP is a prevalent condition in children and adolescents from Montería, Colombia. HBP is significantly associated with OW, AO, and low CRF; therefore, it is necessary to implement initiatives to promote healthy habits aimed at this population in order to reduce the incidence rate of HBP in Colombian adolescents.
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Mansell T, Burgner D, Ponsonby AL, Collier F, Pezic A, Vuillermin P, Juonala M, Ryan J, Saffery R. HIF3A cord blood methylation and systolic blood pressure at 4 years - a population-based cohort study. Epigenetics 2020; 15:1361-1369. [PMID: 32530724 DOI: 10.1080/15592294.2020.1781027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Methylation levels at the hypoxia-inducible factor 3α gene (HIF3A) in blood have been linked to body mass index (BMI) in adults. Despite evidence implicating HIF3A in angiogenesis and metabolism, no studies have examined links between HIF3A methylation in early life and cardiovascular health. Here, we investigated the relationship between HIF3A methylation in blood at birth and 12 months of age with cardiovascular measures at 4 years. We also examined influences of prenatal exposures, birth outcomes, and genetic variation. Methylation of two HIF3A promoter regions in cord blood was measured using Sequenom EpiTYPER mass-spectrometry. The first promoter region was also measured in 12-month blood. Four-year cardiovascular measures included blood pressure, pulse wave velocity, and aortic and carotid intima-media thickness. Associations were tested using partial correlation tests and linear regression modelling. Methylation of the first HIF3A promoter in cord and 12-month blood was not associated with four-year measures. There was modest evidence of an association between DNA methylation at the second HIF3A promoter in cord blood and four-year systolic blood pressure (n = 353, r = 0.12, p = 0.03). In sex-stratified analysis, methylation of the second promoter was modestly associated with systolic and diastolic blood pressure (r = 0.16, p = 0.03 for both) in males only. In conclusion, HIF3A methylation at birth shows some evidence of an association with later blood pressure in childhood. Further work should determine whether this relationship persists into later childhood, and should assess potential functional links between HIF3A methylation and cardiovascular health more generally.
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Affiliation(s)
- Toby Mansell
- Murdoch Children's Research Institute , Parkville, Australia.,Department of Paediatrics, University of Melbourne , Parkville, Australia
| | - David Burgner
- Murdoch Children's Research Institute , Parkville, Australia.,Department of Paediatrics, University of Melbourne , Parkville, Australia.,Department of Paediatrics, Monash University , Clayton, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute , Parkville, Australia.,Department of Paediatrics, University of Melbourne , Parkville, Australia.,Neuroepidemiology Research Group, The Florey Institute of Neuroscience and Mental Health , Parkville, Australia
| | - Fiona Collier
- Murdoch Children's Research Institute , Parkville, Australia.,School of Medicine, Deakin University , Geelong, Australia.,Child Health Research Unit, Barwon Health , Geelong, Australia
| | - Angela Pezic
- Murdoch Children's Research Institute , Parkville, Australia
| | - Peter Vuillermin
- Murdoch Children's Research Institute , Parkville, Australia.,School of Medicine, Deakin University , Geelong, Australia.,Child Health Research Unit, Barwon Health , Geelong, Australia
| | - Markus Juonala
- Murdoch Children's Research Institute , Parkville, Australia.,Department of Medicine, University of Turku , Turku, Finland.,Division of Medicine, Turku University Hospital , Turku, Finland
| | - Joanne Ryan
- Murdoch Children's Research Institute , Parkville, Australia.,School of Public Health & Preventive Medicine, Monash University , Melbourne, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute , Parkville, Australia.,Department of Paediatrics, University of Melbourne , Parkville, Australia
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Smith JD, Mohanty N, Davis MM, Knapp AA, Tedla YG, Carroll AJ, Price HE, Villamar JA, Padilla R, Jordan N, Brown CH, Langman CB. Optimizing the implementation of a population panel management intervention in safety-net clinics for pediatric hypertension (The OpTIMISe-Pediatric Hypertension Study). Implement Sci Commun 2020; 1:57. [PMID: 32835224 PMCID: PMC7386167 DOI: 10.1186/s43058-020-00039-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/29/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Though clinical practice guidelines are available, the diagnosis of pediatric hypertension (HTN) is often missed. Management may not follow guidelines due to the measurement challenges in children, complexity of interpreting youth blood pressure standards that are dependent on height, age, and sex, familiarity with diagnostic criteria, and variable comfort with management of pediatric HTN among providers. Evidence suggests that wide adoption and adherence to pediatric HTN guidelines would result in lower cardiovascular disease and kidney damage in adulthood. The proposed project will develop an implementation strategy package to increase adherence to clinical practice guidelines for pediatric HTN within safety-net community health centers (CHCs). The centerpiece of which is a provider-facing population panel management (PPM) tool and point-of-care clinical decision support (CDS). Prior research indicates that multiple discrete implementation strategies (e.g., stakeholder involvement, readiness planning, training, ongoing audit and feedback) are needed to institute practice- and provider-level adoption of such tools. METHODS Using participatory research methods involving stakeholders from a practice-based research network of CHCs, with input from scientific advisors, the project aims to (1) employ user-centered design methods to tailor an existing CDS tool for use at the point of care and optimize cohort management with a PPM tool to support adherence to the latest pediatric HTN guidelines, and (2) use a stakeholder-driven method for selecting implementation strategies that support tool adoption and increase guideline-adherent physician behaviors. Multilevel process evaluation using surveys and key informant interview data will assess the acceptability, adoption, appropriateness, cost, and feasibility of the PPM tool and its multicomponent implementation strategy package. Usability testing will be conducted with the PPM tool to iteratively refine features and ensure proper functionality. DISCUSSION The proposed research has the potential to improve identification, diagnosis, and management of HTN in primary care settings for high-risk youth by assisting healthcare providers in implementing the American Academy of Pediatrics' 2017 guidelines using an EHR-integrated PPM tool with CDS. Should the strategy package for PPM tool adoption be successful for pediatric HTN, findings will be translatable to other settings and PPM of other chronic cardiovascular conditions affecting overall population health.
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Affiliation(s)
- Justin D. Smith
- Departments of Psychiatry and Behavioral Sciences, Preventive Medicine, Medical Social Sciences, and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Nivedita Mohanty
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Matthew M. Davis
- Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, and Departments of Pediatrics, Medicine, Medical Social Sciences, and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Ashley A. Knapp
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Yacob G. Tedla
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Allison J. Carroll
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Heather E. Price
- Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago and Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Juan A. Villamar
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Roxane Padilla
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Neil Jordan
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - C. Hendricks Brown
- Departments of Psychiatry and Behavioral Sciences, Preventive Medicine, and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL USA
| | - Craig B. Langman
- Ann & Robert H. Lurie Children’s Hospital of Chicago and Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL USA
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Leopold S, Zachariah JP. Pediatric Obesity, Hypertension, Lipids. CURRENT TREATMENT OPTIONS IN PEDIATRICS 2020; 6:62-77. [PMID: 33457188 PMCID: PMC7810340 DOI: 10.1007/s40746-020-00188-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The rise of the pediatric obesity pandemic over the past 40 years has sharpened focus on the management of obesity, hypertension and lipid abnormalities in children. Multiple studies demonstrate that these risk factors track from childhood into adulthood predisposing individuals to premature atherosclerotic cardiovascular disease and putting them at risk for early morbidity and mortality. RECENT FINDINGS Importantly, obesity, hypertension and lipid problems are individual risk factors that can occur independently. Multiple studies have shown that each risk factor causes target organ damage in children. Intensive and focused lifestyle modifications can improve a child's subclinical disease and decrease the risk for future morbidity. SUMMARY Childhood offers a unique opportunity at primordial and primary prevention of atherosclerotic cardiovascular disease. Clinicians must focus on targeting these highly prevalent conditions and applying lifestyle modification and then pharmacologic or surgical therapies as needed.
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Affiliation(s)
- Scott Leopold
- Section of Pediatric Cardiology, Texas Children's Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Justin P Zachariah
- Section of Pediatric Cardiology, Texas Children's Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, TX
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Hessey E, Perreault S, Roy L, Dorais M, Samuel S, Phan V, Lafrance JP, Zappitelli M. Acute kidney injury in critically ill children and 5-year hypertension. Pediatr Nephrol 2020; 35:1097-1107. [PMID: 32162099 DOI: 10.1007/s00467-020-04488-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/03/2020] [Accepted: 01/22/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND To develop a pediatric-specific hypertension algorithm using administrative data and use it to evaluate the association between acute kidney injury (AKI) in the intensive care unit (ICU) and hypertension diagnosis 5 years post-discharge. METHODS Two-center retrospective cohort study of children (≤ 18 years old) admitted to the pediatric ICU in Montreal, Canada, between 2003 and 2005 and followed until 2010. Patients with a valid healthcare number and without end-stage renal disease were included. Patients who could not be merged with the provincial database, did not survive admission, underwent cardiac surgery, had pre-existing renal disease associated with hypertension or a prior diagnosis of hypertension were excluded. AKI defined using the Kidney Disease: Improving Global Outcomes (KDIGO) definition. Using diagnostic codes and medications from administrative data, novel pediatric-specific hypertension definitions were designed. Both the evaluation of the prevalence of hypertension diagnosis and the association between AKI and hypertension occurred. RESULTS Nineteen hundred and seventy eight patients were included (median age at admission [interquartile range] 4.3 years [1.1-11.8], 44% female, 325 (16.4%) developed AKI). Of these patients, 130 (7%) had a hypertension diagnosis 5 years after discharge. Patients with AKI had a higher prevalence of hypertension diagnosis [non-AKI: 84/1653 (5.1%) vs. AKI: 46/325 (14.2%), p < .001]. Children with AKI had a higher adjusted risk of hypertension diagnosis (hazard ratio [95% confidence interval] 2.19 [1.47-3.26]). CONCLUSIONS Children admitted to the ICU have a high prevalence of hypertension post-discharge and children with AKI have over two times higher risk of hypertension compared to those with no AKI.
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Affiliation(s)
- Erin Hessey
- Department of Pediatrics, Division of Nephrology, Montreal Children's Hospital, McGill University Health Centre, Montreal, Québec, Canada.,Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Sylvie Perreault
- Faculty of Pharmacy, Université de Montréal, Montréal, Québec, Canada
| | - Louise Roy
- Department of Medicine, Division of Nephrology, Université de Montréal, Montreal, Québec, Canada
| | - Marc Dorais
- StatSciences Inc, Notre-Dame-de-l'Île-Perrot, Québec, Canada
| | - Susan Samuel
- Department of Pediatrics, Division of Nephrology, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Véronique Phan
- Department of Pediatrics, Division of Nephrology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Québec, Canada
| | - Jean-Philippe Lafrance
- Department of Medicine, Division of Nephrology, Hôpital Maisonneuve-Rosemont, Montreal, Québec, Canada.,Department of Pharmacology and Physiology, Université de Montréal, Montreal, Québec, Canada
| | - Michael Zappitelli
- Department of Pediatrics, Division of Nephrology, Montreal Children's Hospital, McGill University Health Centre, Montreal, Québec, Canada. .,Department of Pediatrics, Division of Nephrology, Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, 6th floor, Room 06.9708, Toronto, ON, M5G 0A4, Canada.
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50
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Fang Z, Chen C, Wang H, Tang K. Association Between Fetal Exposure to Famine and Anthropometric Measures in Adulthood: A Regression Discontinuity Approach. Obesity (Silver Spring) 2020; 28:962-969. [PMID: 32157821 DOI: 10.1002/oby.22760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 01/13/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the differences in six anthropometric measurements of people born during and immediately after the 1959 to 1961 Great Chinese Famine using a regression discontinuity approach. METHODS Data were drawn from the baseline of the China Kadoorie Biobank study, and a subset of data from 76,912 participants was analyzed. We performed regression discontinuity among participants who were born during the famine (October 1959 to October 1962) and immediately after the famine period (November 1962 to October 1964) by using local linear and parametric regressions. All analyses were conducted by sex and study area. RESULTS Significantly, there were increases of 0.30 kg/m2 (P = 0.007) in BMI, 0.81 kg (P = 0.028) in weight, 8.57 mm (P = 0.004) in waist circumference, and 5.07 mm (P = 0.004) in hip circumference for rural women who were exposed to famine during their fetal period compared with those who were not exposed to famine in utero. However, such statistically significant increases in anthropometric values were not observed in local linear regression and most parametric models among rural men or in the urban population. CONCLUSIONS Rural Chinese women who were exposed to famine during the fetal period were observed to have higher levels of BMI, weight, waist circumference, and hip circumference in adulthood.
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Affiliation(s)
- Zhe Fang
- Research Center for Public Health, Tsinghua University, Beijing, China
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Chuanbo Chen
- School of Agriculture Economics and Rural Development, Renmin University of China, Beijing, China
| | - Hanyu Wang
- School of Health Humanities, Peking University, Beijing, China
| | - Kun Tang
- Research Center for Public Health, Tsinghua University, Beijing, China
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