Presión arterial en la infancia y la adolescencia. Estudio de su relación con variables de crecimiento y maduración

Prevalencia de obesidad y tendencia de los factores de riesgo cardiovascular en escolares de 1992 a 2004: estudio de Cuenca

BACKGROUND AND OBJECTIVE

The assess the prevalence of overweight and obesity in school children from the province of Cuenca in 2004, and to examine changes in the main cardiovascular risk factors in school children from the city of Cuenca from 1992 through 2004.

SUBJECTS AND METHOD

Cross sectional survey of 1166 schoolchildren 9-10 years old from 22 public schools of the province of Cuenca. We also analyzed data from 3 earlier, methodologically similar, cross-sectional surveys of school children from the city of Cuenca carried out in 1992, 1996 and 1998.

RESULTS

In 2004, among children aged 9-10 years from the province of Cuenca, 22.0% (95% confidence interval [CI], 19.53-24.37) were overweight and 8.8% (95% CI, 7.16-10.50) were obese. From 1992 through 2004, among children aged 9-10 years from the city of Cuenca, we registered a 12.2% absolute increase in the prevalence of overweight or obesity among males, which did no reach statistical significance (p > 0.05). Among women, changes in body mass index were of lower magnitude and with no statistical significance. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased (p < 0.05) in both sexes, with a greater decline in females. Among the latter, SBP decreased -9.22 mmHg (95% CI, -7.0 to -11.5) and DBP -5.9 mmHg (95% CI, -4.23 to -7.50). Non high density lipoproteins-cholesterol decreased among males (-18.1 mg/dl; 95% CI, -26.0 to -10.1 mg/dl) and among females (-23.7 mg/dl; 95% CI, -30.8 to -16.6 mg/dl). High density lipoproteins-cholesterol increased 6.3 mg/dl (95% CI, 2.6-10.0 mg/dl) in males and 5.1 mg/dl (95% CI, 1.9-8.2 mg/dl) in females. Triglycerides did not show substantial changes over the study period.

CONCLUSIONS

Prevalence of overweight or obesity in schoolchildren of Cuenca is among the highest in Europe. From 1992 through 2004 in the city of Cuenca, frequency of overweight or obesity might have increased among males, while blood pressure and the lipid profile improved in both sexes.

Agrupamiento de factores de riesgo cardiovascular en hijos obesos de padres con hipertensión esencial

INTRODUCTION

The prevalence of obesity in industrialized countries is increasing and is closely related to essential hypertension (EHT) in adolescents.

OBJECTIVE

To analyze the prevalence of obesity and its association with other known cardiovascular risk factors in a sample of children and young adults with at least one parent with EHT.

METHODS

The EHT group consisted 51 children and young adults (28 males [aged 5.4-25.6 years]) with at least one parent with EHT. The control group comprised 73 healthy normotensive children and young adults (43 males [aged 7.2-25.2 years]) who completed the follow-up visits of the RICARDIN study. Blood pressure (BP) was measured with a standardized technique using a mercury sphygmomanometer. A 12-hour fasting blood sample was taken for lipid profile and high sensitivity C-reactive protein (CRP) determinations. Financial support: FIS 03/0350, ESV Foundation Grant, 2003.

RESULTS

The prevalence of obesity was five times higher in the EHT group than in controls (19.6% vs. 4.1%, p = 0.007). In this group, obese subjects showed higher systolic BP (122.0 vs. 110.4 mmHg p = 0.004) and lower high-density lipoprotein cholesterol (HDL-C) levels (47.6 vs. 58.0 mg/dl, p < 0.05). After adjustment for age and systolic BP, obese subjects in the EHT group showed significantly higher CRP values than non-obese subjects in this group (p = 0.024).

CONCLUSIONS

The prevalence of obesity is higher in the offspring of parents with EHT than in non HT-prone subjects. Clustering of other additional risk factors indicates the need for high-risk preventive interventions in this group of children and young adults.

Maternal pregnancy vomiting and offspring salt taste sensitivity and blood pressure

The purpose of this study was to investigate the relationship between salt taste perception and blood pressure (BP) in normotensive adolescents as modified by maternal fluid losses during the first trimester of gestation. Seventy-two healthy adolescents (42 boys) aged between 9.0-21.1 years, recruited from the population-based RICARDIN study, were included. A maternal questionnaire about the duration of pregnancy, birth weight and vomiting or diarrhoea in the first trimester of gestation was collected. The sample was categorized into: "vomiter descendents", those whose mother reported significant vomiting in the first trimester of gestation and "non-vomiter descendents" the remaining. Height, weight, and standardised BP measurement were recorded. Salt gustatory performance was assessed using a behavioral sensitivity test to determine the lower NaCl gustatory threshold, and a behavioral discrimination test, measuring the ability to distinguish among different saline solutions. Salt taste sensitivity showed a significant correlation with systolic BP (SBP) in "vomiter descendents" ( r = -0.66; P =0.003), but not in "non-vomiter descendents". Adjusted by gender, and actual height and weight, salt sensitivity performance remained significantly related to SBP. An association between descendents' SBP and maternal vomiting during gestation exists, adding a new element of evidence to the "Barker hypothesis".

Blood pressure relates to sodium taste sensitivity and discrimination in adolescents

To investigate salt perception and discrimination and their possible association with blood pressure (BP), 72 healthy adolescents (42 boys) aged 9-21 years (mean 16.1 years) were studied. BP was measured with a standardized technique. Anthropometric measurement and conventional renal function tests were performed. Sensitivity tests to recognize the presence of salt when given simultaneously distilled/deionized water and a low sodium concentration water solution, and discrimination tests consisting of six graded samples of different saline solutions presented in randomized order were used to assess individual gustatory sensitivity. Average systolic BP values were 113.2+/-1.6 mmHg in boys and 109.6+/-1.9 mmHg in girls. Mean threshold level for salt sensitivity was 4.55+/-0.6 mmol/l. Systolic BP and salt sensitivity showed a significant correlation ( r=-0.33, P<0.01) even when adjusting for weight. Discrimination score was correlated with salt sensitivity ( r=0.27, P<0.05). There is a significant association between gustatory perception and BP in Spain adolescents, although a real cause-effect relationship has not been established.