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Baker-Smith CM. Tracking of blood pressure levels from childhood. Pediatr Nephrol 2024:10.1007/s00467-024-06485-4. [PMID: 39196350 DOI: 10.1007/s00467-024-06485-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 08/29/2024]
Abstract
The overall goal of this review is to summarize what is currently known regarding the tracking of blood pressure levels from early childhood into later adulthood and to describe the factors contributing to increased hypertension prevalence across the lifespan. This review describes 4 theoretical constructs of blood pressure trajectory across the lifespan: forward development, forward tracking, forward reversal, and maintenance of normal blood pressure levels.
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Affiliation(s)
- Carissa M Baker-Smith
- Nemours Center for Cardiovascular Research and Innovation, Nemours Cardiac Center, Nemours Children's Health, Preventive Cardiology Program, 1600 Rockland Road, Wilmington, DE, 19803, USA.
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Lan X, Wang Z, Zeng Z, Yao H, Xu W, Zhang Y. Association of Different Combinations of ALDH2 rs671, APOE rs429358, rs7412 Polymorphisms with Hypertension in Middle-Aged and Elderly People: A Case-Control Study. Int J Gen Med 2023; 16:915-927. [PMID: 36938306 PMCID: PMC10017832 DOI: 10.2147/ijgm.s402437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023] Open
Abstract
Background Hypertensive patients have a younger trend, and studies on the role of genetic factors in hypertension susceptibility have been inconsistent. Aldehyde dehydrogenases 2 (ALDH2) and apolipoprotein E (APOE) are involved in the pathophysiological processes of hypertension. To investigate the relationship of ALDH2 and APOE polymorphisms with hypertension in middle-aged (30-59 years old) and elderly (≥60 years old) persons. Methods Two thousand six hundred and ten hypertensive patients and 1921 controls were included (between 30 and 100 years old). The genotypes of common polymorphisms in APOE and ALDH2 genes (APOE rs429358, rs7412, and ALDH2 rs671) of the subjects were analyzed by polymerase-chain reaction (PCR)-microarray. Statistical analyses (Student's t-test, Mann-Whitney U-test, χ 2 test, and logistic regression analysis) were performed with SPSS v21.0. Results There were 4531 participants (66.60 ± 12.10 years old) in this study, including 3057 (67.5%) males and 1474 (32.5%) females. There were no significant differences in distributions of ALDH2 rs671, APOE rs429358/rs7412 genotypes and alleles between hypertensive patients and controls. Persons with ALDH2 rs671 G/A or A/A genotype were less likely to have hypertension (G/A+A/A vs G/G: gender-, age-, smoking-, and drinking-adjusted OR 0.885, 95% CI 0.785-0.997, P=0.045), while ALDH2 rs671 A/A+APOE rs429358 or rs7412 wild-type genotype may decrease the risk of hypertension. In middle-aged group, ALDH2 rs671 G/A+APOE rs429358 T/C carriers (adjusted OR 0.547, 95% CI 0.350-0.856, P=0.008), and ALDH2 rs671 A/A+APOE rs7412 C/C genotypes (adjusted OR 0.567, 95% CI 0.361-0.891, P=0.014) were less likely to have hypertension. In elderly group, APOE rs7412 T/T carriers were more likely to have hypertension (rs671 T/T vs C/C: adjusted OR 4.755, 95% CI 1.075-21.027, P=0.040; rs671 T/T vs C/C or C/T: adjusted OR 4.734, 95% CI 1.071-20.928, P=0.040). Conclusion Polymorphism-polymorphism interactions of ALDH2 rs671 and APOE rs429358/rs7412 may effect on hypertension susceptibility. Different genotypes comparison shows different roles in middle-aged and elderly people, respectively.
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Affiliation(s)
- Xinping Lan
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, People’s Republic of China
- Correspondence: Xinping Lan, Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, No. 63 Huangtang Road, Meijiang District, Meizhou, People’s Republic of China, Tel +753-2131-057, Email
| | - Zhenchang Wang
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, People’s Republic of China
- Department of Emergency Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
| | - Zifeng Zeng
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, People’s Republic of China
| | - Huaqing Yao
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, People’s Republic of China
| | - Weiyong Xu
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, People’s Republic of China
| | - Yuxian Zhang
- Center for Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China
- Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, People’s Republic of China
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Jang S, Kim ST, Kim YK, Song YH. Association of blood pressure and hypertension between parents and offspring: The Korea National Health and Nutrition Examination Survey. Hypertens Res 2023; 46:368-376. [PMID: 36460831 PMCID: PMC9899689 DOI: 10.1038/s41440-022-01089-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/27/2022] [Accepted: 10/11/2022] [Indexed: 12/04/2022]
Abstract
As the number of hypertension cases in the pediatric population is growing, we aimed to investigate the parent-offspring association of hypertension in Korea. We performed a cross-sectional analysis using the data of children and adolescents aged 10-18 years and their parents extracted from the Korea National Health and Nutrition Examination Survey (2008-2018). We analyzed the correlation of blood pressure (BP) between offspring and their parents and investigated the odds ratio (OR) of having hypertension in offspring based on parental hypertensive status. A total of 3996 children and adolescents (2224 boys and 1772 girls) aged 10-18 years and their parents (3197 fathers and 3197 mothers) were evaluated. Both boys and girls had positive associations with both parents for systolic and diastolic BP. When neither parent, only the father, only the mother, or both parents were hypertensive, 6.6%, 10.4%, 13.3%, and 25.3% of boys and 6%, 12%, 12.7%, and 22.1% of girls had hypertension, respectively. The risk of having hypertension among offspring was approximately two times higher when one parent was hypertensive and over four times higher when both parents were hypertensive compared to that among controls whose parents were not hypertensive (OR: 2.230, 1.655, and 5.021 in boys with hypertension and 2.321, 2.169, and 4.554 in girls with hypertension in the mother only, the father only, and both parents, respectively). We identified familial aggregation of hypertension in Korea. As there was an increased likelihood of having hypertension in children with parental hypertension, parental hypertension may be utilized as a screening tool for hypertension in children.
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Affiliation(s)
- Seoyun Jang
- grid.412482.90000 0004 0484 7305Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, the Republic of Korea
| | - Susan Taejung Kim
- grid.412482.90000 0004 0484 7305Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, the Republic of Korea
| | - Yun-Kyung Kim
- grid.411134.20000 0004 0474 0479Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, the Republic of Korea
| | - Young Hwan Song
- grid.412480.b0000 0004 0647 3378Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, the Republic of Korea
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Tozo TAA, Gisi ML, Brand C, Moreira CMM, Pereira BO, Leite N. Family history of arterial hypertension and central adiposity: impact on blood pressure in schoolchildren. BMC Pediatr 2022; 22:497. [PMID: 35999624 PMCID: PMC9400321 DOI: 10.1186/s12887-022-03551-4] [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: 05/05/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A family history of arterial hypertension is an important risk factor for arterial hypertension. This study aimed to verify the mediating role of high central adiposity in the relationship between family history of arterial hypertension and blood pressure in schoolchildren. METHODS Cross-sectional study with 118 schoolchildren of both sexes aged between 11 and 17 years. Weight, height, waist circumference and body mass index z score were verified. Somatic maturation was predicted by age for peak growth velocity. The family history of arterial hypertension was verified and defined as hypertensive schoolchildren with systolic blood pressure or diastolic blood pressure. Mediation analysis was used with linear regression models applied by PROCESS macro for SPSS (version 22.0), with significance p < 0.05. RESULTS It was observed that 34.7% of the students have family history of arterial hypertension, 36% of the girls and 44.2% of the boys have arterial hypertension. In girls, the relationship between waist circumference and systolic blood pressure was direct (β = 0.535 p = 0.005), and those with a family history of arterial hypertension and who had a waist circumference greater than those without a family history of arterial hypertension was significant (β = -5,437 p = 0.009). Likewise, the relationship between family history of arterial hypertension and systolic blood pressure was attenuated when waist circumference was included in the model (β = -5.544; p = 0.103), indicating waist circumference as a mediator with an influence percentage of 19%. For boys, waist circumference is not a mediator of the relationship between family history of arterial hypertension and blood pressure. CONCLUSIONS Elevated central adiposity was a mediator of the relationship between family history of arterial hypertension and high blood pressure in girls, indicating the importance of family health strategies in the prevention and management of arterial hypertension in children and adolescents.
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Affiliation(s)
| | - Maria Lourdes Gisi
- Postgraduate Program in Education (School of Humanities) - Pontifical Catholic University of Paraná, Curitiba, Paraná, Brazil
| | - Caroline Brand
- Postgraduate Program in Health Promotion , University of Santa Cruz do Sul, Rio Grande do Sul, Santa Cruz do Sul, Brazil
| | - Carla Marisa Maia Moreira
- Research Center in Physical Activity, Health and Leisure (CIAFEL), University of Porto, Porto, Portugal
| | | | - Neiva Leite
- Department of Physical Education, Federal University of Paraná, Curitiba, Paraná, Brazil
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Yalçin SS, Erdal İ, Oğuz B, Duzova A. Association of urine phthalate metabolites, bisphenol A levels and serum electrolytes with 24-h blood pressure profile in adolescents. BMC Nephrol 2022; 23:141. [PMID: 35410150 PMCID: PMC9004182 DOI: 10.1186/s12882-022-02774-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 04/04/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Among the possible causes of hypertension in adolescence, electrolyte imbalances and environmental pollutants are drawing increasing attention. We aimed to examine the relationship between bisphenol A (BPA), phthalate metabolites, and serum electrolytes and blood pressure. METHODS Eighty-six participants aged 12-15 years were included in the study. Body mass index (BMI), office blood pressure and 24-h ambulatory blood pressure measurements (ABPM), and carotid intima-media thickness were determined. Blood samples were taken for hemogram, renal function tests, and serum electrolytes. Free- and total-BPA and phthalate metabolites were analyzed from urine samples. RESULTS Of the participants, 34 were evaluated as normal blood pressure profile, 33 as white-coat hypertension (WCHT), and 19 as ABPM-hypertension. Adolescents in ABPM- hypertension groups had higher BMI-standard deviation score (SDS), leucocyte, platelet count; but lower serum chloride, compared to the normal blood pressure profile group. The percentage of adolescents with detectable urinary mono-benzyl phthalate (MBzP) was higher in ABPM-hypertension (42.1%) and WCHT groups (33.3%), compared to the normal blood pressure profile group (5.9%, p = 0.004). Associations between MBzP and ABPM- hypertension and WCHT were remained after confounding factor adjustment. Adolescents with detectable MBzP levels had also higher "albumin-corrected calcium" and lower serum phosphate and "albumin-corrected calcium x phosphate product" compared to others. Adolescents with detectable urinary MBzP levels had higher blood pressure profiles in some 24-h (mean arterial pressure-SDS, systolic blood pressure-SDS), daytime (systolic blood pressure-SDS), and night-time (mean arterial pressure-SDS, systolic blood pressure-SDS, and diastolic blood pressure-SDS) measurements, compared to others. WCHT was found to be associated negatively with monomethyl phthalate and the sum of dibutyl phthalate metabolites and ABPM-HT with MCPP. There was no significant association between blood pressure profiles and free- and total-BPA status. CONCLUSION MBzP was associated with adverse blood pressure profiles in adolescence. Additive follow-up studies are necessary for cause-effect relations.
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Affiliation(s)
- Siddika Songül Yalçin
- Unit of Social Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Sihhiye, 06100 Ankara, Turkey
| | - İzzet Erdal
- Unit of Social Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Sihhiye, 06100 Ankara, Turkey
| | - Berna Oğuz
- Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ali Duzova
- Unit of Pediatric Nephrology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Tozo TA, Pereira BO, Menezes FJD, Montenegro CM, Moreira CMM, Leite N. Family History of Hypertension: Impact on Blood Pressure, Anthropometric Measurements and Physical Activity Level in Schoolchildren. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.36660/ijcs.20200346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Zhao W, Mo L, Pang Y. Hypertension in adolescents: The role of obesity and family history. J Clin Hypertens (Greenwich) 2021; 23:2065-2070. [PMID: 34783422 PMCID: PMC8696221 DOI: 10.1111/jch.14381] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 11/28/2022]
Abstract
We evaluated the combined effect of obesity and family history (FH) on the risk of hypertension in adolescents. We studied 1288 school‐aged adolescents aged 16.0 ± 0.5 years (49.0% males) attending the medical examination for enrollment in the city of Nanning, China. Their blood pressure, weight, and height were measured. A questionnaire was administered to both adolescents and their parents to obtain information on the participants’ medical history. Multiple logistic regression analysis, according to bodyweight categories and adjusted for age, gender, and body mass index (BMI), was done to determine the association of FH with hypertension. Hypertension was found in 14.1% of adolescents. The prevalence of hypertension was significantly higher in adolescents with obesity and positive FH than their normal weight and negative FH counterparts. For adolescents with normal weight and waist circumstance (WC), those with a positive FH in parents compared to those without had an significantly increased risk for hypertension (odds ratio [OR], 2.15; 95% confidence interval [CI] 1.28–3.61, and 1.96; 95% CI 1.16–3.32, respectively). These findings were adjusted for age, gender, and BMI. Our study showed that routine screening for pediatric hypertension should be performed in adolescents who are overweight and obese. Furthermore, parental FH of hypertension played an important role in predicting the hypertension phenotype among adolescents with normal weight.
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Affiliation(s)
- Weiying Zhao
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Luxia Mo
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yusheng Pang
- Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Liu K, Li C, Gong H, Guo Y, Hou B, Chen L, Liu F, Liu Y, Wang J, Hou Q, Wang Z, Hui R, Jiang X, Zou Y, Zhang Y, Song L. Prevalence and Risk Factors for Hypertension in Adolescents Aged 12 to 17 Years: A School-Based Study in China. Hypertension 2021; 78:1577-1585. [PMID: 34538102 DOI: 10.1161/hypertensionaha.121.17300] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Kai Liu
- Department of Cardiology (K.L., C.L., R.H., X.J., Y. Zou, Y. Zhang, L.S.), National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Chen Li
- Department of Cardiology (K.L., C.L., R.H., X.J., Y. Zou, Y. Zhang, L.S.), National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Haibin Gong
- Xuzhou Cardiovascular Disease Institute, Jiangsu, China (H.G.)
| | - Ye Guo
- The First Hospital of Fangshan District, Beijing, China (Y.G.)
| | - Bingjie Hou
- The Fourth Central Hospital of Baoding City, Hebei, China (B.H.)
| | - Liangyu Chen
- The First People's Hospital of Chuzhou, Anhui, China (L.C.)
| | - Fusong Liu
- The Third People's Hospital of Qingdao, Shandong, China (F.L.)
| | - Yajuan Liu
- Central Hospital of Yichun City, Heilongjiang, China (Y.L.)
| | - Jizheng Wang
- State Key Laboratory of Cardiovascular Disease (J. W., R.H., L.S.), National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Qing Hou
- BestNovo (Beijing) Diagnostics Laboratory, China (Q.H.)
| | - Zengwu Wang
- Division of Prevention and Community Health (Z.W.), National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Rutai Hui
- Department of Cardiology (K.L., C.L., R.H., X.J., Y. Zou, Y. Zhang, L.S.), National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.,State Key Laboratory of Cardiovascular Disease (J. W., R.H., L.S.), National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xiongjing Jiang
- Department of Cardiology (K.L., C.L., R.H., X.J., Y. Zou, Y. Zhang, L.S.), National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yubao Zou
- Department of Cardiology (K.L., C.L., R.H., X.J., Y. Zou, Y. Zhang, L.S.), National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yuqing Zhang
- Department of Cardiology (K.L., C.L., R.H., X.J., Y. Zou, Y. Zhang, L.S.), National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Lei Song
- Department of Cardiology (K.L., C.L., R.H., X.J., Y. Zou, Y. Zhang, L.S.), National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.,State Key Laboratory of Cardiovascular Disease (J. W., R.H., L.S.), National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.,National Clinical Research Center of Cardiovascular Diseases (L.S.), National Center for Cardiovascular Disease, Fuwai Hospital Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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Amiri P, Rezaei M, Jalali-Farahani S, Karimi M, Cheraghi L, Esbati R, Azizi F. Risk of hypertension in school-aged children with different parental risk: a longitudinal study from childhood to young adulthood. BMC Pediatr 2021; 21:352. [PMID: 34404370 PMCID: PMC8369749 DOI: 10.1186/s12887-021-02807-9] [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: 08/10/2020] [Accepted: 07/07/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Although previous studies have shown the relationship between different parental factors and children's blood pressure status, there is limited data on the cumulative effect of these factors. Considering parental socio-demographic, behavioral and cardio-metabolic characteristics, the current study aimed to distinguish parental risk clusters and their impact on the incidence of hypertension in school-age children over 13 years. METHODS Parental characteristics of 1669 children, including age, education, employment, smoking, physical activity, metabolic syndrome (MetS), hypertension (HTN), weight status, and diabetes were considered to categorize parents into low and high-risk clusters. Crude incidence rates (per 10,000 person-years) of HTN in children were assessed in each maternal and paternal cluster. Using Cox proportional hazard model, results on the association between parental risk clusters and HTN incidence in children were reported in five different models. RESULTS Mean age of children was 13.96 ± 2.89 years, and 51.2% (n = 854) were girls. MetS, HTN, and weight status were the most important factors distinguishing low and high-risk parental clusters, respectively. Crude incidence rates (per 10,000 person-years) of HTN were 86 (95% CI: 71-106) and 38 (95% CI, 29-52) in boys and girls, respectively. Moreover, incidence rates (per 10,000 person-years) of HTN were 50 (95% CI, 40-63) and 80 (95% CI, 64-102) in maternal low and high-risk clusters, respectively. The incidence rates (per 10,000 person-years) of HTN in paternal low and high-risk clusters were 53 (95% CI, 41-70) and 68 (95% CI, 56-84), respectively. CONCLUSION Our findings underscore the prognostic value of maternal characteristics in predicting the incidence of HTN in their offspring. The current results could be valuable in planning related programs to prevent hypertension in similar communities.
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Affiliation(s)
- Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marjan Rezaei
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Jalali-Farahani
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrdad Karimi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Cheraghi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Biostatistics Department, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Romina Esbati
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Islamic Republic of Iran.
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10
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Kolifarhood G, Daneshpour MS, Zahedi AS, Khosravi N, Sedaghati-Khayat B, Guity K, Rasekhi Dehkordi S, Amiri Roudbar M, Ghanbari F, Hadaegh F, Azizi F, Akbarzadeh M, Sabour S. Familial genetic and environmental risk profile and high blood pressure event: a prospective cohort of cardio-metabolic and genetic study. Blood Press 2021; 30:196-204. [PMID: 33792450 DOI: 10.1080/08037051.2021.1903807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND AIMS High blood pressure is the heritable risk factor for cardiovascular diseases. We investigated whether the presence of familial genetic and environmental risk factors are associated with increased risk of high blood pressure. METHODS A total of 4,559 individuals from 401 families were included in this study. Familial aggregation analysis was carried out on systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI) and waist circumference (WC), and heritability was estimated for SBP and DBP. The association between familial risk factors and blood pressure traits including, incidence of hypertension, SBP and DBP was estimated separately using regression-based two-level Haseman-Elston (HE) method, with individual and familial BMI and WC as environmental exposures and familial genetic profile of known variants as genetic risk factors in 210 index families (≥2 hypertensive cases). Models were adjusted for the two nested sets of covariates. RESULTS During a follow-up of 15 years, the SBP, DBP, BMI and WC were highly correlated in inter class of mother-offspring and intraclass of sister-sister with heritability of 30 and 25% for DBP and SBP, respectively. Among index families, those whose members with higher familial BMI or WC had significantly increased risk of hypertension and consistent, strong signals of rs2493134 (AGT) linked with SBP and DBP, rs976683 (NLGN1) linked with SBP and HTN, and epistasis of rs2021783 (TNXB) and known genetic variants linked with all blood pressure traits. CONCLUSIONS Findings from this study show that familial genetic and environmental risk profile increase risk for high blood pressure beyond the effect of the individuals' own risk factors.
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Affiliation(s)
- Goodarz Kolifarhood
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam S Daneshpour
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asiyeh Sadat Zahedi
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasim Khosravi
- Department of Community Health Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Bahareh Sedaghati-Khayat
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamran Guity
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Rasekhi Dehkordi
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmoud Amiri Roudbar
- Department of Animal Science, Safiabad-Dezful Agricultural and Natural Resources Research and Education Center, Agricultural Research, Education & Extension Organization (AREEO), Dezful, Iran
| | - Forough Ghanbari
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Akbarzadeh
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Siamak Sabour
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Abstract
Although relatively rare in childhood, primary hypertension (PH) is thought to have originated in childhood and may be even determined perinatally. PH prevalence increases in school-age children and affects 11% of 18-year-old adolescents. Associated with metabolic risk factors, elevated blood pressure in childhood is carried into adulthood. Analysis of the phenotype of hypertensive children has revealed that PH is a complex of anthropometric and neuro-immuno-metabolic abnormalities, typically found in hypertensive adults. Children with elevated blood pressure have shown signs of accelerated biological development, which are closely associated with further development of PH, metabolic syndrome, and cardiovascular disease in adulthood. At the time of diagnosis, hypertensive children were reported to have significant arterial remodelling expressed as significantly increased carotid intima-media thickness, increased stiffness of large arteries, lower area of microcirculation, and decreased endothelial function. These changes indicate that their biological age is 4 to 5 years older than their normotensive peers. All these abnormalities are typical features of early vascular aging described in adults with PH. However, as these early vascular changes in hypertensive children are closely associated with features of accelerated biological development and neuro-immuno-metabolic abnormalities observed in older subjects, it seems that PH in childhood is not only an early vascular aging event, but also an early biological maturation phenomenon.
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Xu R, Zhang X, Zhou Y, Wan Y, Gao X. Parental overweight and hypertension are associated with their children's blood pressure. Nutr Metab (Lond) 2019; 16:35. [PMID: 31149019 PMCID: PMC6537379 DOI: 10.1186/s12986-019-0357-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 05/01/2019] [Indexed: 01/01/2023] Open
Abstract
Background We evaluated the association between parental factors (overweight, history of hypertension, and education level) and children’s blood pressure status. Further, we evaluated to what extent the potential association could be interpreted by children’s adiposity indices. Methods The current study included 3316 Chinese school students (1579 girls and 1737 boys, aged 6–14 years) and their parents. Parents reported information on their height, body weight, history of hypertension, and the highest education level. Trained medical staff measured children’s blood pressure, height, body weight, waist circumference (WC), and percentage of body fat (PBF, assessed by bio-impedance method). Z-score of all three indices were calculated and used in the analysis. We used generalized linear model to evaluate the association between parental information and z-score of children’s blood pressure. Meditation analysis was used to evaluate the proportion contributed by z-score of children’s adiposity indices (BMI, WC, and PBF). Results We found that parental overweight and hypertension, but not parental education level, were significantly associated with children’s systolic and diastolic blood pressure (P < 0.05 for all). Approximately 30.4–92.2% of the association between these two parental factors and children’s systolic blood pressure were mediated by children’s adiposity indices, and 22.3–55.6% for children’s diastolic blood pressure. The strongest meditative factor, among the three obesity indices, was children’s BMI z-score. Conclusions The association between parental factors and children’s blood pressure was mainly mediated by children’s adiposity indices. Electronic supplementary material The online version of this article (10.1186/s12986-019-0357-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Renying Xu
- 1Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaomin Zhang
- 1Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yiquan Zhou
- 1Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yanping Wan
- 1Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiang Gao
- 2Department of Nutritional Science, The Pennsylvania State University, University Park, PA 16802 USA
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Epidemiology of Childhood Onset Essential Hypertension. J Hum Hypertens 2018; 32:808-813. [PMID: 30224771 PMCID: PMC6265061 DOI: 10.1038/s41371-018-0110-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/15/2018] [Accepted: 08/28/2018] [Indexed: 02/03/2023]
Abstract
The knowledge of epidemiology of a disease is paramount in identifying preventive measures. Currently there is a paucity of literature on the epidemiologic determinants of childhood onset essential hypertension (EH). We evaluated children with EH, ascertained in a rigorous manner, in a large multiethnic population in a tertiary pediatric hypertension clinic. We enrolled children with and without EH and obtained data by in-person interview of their parents and by direct anthropometric measurements including blood pressures. A total of 148 children (76 hypertension probands, 72 control probands, and males 53%, mean age 12.2 ± 4.3 years) were enrolled. Of these 148 children, 51 pairs were matched 1:1 on ethnicity, gender and age (± 2.5 years). In this study we evaluated the demographics, genetic predisposition and a variety of exposures including, socioeconomic, perinatal, lifestyle and environmental, between cases and controls. All measures were similar between cases and controls other than a significantly higher BMI (p = 0.01) and rates of obesity (p = 0.03), and a difference of near-significance in any family history of EH (p = 0.05) higher in cases compared to controls. The odds of obesity was 3.5 times higher among cases than controls. In this study we evaluated a variety of prenatal and postnatal exposures that could potentially contributed to the EH phenotype in childhood. The findings of the study elucidate the epidemiology of EH in children and two important associated risk factors, any family history of hypertension and a higher body weight.
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