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Copeland I, Wonkam-Tingang E, Gupta-Malhotra M, Hashmi SS, Han Y, Jajoo A, Hall NJ, Hernandez PP, Lie N, Liu D, Xu J, Rosenfeld J, Haldipur A, Desire Z, Coban-Akdemir ZH, Scott DA, Li Q, Chao HT, Zaske AM, Lupski JR, Milewicz DM, Shete S, Posey JE, Hanchard NA. Exome sequencing implicates ancestry-related Mendelian variation at SYNE1 in childhood-onset essential hypertension. JCI Insight 2024; 9:e172152. [PMID: 38716726 PMCID: PMC11141928 DOI: 10.1172/jci.insight.172152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 03/19/2024] [Indexed: 05/12/2024] Open
Abstract
Childhood-onset essential hypertension (COEH) is an uncommon form of hypertension that manifests in childhood or adolescence and, in the United States, disproportionately affects children of African ancestry. The etiology of COEH is unknown, but its childhood onset, low prevalence, high heritability, and skewed ancestral demography suggest the potential to identify rare genetic variation segregating in a Mendelian manner among affected individuals and thereby implicate genes important to disease pathogenesis. However, no COEH genes have been reported to date. Here, we identify recessive segregation of rare and putatively damaging missense variation in the spectrin domain of spectrin repeat containing nuclear envelope protein 1 (SYNE1), a cardiovascular candidate gene, in 3 of 16 families with early-onset COEH without an antecedent family history. By leveraging exome sequence data from an additional 48 COEH families, 1,700 in-house trios, and publicly available data sets, we demonstrate that compound heterozygous SYNE1 variation in these COEH individuals occurred more often than expected by chance and that this class of biallelic rare variation was significantly enriched among individuals of African genetic ancestry. Using in vitro shRNA knockdown of SYNE1, we show that reduced SYNE1 expression resulted in a substantial decrease in the elasticity of smooth muscle vascular cells that could be rescued by pharmacological inhibition of the downstream RhoA/Rho-associated protein kinase pathway. These results provide insights into the molecular genetics and underlying pathophysiology of COEH and suggest a role for precision therapeutics in the future.
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Affiliation(s)
- Ian Copeland
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Edmond Wonkam-Tingang
- Childhood Complex Disease Genomics Section, National Human Genome Research Institute, NIH, Bethesda, USA
| | | | - S. Shahrukh Hashmi
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Yixing Han
- Childhood Complex Disease Genomics Section, National Human Genome Research Institute, NIH, Bethesda, USA
| | - Aarti Jajoo
- Childhood Complex Disease Genomics Section, National Human Genome Research Institute, NIH, Bethesda, USA
| | - Nancy J. Hall
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
- US Department of Agriculture Agricultural Research Service Children’s Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | - Paula P. Hernandez
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
- US Department of Agriculture Agricultural Research Service Children’s Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | - Natasha Lie
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
- Childhood Complex Disease Genomics Section, National Human Genome Research Institute, NIH, Bethesda, USA
- US Department of Agriculture Agricultural Research Service Children’s Nutrition Research Center, Baylor College of Medicine, Houston, Texas, USA
| | - Dan Liu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Jun Xu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Jill Rosenfeld
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
- Baylor Genetics, Houston, Texas, USA
| | - Aparna Haldipur
- Childhood Complex Disease Genomics Section, National Human Genome Research Institute, NIH, Bethesda, USA
| | - Zelene Desire
- Childhood Complex Disease Genomics Section, National Human Genome Research Institute, NIH, Bethesda, USA
| | - Zeynep H. Coban-Akdemir
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
- Human Genetics Center, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Daryl A. Scott
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
- Texas Children’s Hospital, Houston, Texas, USA
- Department of Molecular Physiology and Biophysics
| | - Qing Li
- Childhood Complex Disease Genomics Section, National Human Genome Research Institute, NIH, Bethesda, USA
| | - Hsiao-Tuan Chao
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics; and
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
- Cain Pediatric Neurology Research Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital and Baylor College of Medicine, Houston, Texas, USA
- McNair Medical Institute, The Robert and Janice McNair Foundation, Houston, Texas, USA
| | - Ana M. Zaske
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - James R. Lupski
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
- Texas Children’s Hospital, Houston, Texas, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, Texas, USA
| | - Dianna M. Milewicz
- Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Sanjay Shete
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jennifer E. Posey
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
- McNair Medical Institute, The Robert and Janice McNair Foundation, Houston, Texas, USA
| | - Neil A. Hanchard
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
- Childhood Complex Disease Genomics Section, National Human Genome Research Institute, NIH, Bethesda, USA
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El-Setouhy M, Safhi AM, Dallak MY, Ayoub AY, Suwaid OAH, Moafa AK, Al-Ahmed AM, Zaino M, Al Sayed A. Prevalence and associated factors of pediatric hypertension in Jazan region, south of the Kingdom of Saudi Arabia. A pilot cross-sectional study. PLoS One 2023; 18:e0287698. [PMID: 37428728 DOI: 10.1371/journal.pone.0287698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 06/09/2023] [Indexed: 07/12/2023] Open
Abstract
Hypertension (HTN) is a primary global health concern. Moreover, according to the 2010 Global Burden of Disease, hypertension accounted for roughly a quarter of cardiovascular disease fatalities and 1.9 percent of all deaths in Saudi Arabia in 2010. Also, hypertension is a significant risk factor for cardiovascular disease, morbidity, and mortality. However, assessing blood pressure (BP) and preventing hypertension among children and adolescents has become a global priority. This study aims to determine the prevalence of hypertension among children in the Jazan region of Saudi Arabia. Also, to determine the common risk factors associated with pediatric hypertension. We conducted this cross-sectional study among boys and girls aged 6-14 years visiting Al-Rashid Mall, one of the two main malls in Jazan city, the capital of Jazan region, Saudi Arabia, between November 2021 and January 2022. We included children willing to participate in the study after obtaining their parents' consent and children's assent. We used a standardized questionnaire to interview the parents to collect the children's data. We also measured the children's resting BP. Then we classified the measurements according to the updated International Pediatric Hypertension Association (IPHA) chart. We also measured the height and weight of the children and calculated their BMI. We used SPSS version 25 for the data entry and analysis. Our results showed that the prevalence of hypertension and prehypertension was insignificantly higher in females (11.84% and 12.65%) compared to males (11.52% and 11.52%), respectively. Our participants' main associated factors with prehypertension and hypertension were overweight, obesity, and family income. Pediatric hypertension and prehypertension were highly prevalent in Jazan region. Therefore, being overweight and obese should be considered risk factors for pediatric hypertension. Our study emphasizes the need for early intervention to prevent pediatric HTN, particularly among overweight and obese children.
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Affiliation(s)
- Maged El-Setouhy
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
- Department of Community Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- Department of Emergency Medicine, Faculty of Medicine, Maryland University, Baltimore, MD, United States of America
| | - Abdulrahman M Safhi
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Musab Y Dallak
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Ahmed Y Ayoub
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Osama A H Suwaid
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Ahmed K Moafa
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Alhassan M Al-Ahmed
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Mohammad Zaino
- Medical Laboratory Technology Department, Faculty of Applied Medical Science, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Ahmed Al Sayed
- Department of Medicine, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia
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He X, Shao Z, Jing J, Wang X, Xu S, Wu M, Zhu Y. Secular trends of birth weight and its associations with obesity and hypertension among Southern Chinese children and adolescents. J Pediatr Endocrinol Metab 2022; 35:1487-1496. [PMID: 36398930 DOI: 10.1515/jpem-2021-0430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/18/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The association of low or high birth weight (L/HBW) with obesity and hypertension in childhood remains unclear. We aimed to identify the secular trend of birth weight distribution and its relationship to obesity and hypertension in Southern Chinese children and adolescents. METHODS 6,561 individuals (6-17-year-old) were enrolled by multistage cluster sampling to observed the trend of birth weight distribution and its associated factors. 1,218 were further selected by group matching to investigate the correlation between birth weight and obesity or hypertension. RESULTS Between 1997 and 2008, a significant decline in the LBW rate and no significant change in the HBW rate was found. LBW was associated with maternal BMI<18 kg/m2 (OR1.79, 95% CI 1.08-2.97) during pregnancy, while maternal BMI between 25.0 and 27.9 kg/m2 (OR1.62, 95% CI 1.04-2.52) and paternal BMI>28 kg/m2 (OR1.64, 95% CI 1.02-2.63) during pregnancy were associated with HBW. The prevalence of obesity was significantly higher with HBW than normal birth weight (NBW) or LBW (16.73, 6.25 and 5.50%, respectively). The prevalence rates of suspected hypertension were 1.62, 1.25 and 1.49% among LBW, NBW and HBW, respectively (p>0.05). LBW decreased the risks of childhood overweight (OR0.31, 95% CI 0.18-0.54), but had no effect on suspected hypertension. HBW increased the risks of childhood obesity (OR2.19, 95% CI 1.50-3.20), but decreased the risks of suspected hypertension (OR0.22, 95% CI 0.09-0.58). CONCLUSIONS HBW was positively associated with childhood obesity, and parental BMIs management might be one of the measurements to control birth weight to lessen childhood obesity.
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Affiliation(s)
- Xiaoying He
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen Global Health Institute (SGHI), Sun Yat-sen University, Guangzhou, P.R. China
| | - Zixian Shao
- Shunde Women and Children's Hospital (Maternity and Child Healthcare Hospital of Shunde Foshan), Guangdong Medical University, Foshan, P.R. China
| | - Jiajia Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen Global Health Institute (SGHI), Sun Yat-sen University, Guangzhou, P.R. China
| | - Xiaotong Wang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen Global Health Institute (SGHI), Sun Yat-sen University, Guangzhou, P.R. China
| | - Suhua Xu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen Global Health Institute (SGHI), Sun Yat-sen University, Guangzhou, P.R. China
| | - Miao Wu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen Global Health Institute (SGHI), Sun Yat-sen University, Guangzhou, P.R. China
| | - Yanna Zhu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen Global Health Institute (SGHI), Sun Yat-sen University, Guangzhou, P.R. China
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S Machado IB, Tofanelli MR, Saldanha da Silva AA, Simões E Silva AC. Factors Associated with Primary Hypertension in Pediatric Patients: An Up-to-Date. Curr Pediatr Rev 2021; 17:15-37. [PMID: 33430749 DOI: 10.2174/1573396317999210111200222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Arterial hypertension in children is considered a common alteration nowadays, mainly because obesity is a growing worldwide problem closely related to increased blood pressure. Childhood hypertension can be classified as primary or secondary, depending on the etiology. Primary or essential hypertension still has its pathophysiology not fully elucidated, and there is no consensus in the literature on most underlying mechanisms. In this review, genetic and environmental factors, including sodium and potassium intake, socioeconomic status, ethnicity, family structure, obesity, sedentary lifestyle, prematurity and low birth weight, prenatal and postnatal exposures are highlighted. OBJECTIVE The present study aimed to perform an update on primary hypertension in childhood, providing clinicians and researchers an overview of the current state of the literature regarding the influence of genetic and environmental factors. METHODS This integrative review searched for articles on genetic and environmental factors related to primary hypertension in pediatric patients. The databases evaluated were PubMed and Scopus. RESULTS The studies have provided insights regarding many genetic and environmental factors, in addition to their association with the pathophysiology of primary hypertension in childhood. Findings corroborated the idea that primary hypertension is a multifactorial disease. Further studies in the pediatric population are needed to elucidate the underlying mechanisms. CONCLUSION The study of primary hypertension in pediatrics has utmost importance for the adoption of preventive measures and the development of more efficient treatments, therefore reducing childhood morbidity and the incidence of cardiovascular diseases and other health consequences later in life.
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Affiliation(s)
- Isabella Barreto S Machado
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Matheus Rampinelli Tofanelli
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ariadna A Saldanha da Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões E Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Abstract
PURPOSE OF REVIEW Present a conceptual model and review the recent literature on family dynamics, sleep, and hypertension. RECENT FINDINGS Family dynamics predict hypertension and hypertension risk, in part, due to shared health behaviors. Sleep health behaviors (sleep duration, quality, and efficiency) predict hypertension risk in children and youth and are emerging as a family-level health behavior. Importantly, both family dynamics and sleep are modifiable. Family members influence one another's sleep through their physical presence and through psychological and emotional mechanisms. Family members' sleep patterns may also be coregulated. Negative family dynamics are associated with poor sleep health and predict greater cardiovascular risk. Sleep health behaviors in the family context may also interact with family dynamics to dampen or exacerbate hypertension risk factors in children and youth. This review proposes that promoting sleep health in a family context could be one way to reduce long-term hypertension risk.
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Affiliation(s)
- Heather E Gunn
- Department of Psychology, University of Alabama, Box 870348, Tuscaloosa, AL, 35487-0348, USA.
| | - Kenda R Eberhardt
- Department of Psychology, University of Alabama, Box 870348, Tuscaloosa, AL, 35487-0348, 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: 1.0] [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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The evaluation of arterial stiffness of essential hypertension and white coat hypertension in children: a case-control study. Cardiol Young 2018; 28:403-408. [PMID: 29223189 DOI: 10.1017/s1047951117002025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The aim of this study was to determine and compare cardiovascular risks by assessing arterial stiffness in children with essential hypertension and white coat hypertension. METHODS Paediatric patients followed up with essential hypertension and white coat hypertension diagnoses and with no established end organ damage were involved in the study. Arterial stiffness in children included in the study was evaluated and compared by using the oscillometric device (Mobil-O-Graph) method. RESULTS A total of 62 essential hypertension (34 male, 28 female), 38 white coat hypertension (21 male, 17 female), and 60 healthy controls (33 male, 27 female) were assessed in the present study. Pulse wave velocity of the essential hypertension, white coat hypertension, and control group was, respectively, as follows: 5.3±0.6 (m/s), 5.1±0.4 (m/s), 4.3±0.4 (m/s) (p<0.001); augmentation index outcomes were, respectively, determined as follows: 21.3±6.5, 19.3±6.4, 16.0±0.3 (p<0.001). Pulse wave velocity and augmentation index values of children with essential hypertension and white coat hypertension were found to be higher compared with the control group. This level was identified as correlated with the duration of hypertension in both patient groups (p<0.01). CONCLUSION Arterial stiffness in children with essential hypertension and white coat hypertension was impaired compared with healthy children. This finding has made us think that white coat hypertension is not an innocent clinical situation. This information should be taken into consideration in the follow-up and treatment approaches of the patients.
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