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Fleur RS, Tanofsky-Kraff M, Yanovski J, Horton N, Reich L, Chavarro J, Hirschhorn J, Ziobrowski H, Field A. Associations Between Phenotypes of Childhood and Adolescent Obesity and Incident Hypertension in Young Adulthood. RESEARCH SQUARE 2024:rs.3.rs-4113605. [PMID: 38562761 PMCID: PMC10984016 DOI: 10.21203/rs.3.rs-4113605/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Objectives We investigated whether empirically derived childhood obesity phenotypes were differentially associated with risk of hypertension in young adulthood, and whether these associations differed by sex. Methods Data came from 11,404 participants in the Growing Up Today Study, a prospective cohort study in the US established in 1996. We used a childhood obesity phenotype variable that was previously empirically derived using latent class analysis. The childhood obesity phenotypes included an early puberty phenotype (females only), a mothers with obesity phenotype, a high weight concerns phenotype, and a mixed phenotype. Participants without overweight or obesity in childhood or adolescence were the reference group. We then used logistic regression models with generalized estimating equations to examine associations of childhood obesity phenotypes with incident hypertension between ages 20-35 years. All analyses were stratified by sex. Results Among females, participants in all of the empirically derived childhood obesity phenotypes were more likely than their peers without childhood overweight/obesity to develop hypertension in young adulthood (early puberty subtype odds ratio (OR) = 2.52; 95% confidence interval (CI) = 1.75, 3.62; mothers with obesity (MO) subtype OR = 2.98; 95% CI = 1.93, 4.59; high weight concerns (WC) subtype OR = 2.33; 95% CI = 1.65, 3.28; mixed subtype OR = 1.66; 95% CI = 1.25, 2.20). Among males, the childhood obesity phenotypes were associated with a higher risk of developing hypertension, although males in the MO (OR = 2.65; 95% CI = 1.82, 3.87) and WC phenotypes (OR = 3.52; 95% CI = 2.38, 5.20) had a greater risk of developing hypertension than the mixed subtype (OR = 1.51; 95% CI = 1.23, 1.86) (p = 0.004). Conclusion Risk for incident hypertension in young adulthood varied by childhood obesity phenotypes, as well as by biological sex. If replicated, these results may suggest that increased surveillance of specific childhood obesity phenotypes might help in targeting those at highest risk for hypertension.
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Xu H, Zhao Y, Tan R, Li M, Yu C, Rui D, Li J, Xiong Y, Zheng W. Association of consumption of sugar-sweetened beverages with elevated blood pressure among college students in Yunnan Province, China. Public Health Nutr 2024; 27:e85. [PMID: 38418286 DOI: 10.1017/s1368980024000569] [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] [Indexed: 03/01/2024]
Abstract
OBJECTIVE Although some studies have examined the association between eating behaviour and elevated blood pressure (EBP) in adolescents, current data on the association between sugar-sweetened beverages (SSB) and EBP in adolescents in Yunnan Province, China, are lacking. SETTING Cluster sampling was used to survey freshmen at a college in Kunming, Yunnan Province, from November to December. Data on SSB consumption were collected using an FFQ measuring height, weight and blood pressure. A logistic regression model was used to analyse the association between SSB consumption and EBP, encompassing prehypertension and hypertension with sex-specific analyses. PARTICIPANTS The analysis included 4781 college students. RESULTS Elevated systolic blood pressure (SBP) and diastolic blood pressure (DBP) were detected in 35·10 % (1678/4781) and 39·34 % (1881/4781) of patients, respectively. After adjusting for confounding variables, tea beverage consumption was associated with elevated SBP (OR = 1·24, 95 % CI: 1·03, 1·49, P = 0·024), and carbonated beverage (OR = 1·23, 95 % CI: 1·04, 1·45, P = 0·019) and milk beverage (OR = 0·81, 95 % CI: 0·69, 0·95, P = 0·010) consumption was associated with elevated DBP in college students. Moreover, fruit beverage (OR = 1·32, 95 % CI: 1·00, 1·75, P = 0·048) and milk beverage consumption (OR = 0·69, 95 % CI: 0·52, 0·93, P = 0·014) was associated with elevated DBP in males. CONCLUSION Our findings indicated that fruit and milk beverage consumption was associated with elevated DBP in males, and no association was observed with EBP in females.
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Affiliation(s)
- Honglv Xu
- School of Medicine, Kunming University, Kunming, Yunnan650214, China
- Community Nursing Research Team of Kunming University, Kunming, Yunnan650214, China
| | - Yun Zhao
- Department of Infection Control, Yan'an Hospital of Kunming City, Kunming650051, China
| | - Rui Tan
- Department of Infection Control, Yan'an Hospital of Kunming City, Kunming650051, China
| | - Min Li
- The First People's Hospital of Kunming, Kunming, Yunnan650100, China
| | - Chunjie Yu
- The First People's Hospital of Kunming, Kunming, Yunnan650100, China
| | - Danyun Rui
- School of Medicine, Kunming University, Kunming, Yunnan650214, China
- Community Nursing Research Team of Kunming University, Kunming, Yunnan650214, China
| | - Jiangli Li
- School of Medicine, Kunming University, Kunming, Yunnan650214, China
- Community Nursing Research Team of Kunming University, Kunming, Yunnan650214, China
| | - Yuan Xiong
- School of Medicine, Kunming University, Kunming, Yunnan650214, China
- Community Nursing Research Team of Kunming University, Kunming, Yunnan650214, China
| | - Weibin Zheng
- Baoshan Center for Disease Control and Prevention, Baoshan, Yunnan678100, China
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Sewpaul R, Awe OO, Dogbey DM, Sekgala MD, Dukhi N. Classification of Obesity among South African Female Adolescents: Comparative Analysis of Logistic Regression and Random Forest Algorithms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:2. [PMID: 38276791 PMCID: PMC10815679 DOI: 10.3390/ijerph21010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND This study evaluates the performance of logistic regression (LR) and random forest (RF) algorithms to model obesity among female adolescents in South Africa. METHODS Data was analysed on 375 females aged 15-17 from the South African National Health and Nutrition Examination Survey 2011/2012. The primary outcome was obesity, defined as body mass index (BMI) ≥ 30 kg/m2. A total of 31 explanatory variables were included, ranging from socio-economic, demographic, family history, dietary and health behaviour. RF and LR models were run using imbalanced data as well as after oversampling, undersampling, and hybrid sampling of the data. RESULTS Using the imbalanced data, the RF model performed better with higher precision, recall, F1 score, and balanced accuracy. Balanced accuracy was highest with the hybrid data (0.618 for RF and 0.668 for LR). Using the hybrid balanced data, the RF model performed better (F1-score = 0.940 for RF vs. 0.798 for LR). CONCLUSION The model with the highest overall performance metrics was the RF model both before balancing the data and after applying hybrid balancing. Future work would benefit from using larger datasets on adolescent female obesity to assess the robustness of the models.
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Affiliation(s)
- Ronel Sewpaul
- Public Health, Societies and Belonging, Human Sciences Research Council, Merchant House, 2 Dock Rail Road, Cape Town 8001, South Africa
| | - Olushina Olawale Awe
- Institute of Mathematics, Statistics and Scientific Computing (IMECC), University of Campinas, Campinas 13083-859, Brazil
| | - Dennis Makafui Dogbey
- Medical Biotechnology and Immunotherapy Research Unit, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7700, South Africa
| | | | - Natisha Dukhi
- Public Health, Societies and Belonging, Human Sciences Research Council, Merchant House, 2 Dock Rail Road, Cape Town 8001, South Africa
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Honglv X, Wei W, Min W, Junyu C, Chunjie Y, Min L, Dehui L, Jiai W, Yinghong J. A decision tree model of hypertension among college students in Yunnan Province, China. Blood Press 2023; 32:2243337. [PMID: 37559253 DOI: 10.1080/08037051.2023.2243337] [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: 06/14/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE Previous studies have indicated that the prevalence rate of hypertension in adolescents is high, but it has not received much attention and the influencing factors are unclear, especially in Yunnan Province, China. MATERIALS AND METHODS A cluster sampling method was used to investigate 4781 freshmen in a college in Kunming, Yunnan Province from November to December. Demographic and lifestyle data were collected using questionnaires, and height, weight and blood pressure were measured. Decision tree model of hypertension in college students was established by Chi-square automatic interactive detection method. RESULTS Prevalence of prehypertension of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were detected in 33.9% and 32.1%, respectively. Prevalence of hypertension of SBP and DBP was detected in 1.2% and 7.2%, respectively. The hypertension and prehypertension decision tree of SBP has gender (χ2 = 728.64, p < .001) at the first level and body mass index (BMI) (boys: χ2 = 55.98, p < .001; girls: χ2 = 79.58, p < .001) at the second level. The hypertension and prehypertension decision tree of DBP has gender (χ2 = 381.83, p < .001) at the first level, BMI (boys: χ2 = 40.54, p < .001; girls: χ2 = 48.79, p < .001) at the second level, only children (χ2 = 6.43, p = .04) and red wine consumption (χ2 = 8.17, p = .017) at the third level. CONCLUSIONS The present study suggests that gender, BMI, only children and red wine consumption were the main factors affecting hypertension in college students in southwest border areas of China.
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Affiliation(s)
- Xu Honglv
- School of Medicine, Kunming University, Kunming, China
- Community Nursing Research Team of Kunming University, Kunming, China
| | - Wang Wei
- Department of Emergency, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wang Min
- Department of Emergency, The First People's Hospital of Yunnan Province, Kunming, China
| | - Chen Junyu
- Department of Cardiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yu Chunjie
- The First People's Hospital of Kunming, Kunming, China
| | - Li Min
- The First People's Hospital of Kunming, Kunming, China
| | - Liu Dehui
- Campus Hospital, Kunming University, Kunming, China
| | - Wang Jiai
- School of Medicine, Kunming University, Kunming, China
- Community Nursing Research Team of Kunming University, Kunming, China
| | - Jiang Yinghong
- School of Medicine, Kunming University, Kunming, China
- Community Nursing Research Team of Kunming University, Kunming, China
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Niba LL, Navti LK, Musa AJ. Relationship between measures of adiposity and hypertension amongst secondary school adolescents in an urban setting in Cameroon. Pan Afr Med J 2023; 46:57. [PMID: 38223873 PMCID: PMC10787134 DOI: 10.11604/pamj.2023.46.57.41547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/06/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction measures of obesity such as body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) have been shown to be associated with high blood pressure (BP) in children and adolescents. The purpose of this study was to determine the proportion of secondary school adolescents with elevated BP and high BP in relation to some measures of adiposity (BMI, WC, WHtR) and to examine the association between BP and adiposity indices amongst the children. Methods the study was an institutional-based cross-sectional study involving 534 adolescents (mean age 15.1 ± 2.3 years) attending 4 secondary schools (2 public and 2 private) in the Bamenda municipality of the North West Region of Cameroon. Anthropometric and BP measurements were carried out following standard procedures. Diagnosis of hypertension in the children was done by obtaining three elevated systolic or diastolic BP readings (BP ≥ 95th percentile for the child's age, sex and height). Linear regression was used to determine the relationship between BP and some measures of adiposity (BMI, WC, WHtR) amongst the children. Results the prevalence of elevated BP and hypertension amongst the study participants was 33.3% and 33.3% in the BMI-obese children, 25.9% and 25.2% in the WC overweight/obese children and 29.4% and 41.2% in the "high risk" (WHtR ≥ 0.5) children respectively. Body mass index-obese, WC overweight/obese and "high risk" (WHtR ≥ 0.5) children had a significantly (p <0.05) higher mean SBP and DBP compared to their healthy weight counterparts. Linear regression indicated a significant association (p <0.001) between WC (β=0.75; 95% CI = 0.57, 0.92), BMI (β=0.88; 95% CI = 0.49, 1.25) and WHtR (β= 67.08; 95% CI = 45.64, 88.51) with systolic BP for the unadjusted analysis. After adjusting for age, gender and school type, only WC (β= 0.66; 95% CI = (0.43, 0.89) showed a positive significant (p <0.001) relationship with systolic BP. Conclusion this study has demonstrated that WC is positively associated with high BP in children and adolescents. Thus, WC can be used in predicting children and adolescents with a high risk of developing high BP in our setting.
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Affiliation(s)
- Loveline Lum Niba
- Department of Public Health, The University of Bamenda, Bambili, North West Region, Cameroon
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
| | - Lifoter Kenneth Navti
- Nutrition and Health Research Group (NHRG), Bamenda, Cameroon
- Department of Biochemistry, The University of Bamenda, Bambili, North West Region, Cameroon
| | - Ahmadou Jingi Musa
- Department of Clinical Sciences, The University of Bamenda, Bambili, North West Region, Cameroon
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Wang L, Ren L, Wang Y, Ji Z, Zhu R, Sun Y, Li J, Zhang L. Effect of body mass index trajectory on hypertension among children and adolescents aged 5-18 years: a retrospective cohort study. Ann Med 2023; 55:2267572. [PMID: 37844207 PMCID: PMC10580793 DOI: 10.1080/07853890.2023.2267572] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 10/02/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Hypertension has become increasingly prevalent in Chinese children and adolescents in recent decades, which affects growth and development of children, leads to cognitive decline and multiple target organ damage. Here, we assessed the impact of different body mass index (BMI) trajectories on the occurrence of hypertension in children and adolescents using a cohort study in Northeast China. MATERIALS AND METHODS Children and adolescents aged 5-18 years was extracted for physical examination in Fuxin City, Liaoning Province, China during the 2009-2015 period. A latent category growth mixed model (LCGMM) was used to classify BMI changes and analyze the effect of different BMI trajectories on the risk of occurrence of hypertension in these participants within 5 years. RESULTS All participates were divided into five BMI trajectories by LCGMM method: slow increasing group (n = 2616, 30.8%), overweight and obesity (OW/OB) group (n = 1141, 13.4%), normal decreasing group (n = 232, 2.7%), stable normal group (n = 4383, 51.6%), and fast-increasing group (n = 120, 1.4%). Compared with the stable normal group, the slow increasing group [adjusted odds ratio (AOR): 1.610, 95% confidence interval (CI): 1.304-1.989], the OW/OB group (AOR: 3.172, 95% CI: 2.500-4.023) and the fast-increasing group (AOR: 2.708, 95% CI: 1.445-5.074) all increased the risk of developing hypertension in children and adolescents. CONCLUSION The potential of developing hypertension varies among groups of children aged 5-18 with different BMI trajectories. Children and adolescents in the normal BMI range (the slow growth group) still need to be aware of the change in BMI trajectory to stop or slow down the progression of BP abnormalities.
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Affiliation(s)
- Lu Wang
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Longbing Ren
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Yuzhu Wang
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Zixiang Ji
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Rongyu Zhu
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jue Li
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Lijuan Zhang
- Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China
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Kirti K, Singh SK. Obesogenic diet and metabolic syndrome among adolescents in India: data-driven cluster analysis. BMC Cardiovasc Disord 2023; 23:393. [PMID: 37559027 PMCID: PMC10413690 DOI: 10.1186/s12872-023-03429-y] [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: 04/28/2023] [Accepted: 08/04/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Metabolic syndrome is on the rise in India and is primarily linked to obesogenic dietary habits. The synergy of both is a prominent risk factor for cardiovascular diseases (CVDs). Hence, the present study aims to unveil clusters at high risk of metabolic syndrome and ascertain cluster characteristics based on dietary patterns among adolescents aged 10-19 years. DATA AND METHODS The study utilizes secondary data, i.e., Comprehensive National Nutrition Survey conducted in 2016-18. The study sample includes children and adolescents aged 10-19 years. An unsupervised learning algorithm was used to ascertain possible clusters in the data based on individuals' dietary patterns. The k-means were used to cluster the data according to their dietary patterns. To determine the number of clusters elbow method was used, and appropriate validation indices were also obtained for the final k. Further, to ascertain the distribution of the obesogenic dietary patterns and metabolic conditions in each cluster was analysed. Bivariate descriptive analysis was used to draw further inferences. RESULTS The k-means clusters identified five optimum clusters based on 12,318 adolescents (6333 males (mean age:14.2 ± 2.8) and 5985 females (mean age:14.3 ± 2.8)) 17 dietary patterns. Clusters were named based on how prudent these were in terms of consuming a healthy diet. Cluster phenotypic characteristics were defined as follows: a cluster of obesogenic diets (24%) constituted the highest proportion of the total sample and was significantly suffering from obesity (p < 0.001), and greater proportions of lipid anomalies (p = 0.51) and hypertension (p = 0.44) but not statistically significant. In contrast, 21% of the sample comprised a plant-based diet cluster and suffered from all deficiencies but folate (p = 0.625), zinc (p = 0.132), and greater proportion from obesity (p = 0.19; not significant), and diabetes (p < 0.001). A cluster of "convenient" (20%) mainly suffered from lipid anomalies (p = 0.00), diabetes (p = 0.03), and a greater proportion from hypertension (p = 0.56) with deficiencies of all the essential vitamins and minerals but significantly from vitamin A (p < 0.001), folate (p < 0.001), and iron (p = 0.017). Lastly, the cluster of those who follow a "Western diet" (17%) was found to have lipid anomalies (p = 0.003), diabetes (p = 0.016), greater proportion of vitamin B12 (p = 0.136), D (p = 0.002), folate (p < 0.001), and iron deficiencies (p = 0.013). CONCLUSIONS AND RELEVANCE Adolescents in India show a strong association between obesogenic diet and metabolic syndrome. Therefore, the burden of metabolic syndrome at early ages can be prevented by controlling obesogenic dietary practices and addressing micronutrient deficiencies. This may be done by targeted health promotional campaigns in schools and college-going populations in India.
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Affiliation(s)
- Kirti Kirti
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India.
| | - Shri Kant Singh
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai, Maharashtra, 400088, India
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Gu H, Hao L, Li M, Li J. Joint effect of overweight/obesity and tobacco exposure on hypertension in children aged 6-17 years: a cross-sectional study. Front Pediatr 2023; 11:1188417. [PMID: 37456569 PMCID: PMC10347524 DOI: 10.3389/fped.2023.1188417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
Aim To assess the individual effects of overweight/obesity and tobacco exposure, and their combined effects on hypertension in children. Methods This cross-sectional study included 6,339 children aged 6-17 years from National Health and Nutrition Examination Surveys 1999-2018. Participants' height, weight and blood pressure (BP) were measured by trained technicians. Hypertension was defined as: mean systolic BP (SBP) and/or diastolic BP (DBP) ≥ 90th percentile for sex, age, and height (for children aged 1-13 years), and SBP ≥120 mmHg and/or a DBP ≥80 mmHg (for adolescents aged 13-17 years); or self-reported having been diagnosed with hypertension or taking antihypertensive medication. Gender- and age-specific body mass index (BMI) cut-points were used to define overweight/obesity: "overweight" was defined as a BMI > 1 standard deviation (SD); "obesity" was defined as BMI > 2SD; and "thinness" was defined as BMI < -2SD. Tobacco exposure was defined as having serum cotinine levels >0.05 µg/L or reporting the presence of at least one smoker in the household. Weighted univariate and multivariate logistic regression models were used to assess overweight/obesity and tobacco exposure with the odds of hypertension, and the combined effects of overweight/ obesity and tobacco exposure on hypertension, followed by strata-specific analyses. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results The prevalence of overweight/obesity and tobacco exposure was significantly higher in the hypertension group than in the non-hypertension group. Overweight/obesity (OR = 1.67, 95%CI: 1.26-2.21/ OR = 2.38, 95%CI: 1.67-3.39) and tobacco exposure (OR = 1.58, 95%CI: 1.16-2.14) were associated with a higher odd of hypertension in children, respectively. Additionally, we also observed the combined effect between overweight (OR = 3.05, 95%CI: 1.96-4.75)/obesity (OR = 3.68, 95%CI: 2.24-6.03) and tobacco exposure were related to hypertension odds in children, with a significant effect in different populations. Conclusion There may exist joint effect of overweight/obesity and tobacco exposure on the odds of hypertension in American children. These findings offer an insight that early weight control and reduction of tobacco exposure may be important to reduce odds of hypertension in children.
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Affiliation(s)
- Huan Gu
- Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Long Hao
- Department of Pediatrics, Beijing Fangshan District Liangxiang Hospital, Beijing, China
| | - Mingxi Li
- Department of Pediatrics, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ji Li
- Department of Pediatrics, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Bassareo PP, Calcaterra G, Sabatino J, Oreto L, Ciliberti P, Perrone M, Martino F, D'Alto M, Chessa M, DI Salvo G, Guccione P. Primary and secondary paediatric hypertension. J Cardiovasc Med (Hagerstown) 2023; 24:e77-e85. [PMID: 37052224 DOI: 10.2459/jcm.0000000000001432] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
High blood pressure (BP) or hypertension is a well known risk factor for developing heart attack, stroke, atrial fibrillation and renal failure. Although in the past hypertension was supposed to develop at middle age, it is now widely recognized that it begins early during childhood. As such, approximately 5-10% of children and adolescents are hypertensive. Unlike that previously reported, it is now widely accepted that primary hypertension is the most diffuse form of high BP encountered even in paediatric age, while secondary hypertension accounts just for a minority of the cases. There are significant differences between that outlined by the European Society of Hypertension (ESH), the European Society of Cardiology (ESC), and the last statement by the American Academy of Pediatrics (AAP) concerning the BP cut-offs to identify young hypertensive individuals. Not only that, but the AAP have also excluded obese children in the new normative data. This is undoubtedly a matter of concern. Conversely, both the AAP and ESH/ESC agree that medical therapy should be reserved just for nonresponders to measures like weight loss/salt intake reduction/increase in aerobic exercise. Secondary hypertension often occurs in aortic coarctation or chronic renal disease patients. The former can develop hypertension despite early effective repair. This is associated with significant morbidity and is arguably the most important adverse outcome in about 30% of these subjects. Also, syndromic patients, for example those with Williams syndrome, may suffer from a generalized aortopathy, which triggers increased arterial stiffness and hypertension. This review summarizes the state-of-the-art situation regarding primary and secondary paediatric hypertension.
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Affiliation(s)
- Pier Paolo Bassareo
- University College of Dublin, School of Medicine, Mater Misericordiae University Hospital and Children's Health Ireland at Crumlin, Dublin, Ireland
| | | | - Jolanda Sabatino
- Division of Paediatric Cardiology, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Lilia Oreto
- Mediterranean Pediatric Cardiology Center, Bambino Gesù Pediatric Hospital, Taormina, Messina
| | - Paolo Ciliberti
- Department of Cardiology, Cardiac Surgery, Heart and Lung Transplantation, IRCCS Bambino Gesu'Paediatric Hospital
| | - Marco Perrone
- Department of Cardiology, Cardiac Surgery, Heart and Lung Transplantation, IRCCS Bambino Gesu'Paediatric Hospital
| | - Francesco Martino
- Department of Internal Clinical, Anesthesiological and Cardiovascular Sciences, La Sapienza University, Rome
| | - Michele D'Alto
- Department of Cardiology, Monaldi Hospital - University 'L. Vanvitelli', Naples
| | - Massimo Chessa
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS-Policlinico San Donato, San Donato Milanese, Vita Salute San Raffaele University, Milan, Italy
| | - Giovanni DI Salvo
- Division of Paediatric Cardiology, Department of Women's and Children's Health, University of Padua, Padua, Italy
| | - Paolo Guccione
- Department of Cardiology, Cardiac Surgery, Heart and Lung Transplantation, IRCCS Bambino Gesu'Paediatric Hospital
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Dormanesh B, Arasteh P, Daryanavard R, Mardani M, Ahmadi M, Nikoupour H. Epidemiology of obesity and high blood pressure among school-age children from military families: the largest report from our region. BMC Pediatr 2023; 23:37. [PMID: 36683049 PMCID: PMC9868491 DOI: 10.1186/s12887-023-03839-z] [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: 09/13/2022] [Accepted: 01/06/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND For the first time, we aimed to determine the epidemiology and associated factors of obesity and hypertension among children of military families in our region. METHODS In this multi-centered study, children between the ages of 5 to 12 years old, entered the study. Data on baseline and clinical characteristics, history of disease and anthropometric measurements, were collected. RESULTS Among 504 children, 44.2% were males. Mean (SD) age of participants was 7.9 ± 1.9 years. Overall, 5% were obese and 9.9% were overweight. In total, 16.3% had elevated BP, 12.5% had stage one and 0.2% had stage two hypertension. Age (beta = 0.306, OR = 1.35, 95% CI:1.14-1.61), obesity/overweight (OR = 5.58, 95% CI:2.59-12.0), history of hypertension in mother (OR = 43.24, 95% CI:5.99-312.11), low birth weight (OR = 7.96, 95% CI:2.59-12.0), physical activity (OR = 0.27, 95% CI:0.10-0.72), and consumption of fast food more than once a week (OR = 3.36, 95% CI:1.82-6.19), were associated with risk of hypertension. Furthermore, age (beta = 0.346, OR = 1.41, 95% CI:1.21-1.64), history of childhood obesity in the father (OR = 3.78, 95% CI: 1.77-8.06) and mother (OR = 2.44, 95% CI:1.07-5.56), and physical activity (OR = 0.27, 95% CI:0.11-0.66), were associated with obesity. CONCLUSION Age, obesity/overweight, history of hypertension in the mother, birth weight, physical activity, and consumption of fast food, were associated with risk of hypertension. Moreover, age, history of childhood obesity in parents, and physical activity, were associated with obesity. Furthermore, we found that school-age children in military families have higher rates of hypertension and overweight compared to other reports from our region.
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Affiliation(s)
- Banafshe Dormanesh
- Department of Pediatric, AJA University of medical sciences, Tehran, Iran
| | - Peyman Arasteh
- AJA University of Medical Sciences, Tehran, Iran
- Shiraz University of Medical Sciences, Shiraz, Iran
| | - Roya Daryanavard
- Department of Pediatric, AJA University of medical sciences, Tehran, Iran
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Hu J, Zhong Y, Ge W, Lv H, Ding Z, Han D, Hai B, Shen H, Yin J, Gu A, Yang H. Comparisons of tri-ponderal mass index and body mass index in discriminating hypertension at three separate visits in adolescents: A retrospective cohort study. Front Nutr 2022; 9:1028861. [PMID: 36324625 PMCID: PMC9618711 DOI: 10.3389/fnut.2022.1028861] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/30/2022] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVE To estimate whether the new obesity indicator tri-ponderal mass index (TMI) has a better capacity to predict adolescent hypertension (HTN) and HTN subtypes at three separate blood pressure (BP) visits than the conventionally used body mass index (BMI). METHODS A total of 36,950 adolescents who had initial normal BP from 2012 to 2019 were included in Suzhou, China. HTN was defined as having three separate visits of elevated BP in 2020. The area under the receiver-operating characteristic curve (AUC), false-positive rate, false-negative rate, total misclassification rates, net reclassification improvement (NRI), and integrated discrimination improvement were calculated to compare the discriminative ability of HTN between BMI and TMI. RESULTS TMI had better predictive abilities than BMI among all of the participants when predicting HTN (difference in AUC = 0.019, 95% CI = 0.007-0.031; NRI = 0.067, 95% CI = 0.008-0.127) and isolated systolic hypertension (difference in AUC = 0.021, 95% CI = 0.005-0.036; NRI = 0.106, 95% CI = 0.029-0.183). The difference in prediction abilities between BMI and TMI was more obvious in the subgroup of age ≥16. Also, TMI outperformed BMI in predicting adolescent HTN in girls but not in boys. CONCLUSION Compared with BMI, TMI may have a better predictive capacity for HTN, particularly in girls and older adolescents. TMI has the potential to be used as an effective predictor for HTN in clinic practice. Further studies are needed to verify the utility of TMI.
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Affiliation(s)
- Jia Hu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
- Suzhou Institute of Advanced Study in Public Health, Gusu School, Nanjing Medical University, Suzhou, China
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Yi Zhong
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - WenXin Ge
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Huiling Lv
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Ziyao Ding
- Suzhou Center for Disease Prevention and Control, Suzhou, China
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Di Han
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Bo Hai
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Hui Shen
- Suzhou Institute of Advanced Study in Public Health, Gusu School, Nanjing Medical University, Suzhou, China
- Suzhou Center for Disease Prevention and Control, Suzhou, China
| | - Jieyun Yin
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Aihua Gu
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Haibing Yang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
- Suzhou Institute of Advanced Study in Public Health, Gusu School, Nanjing Medical University, Suzhou, China
- Suzhou Center for Disease Prevention and Control, Suzhou, China
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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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