Arterial blood pressure and serum lipids in a population of children and adolescents from Southern Italy: The Calabrian Sierras Community Study (CSCS)

Background/Aims: This study aimed to identify a possible association among high birth weight with overweight/obesity, high arterial blood pressure, dyslipidemia, and insulin resistance in children and adolescents. Methods: This is a cross-sectional study with 719 children and adolescents (6–12 years) stratified according to birth weight (low birth weight [LBW] <2,500 g, adequate birth weight [ABW] 2,500–3,999 g, and high birth weight [HBW] ≥4,000 g). Data collected were anthropometric data, arterial blood pressure levels, lipid profile, and insulin resistance (fasting glucose and insulin, used to calculate homeostatic model assessment-IR). Results: The mean age of schoolchildren was 9.5 ± 2.0 years and 371 (51.6%) were male. LBW and HBW were observed in 79 of 719 (10.9%) and 40 of 719 (55.6%) children/adolescents, respectively. There was no increased risk of overweight (OR 0.9; 95% CI 0.4–2.1; p = 0.964) and obesity (OR 1.4; 95% CI 0.6–3.5; p = 0.588) in HBW group compared to LBW and ABW groups. HBW was not associated with high blood pressure, dyslipidemia, and insulin resistance. The LBW group was independently associated with higher values of systolic (OR 1.07; 95% CI 1.05–1.10; p < 0.01) and diastolic blood pressure (OR 1.04; 95% CI 1.00–1.07; p = 0.044). Conclusion: There was no association between HBW with overweight/obesity and classic cardiovascular risk factors in this group of children/adolescents. Only LBW was related to higher blood pressure levels.

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The status of element homeostasis in children and adolescents with essential arterial hypertension

Kazan medical journal ◽

10.17816/kmj2284 ◽

2012 ◽

Vol 93 (2) ◽

pp. 184-190

Author(s):

T P Makarova ◽

Z R Khabibrakhmanova ◽

D I Sadykova ◽

Yu M Chilikina

Keyword(s):

Blood Pressure ◽

Arterial Hypertension ◽

Blood Serum ◽

Children And Adolescents ◽

Arterial Blood Pressure ◽

Childhood And Adolescence ◽

Functional Variants ◽

Arterial Blood ◽

Essential Arterial Hypertension ◽

Metabolic Type

Aim. To study the features of element homeostasis in children and adolescents with different variants of essential arterial hypertension. Methods. The clinical and functional variant of arterial hypertension was established based on the data of 24-hour monitoring of the arterial blood pressure. Investigation of the element content in the blood serum and daily urine was performed using the method of atomic absorption spectrophotometry. The clearance and the excreted fraction of the investigated elements were measured. Results. Revealed was an increase of the content of lead in the blood serum, an increase in lead excretion with urine, an increase in its clearance and excreted fraction in patients with stable arterial hypertension. It has been shown that for children and adolescents with a variety of clinical and functional variants of arterial hypertension characteristic is an excess of the serum content of a toxic element (lead) over the content of an essential element (zinc), and these changes are most pronounced in the group with stable arterial hypertension. In children and adolescents with the increase in arterial blood pressure registered was a decrease in the content of zinc and magnesium in the blood serum, whereas the disturbances of element homeostasis relate to the metabolic type. The increase in the content of copper and calcium in blood serum of patients with high blood pressure is also a manifestation of the metabolic type of element homeostasis disturbances. Conclusion. The increased level of lead in blood serum in combination with its enhanced excretion may be a cofactor in the development of essential arterial hypertension in childhood and adolescence.

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Frequency and individual severity of arterial blood pressure changes in children and adolescents with attention-deficit/hyperactivity disorder treated with methylphenidate hydrochloride: a prospective non-interventional study

General Psychiatry ◽

10.1136/gpsych-2020-100193 ◽

2020 ◽

Vol 33 (2) ◽

pp. e100193

Author(s):

Dorothee Busold-Hagenbeck ◽

Julia Elmenhorst ◽

Christoph Irtel von Brenndorff ◽

Reinhard Hilgers ◽

Martin Hulpke-Wette

Keyword(s):

Blood Pressure ◽

Attention Deficit Hyperactivity Disorder ◽

Children And Adolescents ◽

Arterial Blood Pressure ◽

Patient Information ◽

Attention Deficit ◽

Information Sheet ◽

Interventional Study ◽

Hyperactivity Disorder ◽

Arterial Blood

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a common behavioural disorder in childhood. The psychostimulant methylphenidate hydrochloride (MPH) is one of the major pharmacological options for ADHD. MPH is known to result, on average, in a small increase in arterial blood pressure (BP). However, there are few clinical data regarding the individual influences of MPH on BP among children and adolescents with ADHD. According to the European Union-wide standardised patient information sheet for MPH, BP changes >10 mm Hg compared with baseline values are ‘common’ (ie, ≥1% to <10%) in children and adolescents with ADHD during MPH therapy.AimTo investigate the frequency and individual severity of BP changes in children and adolescents with ADHD during the first 6 months of new MPH therapy.MethodsIn this study, 44 (77% male) children and adolescents (mean age (SD) 9.13 (1.86) years) with a diagnosis of ADHD according to the International Classification of Diseases, tenth revision, underwent ambulatory BP monitoring before and during the first 6 months of routine MPH therapy. Exclusion criteria were pre-existing MPH therapy and other medications that potentially influence BP or interfere with MPH. The non-interventional study was conducted prospectively at 10 paediatric cardiology centres in Germany and Austria.ResultsAfter beginning MPH therapy, 34% of participants (99% CI 15.52% to 52.66%) had BP increases/decreases >10 mm Hg. The mean changes in systolic BP and diastolic BP were 0.87 mm Hg (95% CI -1.75 mm Hg to 3.48 mm Hg) and 1.96 mm Hg (95% CI 0.21 mm Hg to 3.7 mm Hg), respectively. The proportion of participants with initial prehypertension/hypertension was 54.55% .ConclusionsIn our sample with a high baseline rate of prehypertension/hypertension, BP changes >10 mm Hg during MPH therapy were more frequent than those indicated by the patient information sheet. Moreover, individual BP changes, including increases and decreases >10 mm Hg, resulted in a small average BP increase in the sample, thus reflecting neither the severity nor the direction of individual BP changes. Therefore, the frequency and, due to the common use of the arithmetic mean, the individual severity of BP changes during MPH therapy may be underestimated. Further studies without averaging and with larger samples including patients in primary care settings are warranted.

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