scholarly journals Changes in Ambulatory Blood Pressure Phenotype over Time in Children and Adolescents with Elevated Blood Pressures

2020 ◽  
Vol 216 ◽  
pp. 37-43.e2 ◽  
Author(s):  
Coral D. Hanevold ◽  
Yosuke Miyashita ◽  
Anna V. Faino ◽  
Joseph T. Flynn
Keyword(s):  
Blood Pressure ◽  
Children And Adolescents ◽  
Ambulatory Blood Pressure ◽  
Elevated Blood ◽  
Blood Pressures ◽  
Blood Pressure Phenotype ◽  
Over Time

Abstract P479: Stability of Ambulatory Blood Pressure Patterns Over Time in Children and Adolescents

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Coral D Hanevold ◽  
Yosuke Miyashita ◽  
Joseph T Flynn
Keyword(s):  
Blood Pressure ◽  
Children And Adolescents ◽  
Ambulatory Blood Pressure ◽  
Exclusion Criteria ◽  
The Difference ◽  
The Stability ◽  
Blood Pressure Patterns ◽  
Over Time ◽  
Median Interval

Little is known about the stability of ambulatory blood pressure (ABP) patterns in children and adolescents undergoing evaluation for high blood pressure (HBP). It is possible that children with initially normal ABP may progress to hypertension (HT) or pre-hypertension (PHT), or that those with initial PHT or HT may be normal on repeat. Our objective was to assess stability of ABP patterns over time in children with HBP. We analyzed changes in ABP classification in patients undergoing a minimum of 2 ABP monitoring (ABPM) studies at least 0.5 years (yrs) apart. Exclusion criteria included known secondary HT, therapy with antihypertensive medication and inadequate recordings. ABPM were interpreted according to the 2014 AHA guidelines using BP thresholds of 95 th % for sex and height for children ≤17 yrs. For those > 18 yrs awake and sleep thresholds were 140/85 and 120/70, respectively. Dipping was considered normal if > 10%, blunted if <10% and reversed if < 0%. For those with > 2 ABPM the difference between the 1 st and last were analyzed. Two hundred ABPM on 100 patients (76 males; median age 14.6 yrs at 1st ABPM) were analyzed. Median interval between ABPM was 1.5 yrs. ABP classification was stable in 53% (53/100). As shown in the table 50% (9/18) of those with normal ABPM showed progression to PHT or HT on follow up. PreHT progressed in 31% (8/26) and improved in 38% (10/26). HT improved in 43% (20/46). Dipping designation was stable in 70% (70/100); but blunted dipping normalized in 48% (10/21). In our population ABP patterns were not stable over time, supporting the need for follow up studies even with normal initial ABPM. If confirmed in larger studies, these findings support greater use of repeat ABPM.

The triglycerides and glucose index is associated with elevated blood pressure in apparently healthy children and adolescents

2019 ◽  
Vol 178 (7) ◽  
pp. 1069-1074 ◽  
Author(s):  
Luis E. Simental-Mendía ◽  
Gabriela Hernández-Ronquillo ◽  
Claudia I. Gamboa-Gómez ◽  
Rita Gómez-Díaz ◽  
Martha Rodríguez-Morán ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Children And Adolescents ◽  
Elevated Blood Pressure ◽  
Healthy Children ◽  
Elevated Blood ◽  
Apparently Healthy

scholarly journals The association between serum copper concentrations and elevated blood pressure in US children and adolescents: National Health and Nutrition Examination Survey 2011–2016

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Changsong Liu ◽  
Yanfen Liao ◽  
Zongyuan Zhu ◽  
Lili Yang ◽  
Qin Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Children And Adolescents ◽  
National Health ◽  
Serum Copper ◽  
Elevated Blood Pressure ◽  
Nutrition Examination Survey ◽  
Elevated Blood ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Us Children

Abstract Background Copper is an essential trace metal with potential interest for cardiovascular effects. Few studies have explored the association between copper and blood pressure in children and adolescents. Method We conducted a cross-sectional analysis of 1242 children and adolescents aged 8–17 years who participated in the 2011 to 2016 National Health and Nutrition Examination Survey. Using 2017 American Academy of Pediatrics guidelines, elevated blood pressure (EBP) was defined as a mean systolic and/or diastolic blood pressure (BP) ≥ 90th percentile for sex, age, and height for children aged 1–12 years and systolic BP ≥ 120 mmHg or diastolic BP ≥ 80 mmHg for adolescent age 13–17 years. Mean serum copper was 114.17 μg/dL. Results After multiple adjustments, dose–response analyses revealed that EBP was associated with progressively higher serum copper concentrations in a nonlinear trend. In comparison with the lowest quartile of serum copper concentrations, the adjusted odds of EBP for the highest quartile was 5.26 (95% confidence interval, 2.76–10.03). Conclusion Our results suggested that high serum copper concentrations were significantly associated with EBP in US children and adolescents.

scholarly journals Renal hypertension and cardiovascular disorder in children with chronic kidney disease

2014 ◽  
Vol 142 (1-2) ◽  
pp. 113-117 ◽  
Author(s):  
Amira Peco-Antic ◽  
Dusan Paripovic
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Children And Adolescents ◽  
Ambulatory Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Measurement ◽  
Renal Hypertension ◽  
Masked Hypertension ◽  
Ambulatory Blood Pressure Measurement

Renal hypertension is one of the earliest and the most prevalent complications of pediatric chronic kidney disease (CKD). Among renal patients, hypertension is frequently underdiagnosed and undertreated. For casual blood pressure measurement, the best method is auscultatory, while for ambulatory blood pressure measurement, oscillometric method is the most commonly used. Both casual and ambulatory blood pressure measurement provide more powerful means of diagnosing hypertension. Masked hypertension is a condition in which casual blood pressure is normal but ambulatory blood pressure is elevated. The risk of cardiovascular morbidity and mortality is higher with masked hypertension as compared to the controls. Children and adolescents with CKD are at high risk of cardiovascular disease that has been established as the leading cause of death in patients with end stage renal disease. Left ventricular hypertrophy remains the most thoroughly documented form of end-organ damage caused by hypertension in children and adolescents with CKD. Based on clear evidence on the correlation between blood pressure and cardiovascular morbidity, mortality, and renal function, renal hypertension must be aggressively treated. Target blood pressure for patients with renal hypertension should be at low normal values: <75 percentile for patients without proteinuria and <50 percentile for patients with proteinuria. Renin-angiotensin system antagonists are considered the first choice pharmacological option in hypertensive CKD 2-4 patients while the management of volume overload is the most important in dialysis patients. Successful transplantation can eliminate or significantly improve uremia-related cardiovascular risk factors and increase predicted life expectancy.

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