scholarly journals School-based surveillance on visit-to-visit blood pressure variability and high blood pressure in children and adolescents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiaxiang Wang ◽  
Hui Shen ◽  
Jieyu Liu ◽  
Chengqi Xiao ◽  
Cailong Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Children And Adolescents ◽  
High Blood Pressure ◽  
Blood Pressure Variability ◽  
Pediatric Population ◽  
Health Promotion Program ◽  
Logistic Regression Models ◽  
School Based ◽  
Z Scores ◽  
Average Real Variability

Abstract Background The predictive importance of visit-to-visit blood pressure variability (VVV) for high blood pressure (HBP) in a pediatric population has been largely unsettled. We aimed to evaluate it based on Health Promotion Program for Children and Adolescents (HPPCA), a school-based surveillance conducted from 2012 to 2018 in Suzhou, China. Methods A total of 330,618 participants had BP measurement in 2018 and ≥ 3 BP records during 2012–2017, were recruited from HPPCA. Absolute BP values (in mmHg) were converted into age-, sex- and height- normalized z-scores. VVV was expressed as standard deviation (SD), coefficient of variation (CV) or average real variability (ARV) of BP z-scores during 2012–2017. Logistic regression models were used to assess the associations between VVV and HBP in 2018. Results In 2018, 42,554 (12.87%) subjects were defined as HBP. VVV, except for SBP-CV and DBP-CV, was significantly higher in the HBP group than normotensives group. After adjusting for covariates including mean BP values from 2012 to 2017, SBP-SD, SBP-ARV, DBP-SD and DBP-ARV, increased the risk of HBP by 5.70 [95% confidence interval (95% CI) 5.54–5.87], 4.10 (95% CI 4.01–4.20), 4.70 (95% CI 4.50–4.90) and 3.39 (95% CI 3.28–3.50) times, respectively. Notably, SBP-SD significantly improved risk discrimination of HBP based on other risk variables (c-statistics, net reclassification index and integrated discrimination improvement significantly increased). Conclusions Higher SD or ARV of BP, was independently related with higher probability of HBP in Chinese pediatric population. SBP-SD could be potentially helpful for detecting HBP. Future researches investigating the predictive value of VVV are warrant.

Long term habitual vigorous physical activity is associated with lower visit-to-visit systolic blood pressure variability

2020 ◽  
Author(s):  
Xiaoyong Xu ◽  
Xianghong Meng ◽  
Shin-ichi Oka
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Standard Deviation ◽  
Systolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Vigorous Physical Activity ◽  
Systolic Blood Pressure Variability ◽  
Average Real Variability ◽  
Post Hoc

Abstract Objective Our work aimed to investigate the association between vigorous physical activity and visit-to-visit systolic blood pressure variability (BPV). Methods We conducted a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial), a well-characterized cohort of participants randomized to intensive (<120 mmHg) or standard (<140 mmHg) SBP targets. We assessed whether patients with hypertension who habitually engage in vigorous physical activity would have lower visit-to-visit systolic BPV compared with those who do not engage in vigorous physical activity. Visit-to-visit systolic BPV was calculated by standard deviation (SD), average real variability (ARV), and standard deviation independent of the mean (SDIM) using measurements taken during the 1-, 2-, 3-, 6-, 9- and 12-month study visits. A medical history questionnaire assessed vigorous physical activity, which was divided into three categories according to the frequency of vigorous physical activity. Results A total of 7571 participants were eligible for analysis (34.8% female, mean age 67.9±9.3 years). During a follow-up of 1-year, vigorous physical activity could significantly reduce SD, ARV, and SDIM across increasing frequency of vigorous physical activity. There were negative linear trends between frequency of vigorous physical activity and visit-to-visit systolic BPV. Conclusions Long-term engagement in vigorous physical activity was associated with lower visit-to-visit systolic BPV.

A Comparative Study of Short-Term Blood Pressure Variability in Hemodialysis Patients with and without Intradialytic Hypertension

2018 ◽  
Vol 48 (4) ◽  
pp. 295-305 ◽  
Author(s):  
Athanasios Bikos ◽  
Elena Angeloudi ◽  
Evangelos Memmos ◽  
Charalampos Loutradis ◽  
Antonios Karpetas ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Blood Pressure Variability ◽  
Hemodialysis Patients ◽  
Adverse Outcomes ◽  
Short Term ◽  
Ambulatory Bp Monitoring ◽  
Average Real Variability ◽  
Regular Hemodialysis ◽  
Sustained Increase

Background: Short-term blood pressure (BP) variability (BPV) is associated with increased cardiovascular risk in hemodialysis. Patients with intradialytic hypertension have high risk of adverse outcomes. Whether BPV is increased in these patients is not clear. The purpose of this study was to compare short-term BPV in patients with and without intradialytic hypertension. Methods: Forty-one patients with and 82 patients without intradialytic hypertension (intradialytic SBP rise ≥10 mm Hg to > 150 mm Hg) matched in a 1: 2 ratio for age, sex, and hemodialysis vintage were included. All subjects underwent 48-h ambulatory BP monitoring during a regular hemodialysis and the subsequent interdialytic interval. Brachial and aortic BPV were calculated with validated formulas and compared between the 2 groups during the 48-h and the 44-h periods and during the 2 daytime and nighttime periods respectively. Results: During 48-h or 44-h periods and daytime or nighttime, brachial SBP/DBP and aortic SBP/DBP were significantly higher in cases than in controls. All brachial SBP/DBP BPV indexes [SD, weighted SD (wSD), coefficient-of-variation (CV) and average-real-variability (ARV)] were not significantly different between groups during the 48- or 44-h periods (48-h: SBP-ARV 11.59 ± 3.05 vs. 11.70 ± 2.68, p = 0.844, DBP-ARV: 8.60 ± 1.90 vs. 8.90 ± 1.63, p = 0.357). Analysis stratified by day or night between days 1 and 2 revealed, in general, similar results. No significant differences in dipping pattern were observed between groups. Analysis of aortic BPV had similar findings. Conclusions: BPV is similar between those with and without intradialytic hypertension. However, those with intradialytic hypertension have a sustained increase in systolic and diastolic BP during the entire interdialytic interval.

scholarly journals Obesidade: principal fator de risco para hipertensão arterial sistêmica em adolescentes brasileiros participantes de um estudo de coorte

2013 ◽  
Vol 57 (7) ◽  
pp. 520-526 ◽  
Author(s):  
Naiara Ferraz Moreira ◽  
Ana Paula Muraro ◽  
Flávia dos Santos Barbosa Brito ◽  
Regina Maria Veras Gonçalves-Silva ◽  
Rosely Sichieri ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Children And Adolescents ◽  
High Blood Pressure ◽  
Task Force

OBJETIVO: Identificar a prevalência e os fatores associados à hipertensão arterial sistêmica (HAS) em adolescentes de uma coorte. SUJEITOS E MÉTODOS: Estudo transversal com 1.716 adolescentes, de 10 a 16 anos, participantes de um estudo de coorte. Os dados sociodemográficos, econômicos e de estilo de vida foram obtidos por meio de entrevista e os dados referentes ao nascimento e à infância foram obtidos na linha de base. Foram considerados hipertensos os adolescentes que apresentaram pressão arterial sistólica e/ou diastólica acima do percentil 95, segundo a classificação preconizada pelo Second Task Force High Blood Pressure in Children and Adolescents. O estado nutricional foi diagnosticado pelo índice de massa corporal (IMC), segundo o escore z. O perímetro da cintura foi medido ao nível da cintura natural. A associação da HAS com as variáveis explicativas foi estimada por regressão logística. RESULTADOS: Os entrevistados correspondem a 71,4% dos avaliados na linha de base, sendo 50,7% do sexo masculino. A prevalência global de HAS foi de 11,7%. Na análise ajustada para idade, sexo e cor de pele, a hipertensão arterial associou-se à obesidade [OR = 2,27; IC (95%) = 1,64-3,14], mas não ao perímetro da cintura, que, após ajuste para o IMC, perdeu a associação. Os eventos precoces na vida não foram associados à HAS na adolescência. CONCLUSÃO: Os resultados enfatizam a obesidade como principal fator associado à HAS em adolescentes.

scholarly journals NUTRICIÓN EN EL NIÑO HIPERTENSO

Gastrohnup ◽  
2016 ◽  
Vol 17 (3S3) ◽  
Author(s):  
LINA JOHANNA MORENO GIRALDO ◽  
ADELA HERRERA GENES
Keyword(s):  
Blood Pressure ◽  
Children And Adolescents ◽  
High Blood Pressure ◽  
Education Program ◽  
El Niño ◽  
Working Group ◽  
El Nino ◽  
Tejido Adiposo ◽  
National High Blood Pressure ◽  
Factores De Riesgo

La Hipertensión Arterial (HTA) en niños es un problema creciente en salud. Con una frecuencia estimada en niños del 1-13%, dependiendo de la metodología usada, es uno de los factores de riesgo más importantes para el desarrollo de enfermedad cardiovascular y renal crónica. En 2004, el Cuarto Informe, establece que los valores normales de la presión arterial en niños dependen del género, edad, percentil de talla y para su clasificación se utilizan actualmente las tablas de la National High Blood Pressure Education Program Working Group on High Blood Pressure Children and Adolescents, con los percentiles 50, 90, 95 y 99 de presión arterial sistólica y diastólica. Entre los factores en la patogenia de la HTA primaria ó esencial en pediatría está la obesidad, relacionada con el aumento del gasto cardíaco y del volumen intravascular, aumento de la actividad del sistema simpático, lesión endotelial por radicales libres, aumento de la generación de angiotensina a partir del tejido adiposo, hiperinsulinemia con aumento en la reabsorción de sodio y del tono simpático, de la leptina, además de aterosclerosis temprana, trastornos del sueño relacionados con síndromes de apnea e hipopnea. En los niños, las diferentes guías de manejo incluyendo las de la Organización Mundial de la Salud y de la Sociedad Internacional de Hipertensión (OMS/ISH), se plantean como objetivo terapéutico reconocido ampliamente, que una disminución en el consumo de sodio en niños y adolescentes se ha asociado con reducción en la PA, entre 1 a 3 mmHg. Por lo anterior, teniendo en cuenta las complicaciones en edades tardías de consumo de sal de la dieta desde la infancia y la aparición más frecuente de niños pequeños se debe determinar las necesidades de sodio en la dieta y dentro de las recomendaciones se debe preferir alimentos de origen natural y en lo posible no se debe agregar sal a las preparaciones en el niño menor de 2 años.

scholarly journals Low Birthweight Is Associated with Higher Risk of High Blood Pressure in Chinese Girls: Results from a National Cross-Sectional Study in China

2019 ◽  
Vol 16 (16) ◽  
pp. 2898
Author(s):  
Xijie Wang ◽  
Yanhui Dong ◽  
Zhiyong Zou ◽  
Jun Ma ◽  
Zhaogeng Yang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Low Birthweight ◽  
Cross Sectional Study ◽  
Anthropometric Parameters ◽  
Cross Sectional ◽  
School Based ◽  
Chi Squared ◽  
Chinese Girls ◽  
The Relationship

Objective: To investigate the relationship between low birthweight (LBW) and blood pressure and to assess whether LBW leads to a higher risk of high blood pressure (HBP) by gender in Chinese students aged 6–18 years. Also, to investigate whether the association was affected by childhood obesity. Methods: Data was obtained from a baseline dataset of a national school-based program. Anthropometric parameters, including height, weight, and blood pressure, were measured, while birthweight and other characteristics were obtained from questionnaires. Stratified chi-squared tests were used to compare the prevalence of HBP between LBW and normal birthweight (NBW) groups in each age and sex category. Multivariable logistic regressions were conducted to estimate the HBP risks in each birthweight group. Results: Both systolic and diastolic blood pressure showed a U-shaped relationship with increased birthweight. Compared to NBW groups, LBW girls showed a higher HBP risk, with an odds ratio of 1.29 (95% confidence interval (CI): 1.02, 1.64, p = 0.033), regardless of their current body mass index status, while no significant association in boys was found. Conclusions: Low birthweight is associated with higher HBP risk in adolescent girls, regardless of their childhood BMI status.

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