What Should Blood Pressure Be in Healthy Children?

In a recent commentary,1 Adams and Landaw propose the novel concept that normally growing children need not have an associated progressive increase in blood pressure (BP). Noting that the National Heart, Lung and Blood Institute Task Force graphs to be used for plotting of pressure during growth and maturation show a continual increase of BP levels with age, they state that "Any implication that this is a healthy phenomenon associated with the aging process . . . is unjustified."2 To support this concept they cite data from studies in unacculturated tribes (ie, the Yanomamo Indians) showing that mean BP levels of these indians aged 0 to 50+, except for a slight increase from ages 0 to 9 years to 10 to 19 years, show no increase with age; this pattern is unlike that found in the United States and other Western cultures.

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Blood pressure of children in the United States

PEDIATRICS ◽

10.1542/peds.61.6.931 ◽

1978 ◽

Vol 61 (6) ◽

pp. 931-932

Author(s):

Forrest H. Adams

Keyword(s):

United States ◽

Blood Pressure ◽

Physical Examination ◽

Hypertensive Patient ◽

Blood Pressure Control ◽

Task Force ◽

Pressure Control ◽

The United States ◽

Blood Institute ◽

National Heart Lung

Recently a Task Force of the National Heart, Lung and Blood Institute published a report in Pediatrics on blood pressure control in children.1 The report was good in many respects in that it presented in summary form a critique of what we currently know and do not know about blood pressure in children. Particularly good for pediatricians were the sections on methodology for measurement of blood pressure; mechanisms and causes of hypertension; evaluation of the hypertensive patient; and treatment of the hypertensive patient. The Task Force stressed the importance of further research in the field of blood pressure control in children and specifically recommended that physicians incorporate the measurement of blood pressure in the annual physical examination after 3 years of age.

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Blood Pressure

PEDIATRICS ◽

10.1542/peds.80.3.459b ◽

1987 ◽

Vol 80 (3) ◽

pp. 459-460

Author(s):

MYUNG K. PARK

Keyword(s):

Blood Pressure ◽

Laboratory Testing ◽

Normative Data ◽

Task Force ◽

Pressure Control ◽

Proper Treatment ◽

Blood Institute ◽

National Heart Lung ◽

Standards And Guidelines

To the Editor.— Recently the National Heart, Lung, and Blood Institute Task Force on Blood Pressure Control in Children published revised normal BP standards and guidelines for children.1 I welcome this effort, as reliable normative data have been unavailable but are prerequisite for the early detection of hypertension and its proper treatment. The guidelines published by the Task Force for the detection of hypertension, the diagnostic evaluation, follow-up laboratory testing, and treatment are, in my opinion, excellent.

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Genetic variations of SCNA7 and blood pressure potassium interaction

European Heart Journal ◽

10.1093/ehjci/ehaa946.2702 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C Delgado ◽

M Delgado-Lelievre ◽

D Lelievre ◽

A Delgado-Almeida

Keyword(s):

Blood Pressure ◽

Strong Correlation ◽

Genetic Variations ◽

Sodium Potassium ◽

Blood Institute ◽

Urine Creatinine ◽

National Heart Lung ◽

Gated Channel ◽

K Concentration ◽

The Relationship

Abstract Introduction The sodium voltage-gated channel alpha subunit 7 (SCN7A) has been associated to renal Na regulation and hypertension. This study explores the relationship between blood pressure (BP) and urinary overnight Na/K ratio (UONaK) in hypertensives (HT) and normotensive (NT) subjects from from National Heart, Lung and Blood Institute funded, Family Blood Pressure Program (FBPP) that were genotyped for 3 SNPs for SCN7A: CV2161217, CV 356958 and CV433036. Hypothesis Genetic variations in the SCNA7 are differently associated to BP and UONaK in HT and NT. Methods 1,749 subjects genotyped for SCN7A SNPs CV2161217, CV 356958 and CV433036 were analyzed from FBPP. Subjects with diastolic BP (DBP) ≥80 or systolic BP (SBP) ≥130 mmHg were classified HTN; subjects with SBP <130 and DBP <80 mmHg were classified as NT. UONAK was calculated by dividing overnight Na by K concentration. Correlation analysis done with partial variables (use of antihypertensive drug, use of diuretics, overnight urine creatinine). Results For the CV2161217, HTN group (n=1,030), 52% had C/C, 39% C/T and 9% T/T. In NT group (n=719), 52% had C/C, 38% C/T and 10% T/T. In the HT group, subjects with CC genotype showed strong correlation between DBP and UONaK (Fig 1a) while no significant correlation with SBP. Those with CT genotype maintained the correlation between SBP and UONaK (r=0.10, p=0.03) with no correlation with SBP. The TT showed no correlation between UONaK and SBP or DBP. In the NT, subjects with TT genotype showed strong correlation between DBP and UONaK (Fig 1b) and with SB (r=0.256, p=0.03). Those with CT or TT genotypes showed no correlation between UONaK and SBP or DBP. Similar finding were obtained for CV356958 SNP; no similar association was observed in the CV433036 SNP. Conclusions Subjects with the genetic variations in the SCNA7, such as CV2161217 and CV 356958 SNPs, showed significant correlation between blood pressure and overnight urinary sodium potassium. This finding could have important implications in non dipping status observed in some hypertensive patients. Funding Acknowledgement Type of funding source: None

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Preliminary Report of the Cooperative Study of Spontaneously Occuring Factor VIII Inhibitors in Patients with Hemophilia

10.1055/s-0039-1682469 ◽

1977 ◽

Author(s):

S.S. Shapiro

Keyword(s):

Factor Viii ◽

The United States ◽

General Information ◽

Factor Ix ◽

Cooperative Study ◽

Computer Center ◽

Hbsag Positivity ◽

Blood Institute ◽

National Heart Lung ◽

History Of

A cooperative study was started in July 1975, sponsored by the Division of Blood Diseases, National Heart, Lung and Blood Institute, National Institutes of Health. The study includes 11 cooperating Centers throughout the United States as well as a computer center. All patients with Factor VIII coagulant levels below 0.10 u/ml (or even higher, if transfused often) are eligible for entry. Currently more than 1200 patients have been entered, including more than 200 with Factor VIII inhibitors. General information concerning the natural history of hemophilia is being collected, including a comparison of severity assessed clinically and in the laboratory, the incidence and degree of liver dysfunction, HBsAg positivity, and hypertension. More than 200 patients with Factor VIII inhibitors have been identified, falling clearly into categories of “strong” and “weak” antibody producers. More than 200 treatment episodes have been documented in inhibitor patients, over 100 treated with Factor VIII and an equal number treated with Factor IX concentrates. Among the latter, some 20% have resulted in secondary rises in Factor VIII antibody titer. A controlled, blinded study of the efficacy of several Factor IX concentrates will begin shortly, and should be completed within a year.

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Lessons learned from the Pediatric Cardiomyopathy Registry (PCMR) Study Group

Cardiology in the Young ◽

10.1017/s1047951115000943 ◽

2015 ◽

Vol 25 (S2) ◽

pp. 140-153 ◽

Cited By ~ 20

Author(s):

James D. Wilkinson ◽

Joslyn A. Westphal ◽

Neha Bansal ◽

Jason D. Czachor ◽

Hiedy Razoky ◽

...

Keyword(s):

Heart Transplantation ◽

Current Knowledge ◽

The United States ◽

Lessons Learned ◽

Cardiac Biomarkers ◽

Diagnostic Strategies ◽

Blood Institute ◽

National Heart Lung ◽

Pediatric Cardiomyopathy ◽

Associated Risk Factors

AbstractCardiomyopathy is a rare disorder of the heart muscle, affecting 1.13 cases per 100,000 children, from birth to 18 years of age. Cardiomyopathy is the leading cause of heart transplantation in children over the age of 1. The Pediatric Cardiomyopathy Registry funded in 1994 by the National Heart, Lung, and Blood Institute was established to examine the epidemiology of the disease in children below 18 years of age. More than 3500 children across the United States and Canada have been enrolled in the Pediatric Cardiomyopathy Registry, which has followed-up these patients until death, heart transplantation, or loss to follow-up. The Pediatric Cardiomyopathy Registry has provided the most in-depth illustration of this disease regarding its aetiology, clinical course, associated risk factors, and patient outcomes. Data from the registry have helped in guiding the clinical management of cardiomyopathy in children under 18 years of age; however, questions still remain regarding the most clinically effective diagnostic and treatment approaches for these patients. Future directions of the registry include the use of next-generation whole-exome sequencing and cardiac biomarkers to identify aetiology-specific treatments and improve diagnostic strategies. This article provides a brief synopsis of the work carried out by the Pediatric Cardiomyopathy Registry since its inception, including the current knowledge on the aetiologies, outcomes, and treatments of cardiomyopathy in children.

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