Blood Pressure In Adolescents Research Articles

Association between Sleep Time and Blood Pressure in Korean Adolescents: Cross-Sectional Analysis of KNHANES VII

Background: Hypertension is highly related to sleep, and there have been a number of studies on sleep deprivation and the occurrence of hypertension. However, there is still insufficient research on the relationship between hypertension and various factors related to sleep. Thus, this study attempted to investigate the relationship between hypertension and sleep time-related variables in Korean adolescents. Methods: A total of 1470 adolescents (709 girls and 761 boys) between 12 and 18 years of age were enrolled through the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII). The systolic and diastolic blood pressure were measured. Sleep time-related variables such as sleep onset time, wake time, and sleep duration (weekday and weekend, each) were also investigated using a questionnaire. We performed multivariate regression analyses to determine the independent effects of the variables. Results: Systolic blood pressure was negatively correlated with the wake time (r = −0.081; p = 0.002) and sleep onset time (r = −0.088; p = 0.001) on weekends. There was a positive correlation between diastolic blood pressure and weekday sleep onset time (r = 0.158; p = 0.000) and weekend sleep onset time (r = 0.184; p = 0.000). The sleep duration on weekdays and weekends showed a negative correlation (r = −0.136; p = 0.000, r = −0.088; p = 0.001, respectively). In the multivariate linear regression analysis results, the sleep onset time on weekends was significantly correlated with elevated diastolic blood pressure. Conclusions: Delayed sleep onset time on weekends was significantly associated with increased diastolic blood pressure in Korean adolescents. Further investigation is needed to confirm the clinical significance of these findings.

Association of exposure to organophosphate esters with increased blood pressure in children and adolescents

Organophosphate esters (OPEs) are widely added to various industrial and consumer products, and are mainly used as flame retardants and plasticizers. Existing epidemiological studies suggest that OPE exposure may be linked to increased blood pressure (BP) and hypertension risk in adults. However, it remains unclear whether OPE exposure is associated with increased BP in children and adolescents. Here, we investigated the associations between OPE exposure and BP levels in 6–18-year-old children and adolescents from a cross-sectional study in Liuzhou, China. OPE metabolites were determined in spot urine samples (n = 1194) collected between April and May 2018. Three measurements of systolic and diastolic BP for each participant were averaged as study outcomes. Associations of OPE exposure with age-, sex- and height-standardized BP were assessed using linear regression models. We found that each natural log unit increment of bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) was associated with a 0.06 standard deviation unit (95% confidant interval (CI): 0.01, 0.11) increase in systolic BP z-score. When conducting stratified analysis based on sex, age, and BMI category, BDCIPP was shown to be positively associated with systolic/diastolic BP z-score in females, but not in males. The associations between bis(2-butoxyethyl) phosphate (BBOEP) and systolic/diastolic BP z-score were pronounced in adolescents, but not in children. Moreover, a significant positive association between 1-hydroxy-2-propyl bis(1-chloro-2-propyl) phosphate (BCIPHIPP) and diastolic BP z-score was observed in obese subjects. The present study provides the first evidence that OPE exposure was related to increased BP in children and adolescents. Given the scarcity of high-quality evidence supporting these results, the health effects of OPEs are warrant investigation in well-designed prospective studies.

Blood pressure and glomerular filtration rate in obese adolescents

Background: Obesity in children has the potential to increase the risk of morbidity and even death in the future. One of the diseases that are at risk due to obesity is hypertension and also impaired kidney function. Glomerular filtration rate differences in obese and normal-weight children are somehow contradictory. This study aims to prove the difference in blood pressure and kidney function in adolescents with obese and non-obese.Methods: A cross-sectional study was conducted among high school children in Denpasar. Subjects were classified as obese and non-obese. The Mann-Whitney test was used to assess the mean difference of blood pressure, whereas the Independent t-test was used to determine the mean difference of GFR. Multivariate analysis was performed with logistic regression and ANCOVA. Data were analyzed using SPSS version 20 for Windows.Results: A total of 68 subjects with obese and 52 subjects with non-obese were included in this study. Systolic and diastolic blood pressure in the obese group was higher than in a non-obese group, with the mean difference in systolic and diastolic blood pressure was 29 mmHg (P<0.001) and 18 mmHg (P=0.002), respectively. Obesity increases the risk of hypertension 9.78 times (95% CI: 1.86-51.39; P=0.007), and obese adolescents have an average GFR of 11.51 lower than non-obese (95% CI: 17.32 – (-5.69); P<0.001).Conclusion: Hypertension is higher in obese adolescents than non-obese, while glomerular filtration rate is lower than non-obese adolescents.

Heart Rate Variability Peculiarities in Adolescents with Psychopathology in the Educational Environment

Under conditions of inclusive education, students with health limitations, in particular, children with neurological and mental disorders, have the opportunity to study at a general school. The goal of this study was to assess the possibility of using analysis of heart rate variability (HRV) as a relatively simple tool for evaluation of the adaptive resources in students with mental disorders and for early detection of dysfunctions in the neuroregulatory mechanisms in healthy students. We compared the spectral parameters of HRV and peripheral blood pressure in healthy adolescents (n = 70) and adolescents with neuropsychiatric disorders (n = 58). Electrocardiogram was recorded for 2 minutes in a sitting posture, wearing a spirometric mask with voluntary breathing. Adolescents with mental disorders demonstrated a high total power of the HRV spectrum, an increased high-frequency power (0.15–0.4 Hz), a decreased low frequency / high-frequency ratio, and reduced total power and low frequency spectral power of systolic blood pressure variability. The revealed differences were observed mainly in males. The presented data demonstrate an increased vagal tone in adolescents with mental disabilities. Our findings support the idea that HRV can be used in schools to identify risk groups of vulnerability to mental disorders.

The association between growth patterns and blood pressure in children and adolescents: A cross-sectional study of seven provinces in China.

Aimed to investigate the associations between different growth patterns with high blood pressure, and further examine the mediation effect of BMI between growth patterns and high blood pressure among children and adolescents. A total of 31581 children and adolescents aged 7–18 years were selected based on the stratified cluster sampling method. Logistics regression models were used to calculate the odds rations (ORs) and 95% confidence interval (95%CI) of the association between different growth patterns and high blood pressure. Mediation effect analyses were applied to estimate the effect of BMI on the increase of blood pressure levels in different growth patterns. In different sex and ages, compared to reference group of normal growth, blood pressure levels and prevalence of high blood pressure of the catch‐up growth were higher, but that of the catch‐down growth were lower. The prevalence of high blood pressure was 11.69%, 16.06%, and 9.68% in normal growth, catch‐up growth, and catch‐down growth, respectively. In total, compared with the normal growth pattern, the ORs (95%CI) of high blood pressure, high systolic blood pressure and high diastolic blood pressure in the catch‐up growth were 1.171(1.073,1.280), 1.110(1.001,1.230) and 1.141(1.025,1.270) (p < .05), respectively. Additionally, the mediation effect of current BMI existed in the association between blood pressure levels and different growth patterns, particularly in boys. Our findings suggested that different growth patterns after birth could modify blood pressure, and the potential risks of high blood pressure could be increased by catch‐up growth at childhood and adolescence.

Pediatric hypertension based on Japanese Society of Hypertension Guidelines (JSH 2019) with actual school blood pressure screening data in Japan.

Blood pressure (BP) in children and adolescents is associated with their growth. BP is most strongly associated with height during height gain and with degree of obesity after reaching final height. BP in childhood and adolescence is correlated with BP in adulthood. The pathophysiology of pediatric essential hypertension is associated with obesity, excess salt intake, and a low birth weight. The common causes of pediatric secondary hypertension are renal parenchymal and renovascular diseases. The significance of diagnosing pediatric hypertension involves detecting secondary hypertension and preventing organ damage due to hypertension as well as tracking essential hypertension in adulthood. Appropriate BP measurement procedures are required for diagnosing pediatric hypertension. The inflatable bladder of an appropriately sized cuff should exceed 40% of the arm circumference. BP measurements should be performed consecutively at least 3 times using an appropriately sized cuff. The diagnosis of hypertension requires that all BP values measured on 3 or more occasions be above the reference value. The criteria for pediatric hypertension are determined based on the distribution of BP in healthy children and adolescents, with values above the 95th percentile of normal representing hypertension. Japanese criteria define pediatric hypertension as ≥120/70 mmHg for preschool children, ≥130/80 mmHg for 1st–3rd graders, ≥135/80 mmHg for 4th–6th graders, ≥140/85 mmHg for 7th–9th grade boys, ≥135/80 mmHg for 7th–9th grade girls, and ≥140/85 mmHg for senior high school boys and girls. The prevalence of Japanese pediatric hypertension was 0.9% based on proper measurement protocols. The basis of managing pediatric essential hypertension is healthy lifestyle modifications. Pharmacotherapy is indicated for persistent hypertension, symptomatic hypertension, secondary hypertension, the development of target organ damage, the presence of chronic kidney disease, and diabetes mellitus. Screening for pediatric hypertension is important; therefore, BP should be routinely measured in children and adolescents.

Abstract 11678: Prevalence of Elevated Blood Pressure and Left Ventricular Hypertrophy in Adolescents With Congenital Heart Disease

Introduction: Left ventricular hypertrophy (LVH) is defined as LVM indexed to height 2.7 (LVMi-HT 2.7 ≥ 51 g/ht 2.7 in men, ≥ 47 g/ht 2.7 in women), and ≥ 38.6 g/ht 2.7 in the pediatric population. LVH associated with hypertension (HTN) is a predictor of adverse cardiovascular (CV) events in adulthood. Adults with congenital heart disease (CHD) have higher rates of HTN compared to the general adult population. Data on the prevalence of elevated systolic blood pressure (SBP) in youths with CHD is limited. The aim of our study was to determine the prevalence of elevated SBP and LVH in adolescents with CHD. Hypothesis: We hypothesized that youths with elevated SBP will have increased LVMi-HT 2.7 by echocardiography. Methods: We retrospectively analyzed echocardiograms with a diagnosis code of CHD from 2012 to 2019. We included patients aged 13-17 years with documented BP, height, weight, and echocardiography measurement for LVMi-HT 2.7 . Patients were grouped by BP category into normotensive (NT, SBP &lt; 120 mm Hg), elevated BP (E-BP, 120 ≤ SBP &lt; 130 mm Hg), Stage 1 HTN (HTN-1, 130 ≤ SBP &lt; 140 mm Hg), and Stage 2 HTN (HTN-2, SBP ≥ 140 mm Hg). The prevalence of LVH was reported in each group defined as LVMi-HT 2.7 ≥ 38.6 g/ht 2.7 . Results: 855 patients were included with a mean age of 15.5±1.5 years with 485/855 (56.7%) male, SBP 117±13.5 mm Hg, and LVMi-HT 2.7 34.2±10.5 g/ht 2.7 . 493/855 (57.7%) were in the NT group, 214/855 (25%) in E-BP, 99/855 (11.6%) in HTN-1, and 49/855 (5.7%) in HTN-2. The prevalence of LVH increased with higher SBP with 96/493 (19.5%) in NT, 80/214 (37.4%) in E-BP, 32/99 (32.3%) in HTN-1, and 20/49 (40.8%) in HTN-2. Of the youths with LVH, 49/228 (21.5%) met adult criteria of ≥ 51 g/ht 2.7 . Conclusions: Youths with CHD have a high prevalence of elevated BP, HTN, and LVH. These findings support the importance of early detection and screening for high BP in this group because youths with CHD have baseline increased CV risk that may be compounded by HTN. Future studies will be needed to determine longitudinal changes and the influence of body mass index and sex on BP in this group.

Trajectories of body mass index Z-score and risk of high blood pressure in late adolescence in Suzhou children

Objective: To identify age and gender standardized body mass index among children and adolescents and explore their associations with high blood pressure (HBP) in late adolescence. Methods: The current study was based on the Health Promotion Program for Children and Adolescents, school-based surveillance successively conducted from 2012 to 2019 in Suzhou, China. A total of 11 812 children and adolescents aged 16-18 years, who had ≥4 examination records during 2012-2018 and were also involved in a surveillance program in 2019, were included. Latent class growth mixture modeling was used to identify the BMI-Z trajectories in different genders, and multivariate logistic regression was used to analyze the associations between different BMI-Z trajectories and risk of HBP in late adolescence. Results: Six distinct BMI-Z trajectories were determined for both genders:thin, slightly thin,standard, declining, overweight, and obese. Compared with the regular group, the obesity group had 94.0% (OR=1.94, 95%CI: 1.43-2.63) and 107.0% (OR=2.07, 95%CI: 1.33-3.22) increased risk of developing HBP in late adolescence in boys and girls, respectively. However, a neutral association was found between the descending group and HBP in late adolescence. Conclusions: Persistent obesity in children may increase the risk of HBP in their late adolescence. If an obese child restores normal weight before late adolescence, the risk of HBP may reduce.

Sodium intake and high blood pressure among adults on caloric deficit: a multi-year cross-sectional analysis of the U.S. population, 2007-2018.

Small studies have shown reduced sodium-sensitivity of blood pressure in obese adolescents on a caloric deficit. We aimed to explore the association between mean daily sodium intake and prevalent hypertension among a nationally representative sample of U.S. adults on a calorie deficit. We used a design-based regression model to explore the association between sodium intake and prevalent hypertension. We also conducted sensitivity analyses using multiple imputation chained equations and propensity score matching. We also measured the effect of a binary exposure derived from the widely recommended threshold of 2.3 grams of sodium intake per day. Among 5756 individuals, we did not detect any significant association between increased sodium and the odds of hypertension (OR: 0.97; 95% CI: 0.90; 1.05). All our sensitivity analyses are consistent with our main findings. People on a calorie deficit-a component of healthy weight loss-without malnutrition saw no benefit in reduced sodium intake to lower blood pressure. These results highlight the need to explore new population-specific strategies for sodium intake reduction, including new dietary prescription approaches to improve dietary adherence and reduce the risk associated with sodium-deficient diets.

Hemoglobin and hematocrit levels are positively associated with blood pressure in children and adolescents 10 to 18\xa0years old

To investigate the associations between hemoglobin (Hb) concentration and hematocrit (Hct), and blood pressure (BP) in children and adolescents. The study population consisted of 7950 subjects total (4229 boys and 3721 girls) aged 10–18 years who participated in the Korea National Health and Nutrition Examination Surveys conducted between 2007 and 2017. The prevalence of hypertension was 19.19% (21.51% for boys and 16.5% for girls) among the study population, and the prevalence of obesity was 9.59% (10.5% for boys and 8.6% for girls). Hb count and Hct tended to increase with the degree of obesity and BP elevation. Systolic BP (SBP) and diastolic BP (DBP) positively correlated with Hb count and Hct in both sexes. Following multiple linear regression analysis, Hb count and Hct presented a positive association with SBP and DBP after adjusting for age, BMI SDS, alcohol consumption, smoking status, physical activity, rural residence, household income, diagnosis of T2DM, hypertension, and dyslipidemia. Hb count and Hct were positively associated with SBP and DBP in children and adolescents 10–18 years old.

Is vitamin D status associated with non-communicable disease risk in children? A cohort study

Background: Studies in children and adults have reported variations in 25-hydroxyvitamin D (25(OH)D), body mass index (BMI) and blood pressure (BP) over time. Furthermore, there has been a reported association of 25(OH)D with BMI, BP and lipid levels in some cross-sectional and longitudinal studies. Methods: This is a longitudinal study of a group of adolescents with measurements of 25(OH)D, BP, anthropometry and lipids at the ages of 11, 12 13, 15 and 18–20 years. For age-related changes, year 12 participants (n = 261) were matched with year 18–20 participants (n = 368), resulting in 200 paired participants. Longitudinal analyses using the Generalized Estimating Equations (GEE) comprised the following groups of participants, Year 11 (n = 288), Year 12 (n = 253), Year 13 (n = 292), Year 15 (n = 238) and Year 18–20 (n = 368). The relationship of 25(OH)D with BMI, BP and lipid levels over a period of 10 years was assessed. Results: There were significant increases in mean BMI and BP, and decreases in 25(OH)D levels with age (all p-values < 0.0001). In females, systolic BP was significantly higher in older participants (18–20) years than younger participants (12 years), but 25(OH)D was significantly higher in younger than older participants. In males, there was significant increase in BP in participants between age 12 years and 18–20 years. 25(OH)D, total cholesterol (TC) and low-density lipoprotein (LDL-C) were significantly lower in 18–20-year-old participants compared with 12-year-old participants. Longitudinally, 25(OH)D was inversely associated with LDL-C. Conclusion: There is evidence of changes in 25(OH)D, BMI and BP in adolescents over a period of 10 years. After adjusting for covariates, BMI and LDL-C were significantly negatively associated with 25(OH)D, which suggests that vitamin D status might be associated positively with favourable lipid profiles in children and adolescents.

A sex-related mediating effect of uric acid in the association between body composition and blood pressure in children and adolescents.

The increase in blood pressure (BP) during somatic growth might have direct determinants but also mediating factors. We investigated whether uric acid (UA) and other metabolic factors would mediate the association between body composition components and BP. A cross-sectional study was conducted in 928 children and adolescents (aged 6-18years), in which body composition and blood biochemistry were evaluated. Structural equation modeling was performed to test the direct and indirect pathways between systolic blood pressure (SBP) and body composition parameters. Muscle mass (MM) showed a strong direct effect on BP, regardless of sex. In girls, a mediating pathway through UA was not significant, but the association between fat mass (FM) and MM with SBP was mediated by the cluster of metabolic factors. In boys, both MM and FM were associated with SBP through a mediating pathway via UA, but not via the cluster of metabolic factors. The association between body composition and BP in children and adolescents has a complex design and also has a sex-specific mediating component. The increase in the UA levels may affect BP levels early in boys. Also, metabolic changes elicited by FM contribute to the increase in BP at an early age in girls. Novelty: MM showed a strong direct effect on BP, regardless of sex. In girls, the association between FM and MM with SBP was mediated by the cluster of metabolic factors. In boys, both MM and FM were associated with SBP through a mediating pathway via UA.

Serum metabolites of hypertension among Chinese adolescents aged 12-17 years.

The regulatory mechanisms of hypertension in youth are incompletely understood. We aimed to identify potential serum metabolic alterations associated with hypertension in adolescents. A 1:1 age- and sex-matched case-control study including 30 hypertensive adolescents aged 12-17 years and 30 normotensive adolescents for the training set and 14 hypertensive adolescents and 14 normotensive adolescents for the test set was performed, which came from one cross-sectional study in Ningxia, China. Hypertension was defined based on blood pressure (BP) values measured on three different occasions according to the BP reference of Chinese children and adolescents. Untargeted ultra-high-performance liquid tandem chromatography quadrupole time of flight mass spectrometry was used to identify differential metabolites between hypertensive and normotensive adolescents. A total of 77 metabolites in positive mode and 101 in negative mode were identified (VIP > 1.0 and P < 0.05). After adjustment for the false discovery rate, 4 differential metabolites in positive mode and 10 in negative mode were found (Q value < 0.05). The logistic regression model adjusted for body mass index and lipid profile selected four significant metabolites (4-hydroxybutanoic acid, L-serine, acetone, and pterostilbene). The main metabolic pathways of amino acid metabolism, pantothenate and CoA biosynthesis, glyoxylate and dicarboxylate metabolism, fructose and mannose metabolism, and linoleic acid metabolism may contribute to the development of hypertension in Chinese adolescents. Based on the receiver operating characteristic plot, 4-hydroxybutanoic acid, L-serine, acetone, and pterostilbene may preliminarily help distinguish hypertension from normal BP in adolescents, with AUC values of 0.857 in the training set and 0.934 in the test set. The identified metabolites and pathways may foster a better understanding of hypertension pathogenesis in Chinese adolescents.

Association of Genetic Variants With Body-Mass Index and Blood Pressure in Adolescents: A Replication Study.

The strong correlation between adiposity and blood pressure (BP) might be explained in part by shared genetic risk factors. A recent study identified three nucleotide variants [rs16933812 (PAX5), rs7638110 (MRPS22), and rs9930333 (FTO)] associated with both body mass index (BMI) and systolic blood pressure (SBP) in adolescents age 12–18years. We attempted to replicate these findings in a sample of adolescents of similar age. A total of 713 adolescents were genotyped and had anthropometric indicators and blood pressure measured at age 13, 15, 17, and 24years. Using linear mixed models, we assessed associations of these variants with BMI and SBP. In our data, rs9930333 (FTO) was associated with body mass index, but not systolic blood pressure. Neither rs16933812 (PAX5) nor rs7638110 (MRPS22) were associated with body mass index or systolic blood pressure. Although, differences in phenotypic definitions and in genetic architecture across populations may explain some of the discrepancy across studies, nucleotide variant selection in the initial study may have led to false-positive results that could not be replicated.

Incidence and correlates of high blood pressure from childhood to adulthood: the Birth to Twenty study.

Background:There is growing evidence from high-income countries suggesting that hypertension developed in childhood and adolescence persists into adulthood. The objective of this study was to investigate the incidence and risk factors of high blood pressure (BP) in urban black children.Methods:We used data from the Birth to Twenty (BT20+) cohort in Johannesburg, South Africa constituting of children born in 1990 and who had their growth, development and blood pressure measured at six follow-up periods over the course of 13 years. High BP was classified as at least 95th percentile for age, sex and height. Incidence rate of high BP was calculated using survival analysis and risk factors were determined by use of Cox proportional hazard regression.Results:Over a follow-up period of 13 years, the overall incidence rate of high BP was 57 cases per 1000 person-years (95% CI 53.2–61.1). Risk for incident high BP increased with rapid relative weight gain in early childhood (hazard ratio =1.11, 95% CI 1.00–1.22), mid-childhood (hazard ratio = 1.13, 95% CI 1.03–1.24) and adolescence (hazard ratio = 1.21, 95% CI 0.99–1.47). Maternal parity significantly increased the risk for incident high BP (hazard ratio = 1.08, 95% CI 1.01–1.15).Conclusion:Maternal parity and relative weight gain were determinants for incident high blood pressure in urban black South African children and adolescents. To reduce the high incidence and the disease burden of high BP, national programs should focus on promoting healthy lifestyle in early stages of life to prevent rapid weight gain and later cardiovascular disease risk. Further research is required to investigate whether incident high BP in childhood predict clinical outcomes in adulthood.

Prenatal Metal Mixtures and Child Blood Pressure in the Rhea Mother-Child Cohort

BACKGROUND AND AIM: Blood pressure (BP) in childhood is an important risk factor for cardiovascular disease in adulthood. {In utero} exposure to metals has been associated with higher BP in childhood. However, most studies have evaluated elements individually and measured BP at a single time point. The objective of the current study was to investigate the impact of a complex mixture of metals on child BP trajectories and elevated BP at age 11. METHODS: The current study included 176 mother-child pairs from the Rhea Study in Heraklion, Greece who had three BP measurements in childhood (at ages 4, 6, and 11). We focused on eight metals (antimony, arsenic, cadmium, cobalt, lead, magnesium, molybdenum, selenium), which were measured by inductively coupled plasma mass spectrometry in maternal urine samples collected during pregnancy (median gestational age at collection: 12 weeks). Covariate-adjusted Bayesian Varying Coefficient Kernel Machine Regression and Bayesian Kernel Machine Regression were used to simultaneously evaluate these eight metals in relation to the change in BP from age 4 to 11 and elevated BP at age 11, respectively. RESULTS:J-shaped associations were observed between molybdenum and both systolic and diastolic BP at age 4. Similar associations were identified for both molybdenum and lead in relation to elevated BP at age 11. Positive associations between molybdenum and BP at age 4 (for concentrations 40-80 μg/L) were stronger at high levels of lead. Lead was positively associated with BP measures at age 4, but only at high levels of molybdenum. CONCLUSIONS:Co-exposure to high levels of molybdenum and lead during the prenatal period may contribute to increased BP at age 4, which in turn may contribute to elevated BP in adolescence. KEYWORDS: Metals, mixtures, blood pressure, childhood, BKMR, BVCKMR

Serum Sclerostin Is Associated with Peripheral and Central Systolic Blood Pressure in Pediatric Patients with Primary Hypertension.

Recent studies showed the significance of the canonical Wnt/beta-catenin pathway and its inhibitor—sclerostin, in the formation of arterial damage, cardiovascular morbidity, and mortality. The study aimed to assess serum sclerostin concentration and its relationship with blood pressure, arterial damage, and calcium-phosphate metabolism in children and adolescents with primary hypertension (PH). Serum sclerostin concentration (pmol/L) was evaluated in 60 pediatric patients with PH and 20 healthy children. In the study group, we also assessed calcium-phosphate metabolism, office peripheral and central blood pressure, 24 h ambulatory blood pressure, and parameters of arterial damage. Serum sclerostin did not differ significantly between patients with PH and the control group (36.6 ± 10.6 vs. 41.0 ± 11.9 (pmol/L), p = 0.119). In the whole study group, sclerostin concentration correlated positively with height Z-score, phosphate, and alkaline phosphatase, and negatively with age, peripheral systolic and mean blood pressure, and central systolic and mean blood pressure. In multivariate analysis, systolic blood pressure (SBP) and height expressed as Z-scores were the significant determinants of serum sclerostin in the studied children: height Z-score (β = 0.224, (95%CI, 0.017–0.430)), SBP Z-score (β = −0.216, (95%CI, −0.417 to −0.016)). In conclusion, our results suggest a significant association between sclerostin and blood pressure in the pediatric population.

Trends in associations between socioeconomic development and urban-rural disparity with high blood pressure in Chinese children and adolescents over two decades.

This study aimed to assess the association between the trend of urban-rural disparity in high blood pressure (HBP) in Chinese children and adolescents and socioeconomic development. Data on 1,054,602 students aged 7-18 years were obtained from five successive national surveys administered in 29 Chinese provinces in 1995, 2000, 2005, 2010, and 2014. HBP was defined as average measured systolic BP and/or diastolic BP equal to or more than 95th percentile. The socioeconomic indicators at the provincial-level included gross domestic product (GDP) per capita, the Engel coefficient, and urbanization rates. From 1995 to 2014, HBP prevalence in Chinese children and adolescents fluctuated between 6.9% and 9.2%. Rural areas had a higher prevalence of HBP than urban areas, with a diminishing trend in urban-rural disparity from 1995 to 2010 with a reduced OR from 1.45 (95% CI: 1.40-150) in 1995 to 1.09 (1.05-1.12) in 2010, whereas a widening gap in 2014 with OR of 1.23 (1.19-1.26)). A positive association existed between the improvement of socioeconomic indicators and the increase in HBP, which was demonstrated obviously by the Engel coefficient strata. The increases in the urbanization rates were accompanied by a greater increase of HBP in urban than in rural areas. The large urban-rural disparity suggests a priority of HBP control in rural children due to their current and future HBP and cardiovascular disease risks. Socioeconomic development could affect the urban-rural disparity in HBP risk, reflecting the importance of effective policy responses for preventing HBP by avoiding unhealthy lifestyles brought about by rapid economic development.

High blood pressure in children and adolescents from urban peripheral areas of La Plata, Argentina

Objective: The aim of the present study was to estimate the prevalence of high blood pressure in schoolchildren aged 4-14 years from urban peripheral areas of the city of La Plata, and analyze variations in high blood pressure prevalence by sex, age, excess weight and family socioeconomic status. Materials and methods: Systolic and diastolic blood pressure, body weight and height were measured in 3,312 schoolchildren of both sexes. The prevalence of high blood pressure (HBP), overweight and obesity was calculated. Socioeconomic information was obtained through a semi-structured survey and processed by categorical principal-component analysis. The prevalence of HBP was compared with sex, age and nutritional status (chi square test) and family socioeconomic status (generalized linear model) (p&lt; 0.05.). Results: The results showed that the prevalence of HBP, was 20.5% and that it varied by age, nutritional status and family socioeconomic status. Sexual differences were observed only in HBP obese schoolchildren. Conclusions: Children and adolescents living in urban peripheral areas of the city of La Plata, Argentina, presented higher HBP prevalence. While HBP prevalence was higher among overweight/obese children, those aged &gt;8 years and those of more favorable family socioeconomic status, sex did not affect HBP development. However, when HBP was analyzed associated with nutritional status, obese boys were more likely to have HBP than girls.

Prevalence and correlation of vitamin D deficiency and high blood pressure in primary and middle school students in Chongqing

Objective To understand the status of vitamin D deficiency and high blood pressure in primary and middle school students aged 7 to 17 years old in Chongqing, and to explore the correlation between vitamin D deficiency and high blood pressure in children and adolescents. Methods From 2016 to 2017, a total of 1 360 primary and middle school students, aged 7 to 17 years old, were selected from three rural and three urban sites in Chongqing using multi-stage stratified random sampling. This study carried out a questionnaire survey, and participants underwent a physical examination which included blood pressure and serum vitamin D assessments. Results The deficiency and insufficiency rates of vitamin D were 9.71%, and 62.57%, respectively. The high blood pressure rate was 25.88%. Multivariate Logistic regression analysis showed that after adjusting for age, economic status, waist circumference, BMI classification, and family history of hypertension, the risk of hypertension was 1.42 times that of the normal group ( P<0.05), and the risk of high systolic blood pressure was 1.59 times that of the normal group ( P<0.05). Conclusion The deficiency and insufficiency rate of vitamin D among children and adolescents aged 7 to 17 years old in Chongqing was high, and the phenomenon of high blood pressure was prominent. Students with vitamin D deficiency and insufficiency were more likely to have high blood pressure. 【摘要】 目的 了解重庆市中小学生维生素 D 缺乏和血压偏高现况及其相关性, 为有针对性防治儿童高血压的发生发展 提供参考依据。 方法 2016 年 10 月至 2017 年 1 月, 通过多阶段分层随机抽样在重庆市选择 3 个农村点和 3 个城市点共 1 360 名 7~17 岁中小学生, 开展问卷调查、体格测量、血压测量和血清维生素 D 检测。 结果 中小学生维生素D缺乏率为 9.71%, 不足率为 62.57%; 血压偏高率为 25.88%。多因素 Logistic 回归分析结果显示, 调整了年龄、经济状况、腰围和体质 量指数 (BMI) 分类、高血压家族史等因素后, 维生素 D 缺乏和不足组发生高血压的风险是正常组的 1.42倍, 收缩压偏高的 风险是正常组的 1.59倍 ( P 值均<0.05)。 结论 重庆市中小学生维生素 D 缺乏和不足、血压偏高现象较突出, 需引起关 注。维生素 D 不足和缺乏者较容易出现血压偏高。