Blood Pressure In Adolescents Research Articles

Abstract 15182: Evaluation of an Electronic Clinical Decision Support Tool for Incident Elevated Blood Pressure in Adolescents

Introduction: The PedsBP Clinical Decision Support (CDS) is an electronic health record-linked tool developed in an urban health system that aims to improve the quality of blood pressure (BP) measurement and recognition of hypertension in children. Aims: To describe the feasibility of implementing the PedsBP tool for use in a rural health system, and to describe repeat BP measurement among patients 6-17 years with an incident hypertensive BP at high-intensity clinics using the PedsBP CDS. Methods: This is a 3-arm, parallel group, cluster randomized controlled pragmatic trial in 40 community-based primary care clinics in a rural Midwestern health system (Essentia Health). Clinics were randomized 1:1:1 to usual care, low-intensity implementation (PedsBP CDS only), or high-intensity implementation (Peds BP CDS plus in-person training, monitoring CDS use, and feedback). The PedsBP CDS includes an alert to re-measure a hypertensive BP at that visit, an alert that a hypertensive BP should be repeated in 1-3 weeks, and patient-specific order sets. Study outcomes include repeat BP measurement at an index visit and diagnosis of hypertension within 6 months of meeting clinical criteria. Safety outcomes include stroke, transient ischemic attack, acute renal failure, uncontrolled hypertension within 6 months of index visit. Results: Among 22,238 (50.9% female, mean age 11.7 years, SD=3.5 years) patients with visits between 8/1/22-1/31/23 at participating clinics, 4008 (18.0%) had an incident hypertensive BP and 239 (1.1%) met clinical criteria for hypertension. Among those who met clinical criteria for hypertension, there were no cases of uncontrolled hypertension or other safety outcomes. Of 7974 patients with encounters at 13 high-intensity clinics and with a BP measured, the initial BP was elevated for 1307 (16.4%) and remeasured in 628 (48.1%). Among 1265 patients at high-intensity clinics with a BP elevated and with body mass index (BMI) information, 482 (38.1%) were obese (BMI percentile ≥95%), 209 (16.5%) were overweight (BMI percentile 85% to <95%), and 574 (45.4%) were not overweight or obese (BMI percentile <85%). Conclusions: The PedsBP CDS is feasible to implement in a new health system and has the potential to improve the quality of pediatric BP care.

Physical activity interventions for cardiopulmonary fitness in obese children and adolescents: a systematic review and meta-analysis

PurposeThis study [PROSPERO CRD42023416272] systematically analysed the effects of a physical activity intervention on cardiorespiratory fitness in obese children and adolescents and elucidated the factors that influenced those effects.MethodsA systematic review of the literature on physical activity interventions for improving cardiopulmonary fitness in obese children and adolescents from January 1, 2011, to March 1, 2023, was conducted. The search was performed on the Web of Science and PubMed databases, and the selected literature was first screened and then assessed for quality. Finally, a systematic review was conducted.ResultsOut of the initially identified 1424 search records, 28 studies were eventually included in the systematic review. These studies encompassed a total of 2724 participants aged 5 to 18 years, with the publication dates of the literature primarily ranging from 2011 to 2023. Physical activity was found to effectively improve the following parameters in obese children and adolescents: weight [mean difference (MD), -2.03 (95% confidence interval, -2.59 to -1.47), p < 0.00001], maximal oxygen consumption [MD, -1.95 (95% CI, -1.06 to -2.84), p < 0.0001], heart rate [MD, -2.77 (95% CI, -4.88 to -0.67), p = 0.010], systolic blood pressure [MD, -8.11 (95% CI, -11.41 to -4.81), p < 0.00001], and diastolic blood pressure [MD, -4.18 (95% CI, -5.32 to -3.03), p < 0.00001]. High-intensity exercise was found to yield greater improvements than low- to moderate-intensity exercise in maximal oxygen consumption [MD, 1.43 (95% CI, 0.04 to 2.82), p = 0.04] and diastolic blood pressure [MD, -6.94 (95% CI, -10.61 to -3.26), p = 0.0002] in obese children and adolescents.ConclusionPhysical activity can effectively improve the body weight, maximal oxygen consumption, heart rate, systolic blood pressure, and diastolic blood pressure of obese children and adolescents. The type of physical activity directly influences the participation interest of obese children and adolescents, with moderate- to high-intensity physical activity showing the most significant impact on intervention outcomes. High-frequency, long-term interventions yield better results than short-term interventions.

The impact of dietary and sleep rhythms on blood pressure in children and adolescents: a cross-sectional study.

Evidence about the relationship between meal and sleep time and CVD in children is scarce. The aims of this study were to describe the association between life rhythm patterns and blood pressure in children. This research was conducted among 5,608 children aged 6 to 15 years old in Chongqing and Sichuan provinces in 2021 and 2022. Dietary and sleep rhythms information was collected. The time of the first meal and last meal, and sleep time, were obtained. The mean age was 10.48 ± 2.24 years old, with 2958 (52.75%) male participants. The mean feeding window on weekdays was 11.69 h, 12.42 h, and 13.23 h for participants aged 6-7 years old, 8-12 years old and 13-15 years old, respectively. Weekday feeding window and last mealtime were positively correlated with blood pressure levels. And the changes in the feeding window between weekdays and weekends were significantly correlated with BP. Sleep duration and change in wake time were significantly correlated with SBP. Based on these results, this study identified the optimal combination of dietary and sleep rhythm interventions for children younger than 12 years of age and aged 12 and older, respectively. Disorder dietary and sleep rhythms disorders may correlate with elevated blood pressure levels, suggesting developing optimal dietary and sleep rhythm patterns could prevent the incidence of CVDs in children. The optimal dietary rhythm was defined by the indexes of breakfast time, dinner time and daily feeding window. As good meal patterns are defined as satisfied the following three items: for children younger than 12 years should have breakfast after 7:30 am; aged 12 years and over should have breakfast after 7 am; having dinner before 6 pm; daily feeding window less than 12.5 h. And less optimal dietary rhythm should satisfy any condition or eat dinner between 6 pm and 8 pm; and poor dietary rhythm should not satisfy any of the three criteria and eat dinner after 8 pm. Children with optimal dietary rhythm (in group A) had lower SBP (P < 0.001), DBP (P = 0.002) and MAP (P < 0.001) than those in group C.

Association Between Epigenetic Age Acceleration at Extremely Preterm Birth and Systolic Blood Pressure in Adolescence

Association Between Epigenetic Age Acceleration at Extremely Preterm Birth and Systolic Blood Pressure in Adolescence

The Effect of Udenafil on Heart Rate and Blood Pressure in Adolescents With the Fontan Circulation

The Fontan Udenafil Exercise Longitudinal (FUEL) trial showed that treatment with udenafil was associated with improved exercise performance at the ventilatory anaerobic threshold in children with Fontan physiology. However, it is not known how the initiation of phosphodiesterase 5 inhibitor therapy affects heart rate and blood pressure in this population. These data may help inform patient selection and monitoring after the initiation of udenafil therapy. The purpose of this study is to evaluate the effects of udenafil on vital signs in the cohort of patients enrolled in the FUEL trial. This international, multicenter, randomized, double-blind, placebo-controlled trial of udenafil included adolescents with single ventricle congenital heart disease who had undergone Fontan palliation. Changes in vital signs (heart rate [HR], systolic [SBP] and diastolic blood pressure [DBP]) were compared both to subject baseline and between the treatment and the placebo groups. Additional exploratory analyses were performed to evaluate changes in vital signs for prespecified subpopulations believed to be most sensitive to udenafil initiation. Baseline characteristics were similar between the treatment and placebo cohorts (n=200 for each). The groups demonstrated a decrease in HR, SBP, and DBP 2 hours after drug/placebo administration, except SBP in the placebo group. There was an increase in SBP from baseline to after 6-min walk test in the treatment and placebo groups, and the treatment group showed an increase in HR (87.4 ± 15.0 to 93.1 ± 19.4 beats/min, p <0.01) after exercise. When comparing changes from baseline to the 26-week study visit, small decreases in both SBP (-1.9 ± 12.3 mm Hg, p=0.03) and DBP (-3.0 ± 9.6 mm Hg, p <0.01) were seen in the treatment group. There were no clinically significant differences between treatment and placebo group in change in HR or blood pressure in the youngest age quartile, lightest weight quartile, or those on afterload-reducing agents. In conclusion, initiation of treatment with udenafil in patients with Fontan circulation was not associated with clinically significant changes in vital signs, implying that for patients similar to those enrolled in the FUEL trial, udenafil can be started without the requirement for additional monitoring after initial administration.

Association between sleep duration and high blood pressure in Lithuanian adolescents

Abstract Background Sufficient sleep duration in children plays an essential role in physical, mental, and emotional development. High blood pressure (HBP) is growing public health problem in youth. The aim of this study was to evaluate the association between short sleep duration (SSD) and HBP in Lithuanian adolescents aged 11-18 years. Methods The cross-sectional study was conducted from 2019 to 2020 in Kaunas district, Lithuania. HBP was defined according to the 2017 AAP guidelines. Sleep duration was calculated from the time of going to bed to the time of waking up. SSD was defined as sleeping &amp;lt;8 h/day. Multivariate logistic regression was used to calculate aORs and 95% CI. Results The present analysis included 1368 subjects (723 boys and 645 girls) with a mean age of 13.96±1.76 years. Overall, the prevalence of HBP was 43.6% (51.3% for boys and 34.9% for girls). Overall, 21.7% of the subjects reported sleep duration of 7- &amp;lt; 8 h/day, and 11.3% - &amp;lt;7 h/day. In the total sample, after adjustment for sex, BMI, breakfast consumption, and parental smoking, significant associations were found between SSDs and HBP (7-&amp;lt;8 h/day: aOR=1.47; 95% CI, 1.12-1.95; P = 0.006, and &amp;lt;7 h/day: aOR=1.52; 95% CI, 1.05-2.20; P = 0.025), compared to subjects who were sleeping ≥8 h/day. In boys, after adjustment for potential confounders, SSDs were associated with higher odds of HBP (7-&amp;lt;8 h/day: aOR=1.94; 95% CI, 1.30-2.89; P = 0.001, and &amp;lt;7 h/day: aOR=2.35; 95% CI, 1.35-4.12; P = 0.003). There was no significant association between SSD and HBP among girls. Conclusions Our study showed that SSD was significantly associated with increased odds of HBP in Lithuanian adolescents, especially in boys. Public health strategies should focus more on prevention of modifiable cardiovascular disease risk factors. Key messages • Sufficient sleep duration is important for adolescents’ health and may contribute to reduce the risk of cardiovascular disease. • Future prospective studies are needed to confirm these findings.

Relationship between adiponectin and blood pressure in obese Latino adolescent boys with a family history of type 2 diabetes

introductionAdipokines are associated with several pathological states including, metabolic syndrome, obesity, insulin resistance and type 2 diabetes. One of these adipokines, adiponectin is of particular interest as it has been shown to have numerous anti-inflammatory effects, However, the association between adiponectin and blood pressure remains inconclusive especially in the Latino adolescent with obesity.PurposeTo investigate the relationship between plasma adiponectin and blood pressure in Latino adolescents’ boys with obesity and a with a family history of Type 2 diabetes.MethodsThirty two Latino adolescent males with obesity aged 14–17 years with a family history of type 2 diabetes underwent a frequently sampled glucose tolerance test (FSIVGTT) to measure insulin sensitivity. Body composition was assessed using dual energy x-ray absorptiometry. Obesity was defined as having a BMI percentile ≥95. Blood pressure was assessed using the Dinamap automated blood pressure monitor, and the average of three readings was used in the analysis. Fasting plasma adiponectin was determined using radioimmunoassay.ResultsThere were moderate positive significant correlations for adiponectin and Systolic blood pressure(SBP) (rho = 0.436, p < 0.027) and Diastolic blood pressure(DBP) (rho = 0.41,p < 0.028). A multivariate liner regression showed that plasma adiponectin could significantly detect 19% of the variance in SBP (p = 0.017, and 33% for DBP (p = 0.017). In a simple linear regression adiponectin was not related to any of our variables (p < 0.05).ConclusionIn conclusion, adiponectin was positively and significantly correlated to blood pressure in Latino adolescent with obesity. Future studies should investigate this relationship in a large sample of Latino adolescent youth.

Four-year longitudinal associations of physical activity, waist circumference, and blood pressure in UK adolescents.

This study assessed the specific influence of physical activity (PA) and waist circumference (WC) on the 4-year growth trajectory of blood pressure in UK high-school students. Four-year longitudinal monitoring of 1501 adolescents was conducted as part of the EoEHHS. Measurements were taken in Grades (G)7, 9, and 11. Systolic (SBP) and diastolic blood pressure (DBP) increased over the 4-year period (SBP G7 114.6 ± 8.9 mmHg, G9 118.1 ± 9.7 mmHg, G11 122.8 ± 7.8 mmHg; DBP G7 66.7 ± 6.6 mmHg, G9 68.0 ± 6.4 mmHg, G11 70.0 ± 5.2 mmHg). Baseline WC predicted baseline and growth in SBP, but the strongest contribution to SBP came from changes in WC (β = 0.084, p = 0.002). Baseline PAQ-A score (β = -0.822, p = 0.020) and changes in PAQ-A score (β = -0.650, p = 0.019) were associated with smaller increases in DBP over the 4-year measurement period. Baseline and change in WC predicted the growth trajectory of SBP, while baseline and change in PA predicted the growth trajectory of DBP. PA and WC have a prognostic value in predicting changes in blood pressure in adolescents. Increasing PA during adolescence could slow the rise in DBP over time. This is meaningful for future hypertension and CVD risk reduction into adulthood. Hypertension in adolescents is a growing health problem that is often overlooked. Baseline and changes in waist circumference over a 4-year period predicted development of systolic blood pressure, while baseline and changes in physical activity predicted development of diastolic blood pressure. Physical activity and waist circumference have a prognostic value in predicting changes in blood pressure in adolescents and could be valuable in planning programmes to prevent hypertension in similar communities and reduce the risk of future adult hypertension.

Association of exposure to artificial light at night during adolescence with blood pressure in early adulthood

ABSTRACT Artificial light at night (ALAN) is related to various diseases, such as cancer, obesity, and coronary heart disease. However, its impact on blood pressure in adolescents is not well understood. To investigate this, we conducted a cross-sectional study with a nationwide sample of college students in China, who were freshmen from four disperse universities during Sep. and Oct. 2018. Mean levels of ALAN at participants’ residential addresses during 2013–2018 were estimated using time-varying satellite data. The association of the 6-y average of ALAN with blood pressure was estimated by using generalized linear mixed models. A total of 17 046 participants (18.2 ± 0.7 y of age, 46.79% female) from 2,412 counties and cities were included in the final analysis. After a full adjustment for potential confounders, ALAN was positively associated with systolic blood pressure (β = 0.20, p = 0.032) and pulse pressure (β = 0.28, p = 0.001), but there was no association between ALAN and diastolic blood pressure (β = -0.08, p = 0.213). In the sensitivity analysis, the results consistent with the main analysis were observed. The blood pressure of males and those with a BMI ≤24 kg/m2 were more susceptible to ALAN exposure. Our findings highlight the importance of ALAN management for blood pressure control, particularly among male and normal-weight individuals.

Blood Pressure Level in Late Adolescence and Risk for Cardiovascular Events : A Cohort Study.

Not enough is known about the association between blood pressure (BP) in adolescence and future cardiovascular events. To measure this association using the 2017 American College of Cardiology/American Heart Association guidelines for classifying BP elevation. Cohort study. Sweden. Males in late adolescence who were conscripted into the military from 1969 to 1997. Baseline BP was measured at conscription. The primary outcome was a composite of cardiovascular death or first hospitalization for myocardial infarction, heart failure, ischemic stroke, or intracerebral hemorrhage. The study included 1 366 519 males with a mean age of 18.3 years. The baseline BP was classified as elevated (120 to 129/<80 mm Hg) for 28.8% of participants and hypertensive (≥130/80 mm Hg) for 53.7%. During a median follow-up of 35.9 years, 79 644 had a primary outcome. The adjusted hazard ratio was 1.10 for elevated BP (95% CI, 1.07 to 1.13), 1.15 for stage 1 isolated systolic hypertension (ISH) (CI, 1.11 to 1.18), 1.23 for stage 1 isolated diastolic hypertension (IDH) (CI, 1.18 to 1.28), 1.32 for stage 1 systolic-diastolic hypertension (SDH) (CI, 1.27 to 1.37), 1.31 for stage 2 ISH (CI, 1.28 to 1.35), 1.55 for stage 2 IDH (CI, 1.42 to 1.69), and 1.71 for stage 2 SDH (CI, 1.58 to 1.84). The cumulative risk for cardiovascular events also increased gradually across BP stages, ranging from 14.7% for normal BP to 24.3% for stage 2 SDH at age 68 years. This was an observational study of Swedish men. Increasing BP levels in late adolescence are associated with gradually increasing risks for major cardiovascular events, beginning at a BP level of 120/80 mm Hg. Västerbotten County Council, Swedish Society for Medical Research, and Heart Foundation of Northern Sweden.

Effects of a 12-Week Yoga Training Intervention on Blood Pressure and Body Composition in Obese Female Adolescents: A Randomized Controlled Pilot Study

Effects of a 12-Week Yoga Training Intervention on Blood Pressure and Body Composition in Obese Female Adolescents: A Randomized Controlled Pilot Study

Fat-free mass may play a dominant role in the association between systolic blood pressure and body composition in children and adolescents.

Systolic blood pressure (SBP) is significantly associated with body composition in children and adolescents. However, which one of the components of body composition is the dominant contributor to SBP in children and adolescents remains unclear. We, therefore, aimed to determine the dominant contributor to SBP among components of body composition in a large cohort of American children and adolescents derived from the National Health and Nutrition Examination Survey with cross-sectional analysis. In total, 13618 children and adolescents (median age 13 years; 6107 girls) with available data on whole-body dual-emission X-ray absorptiometry measurements were included. Multiple linear regression showed that SBP was associated with higher total fat-free mass in boys (β = 0·49, P < 0·001) and girls (β = 0·47, P < 0·001) and with higher total fat mass only in boys (β = 0·12, P < 0·001) after adjustment for covariates. When taking fat distribution into consideration, SBP was associated with higher trunk fat mass (boys: β = 0·28, P < 0·001; girls: β = 0·15, P < 0·001) but negatively associated with leg fat mass (Boys: β = -0·14, P < 0·001; Girls: β = -0·11, P < 0·001), in both boys and girls. Dominance analysis showed that total fat-free mass was the dominant contributor to SBP (boys: 49 %; girls: 55·3 %), followed by trunk fat mass (boys: 32·1 %; girls: 26·9 %); leg fat mass contributed the least to SBP in boys (18·9 %) and girls (17·8 %). Our findings indicated that total fat-free mass was not only associated with SBP but also the most dominant contributor to SBP variation in American children and adolescents.

Role of muscle mass in the association between handgrip strength and blood pressure in children and adolescents.

Studies have reported conflicting results on the association between handgrip strength (HGS) and blood pressure during childhood and adolescence. High multicollinearity involving somatic components that influence both HGS and blood pressure might be an important source of bias. This study sought to investigate the independent effects of HGS and muscle mass on blood pressure levels in children and adolescents. Muscle mass and fat mass (Multifrequency Electrical Bioimpedance) and systolic (SBP) and diastolic (DBP) blood pressure (Automatic oscillometric device) were assessed in 833 volunteers aged 6-18 years, of both sexes. Handgrip strength-for-age quartiles were calculated and participants were assigned to groups by HGS quartiles. Analysis of covariance was conducted to address the linear association between HGS and SBP adjusted for height, muscle mass, and fat mass. To test for linear trend, contrast analysis was conducted. Partial eta-squared was used to confirm or rule out a small significant effect of the independent variables on SBP. The effect size of HGS on SBP was not significant in both sexes. In girls, 1.7% of the between-groups variance in SBP was accounted for by muscle mass (P = 0.016). In boys, 2.3% and 1.8% of the between-groups variance in SBP was accounted for by muscle mass (P = 0.001) and height (P = 0.005), respectively. In conclusion, children with a more advanced physical maturity for their age, that is, who are taller, stronger, and have greater fat-free mass, may be nearly reaching the physiological parameters of adulthood, and consequently have higher systolic blood pressure.

Secular trends and age-specific distribution of blood pressure in Japanese adolescents aged 12-18 years in 2000-2019.

Adolescent blood pressure is a predictor of future risk for hypertension and cardiovascular diseases, and therefore its status needs to be accurately determined. However, limited evidence is available regarding the secular trends and distribution of adolescent blood pressure. In the present study, we assessed the secular trends and age-specific distributions of blood pressure in Japanese adolescents aged 12-18 years by using data drawn from 20 years of annual health checkups conducted between 2000 and 2019. Participants underwent health checkups every year for three years at the same school and the data were divided into four 5-year cycles: 2000-2004, 2005-2009, 2010-2014, and 2015-2019. From a total of 124,460 records (33,496 individuals) retrieved, 3000 records (3000 individuals) from each year-cycle were randomly selected to avoid duplicating data from the same individuals. In the study period, in males systolic blood pressure showed a decreasing trend over time, whereas in females diastolic blood pressure showed an increasing trend. Subgroup analyses by school category (junior/senior high school) and by obesity category showed similar blood pressure trends as in the overall analysis. Age-specific blood pressure values in Japanese adolescents increased with age in males but not in females. Thus, different patterns of change in blood pressure values over the past 20 years were observed between males and females. Age-specific blood pressure distributions are also presented. Together, these findings will be useful for understanding blood pressure trends among adolescents.

Undiagnosed Pediatric Elevated Blood Pressure Is Characterized by Induction of Proinflammatory and Cytotoxic Mediators.

Inflammatory processes have been suggested as a culprit of vascular damage in pediatric hypertension. We aimed to investigate transcriptional changes of immune modulators and determine their association with office blood pressure in adolescents who were not diagnosed with hypertension at the time of the study visit. Office blood pressure measurements and blood samples were taken from adolescents of 2 German birth cohorts, GINIplus (The German Infant Study on the Influence of Nutrition Intervention Plus Air Pollution and Genetics on Allergy Development; discovery cohort, n=1219) and LISA (Influences of Lifestyle-related factors on the Immune System and the Development of Allergies in Childhood; validation cohort, n=809), during the 15-year follow-up visit and categorized based on the European Society of Hypertension Guideline. Hs-CRP (high-sensitivity C-reactive protein) and expression of 51 genes encoding cytokines/receptors and transcription factors were analyzed. The prevalence of elevated systolic blood pressure (overweight/obese) was 14.0% (5.1%) and 16.4% (5.2%) in the discovery and validation cohorts, respectively. An enhanced cytotoxic (GZMB, PRF1, IL2RB) and proinflammatory (FOS, IL1B, hs-CRP) immune profile was observed in association with the hypertension class in both cohorts. Expression of hs-CRP and IL1B was driven by overweight with IL1B being identified as a mediator between body mass index and elevated systolic blood pressure (adj.β/95% CI, 0.01/0.0002-0.02). The association of GZMB (adjusted odds ratio/95% CI, 1.67/1.26-2.21; P=0.0004) and PRF1 (adjusted odds ratio/95% CI, 1.70/1.26-2.29; P=0.0005) in the hypertension class remained significant in normal-weight individuals without parental predisposition. These effects were confirmed in LISA. Adolescent hypertension is not limited to known risk groups. As adolescents in the hypertension class show an inflammatory profile similar to that of established hypertension in adults, blood pressure monitoring at a young age is critical to ensure early intervention and prevention of adverse sequelae.

Abstract P199: Plasma Metabolomic Profiles Related To Blood Pressure (BP) In Early And Mid-adolescence: Findings From The Project Viva Cohort

Background: The identification of metabolites related to BP may afford opportunities to reveal novel biomarkers, elucidate pathogenesis, and provide potential intervention targets for prevention of hypertension. Methods: We conducted 2 cross-sectional analyses using data from the Early Teen ( n = 560, median age: 12.9y; IQR: 12.5-13.3y) and Mid-Teen ( n = 503, median age: 17.4y; IQR: 17.2-17.8y) visits of Project Viva. At each visit, we assayed plasma metabolites via untargeted metabolomics profiling (1135 at Early Teen; 1278 at Mid-Teen) and measured systolic BP (SBP) and diastolic BP (DBP). Using weighted-correlation network analysis, we identified metabolite modules and examined associations with BP using Spearman's partial correlations, adjusting for age, sex, and height. We used false discovery rate (FDR) to account for testing across multiple modules. Results: At the Early Teen visit, we identified a module of 59 metabolites ( Figure ; Network 7) comprised primarily of steroids (e.g., 24 androgenic steroids, 19 corticosteroids) that was correlated with higher SBP and DBP (ρ adjusted = 0.13-0.16; FDR ≤ 0.03). Associations were similar between males vs. females. Within this network, androgenic steroids (e.g., androstenediol (3beta,17beta) disulfate and monosulfate) seemed to drive the overall associations. At the Mid-Teen visit, the module primarily consisting of androgenic steroids was also correlated with higher SBP in the unadjusted models (ρ crude = 0.23; FDR &lt; 0.01), but the association was attenuated in the adjusted model. Conclusions: A distinct module of metabolites, largely driven by androgenic steroids, was associated with higher BP in adolescents.

Abstract P196: Association Of Chronic Kidney Disease With Blood Pressure Severity And Target Organ Injury At Baseline In Youth Referred For Hypertension Disorders

Youth with chronic kidney disease (CKD) are at risk for hypertension (HTN) and associated target organ injury (TOI). This population may need an alternate screening schedule for TOI. Our objective was to determine the association of CKD with TOI and blood pressure (BP) severity at baseline in youth referred for HTN disorders, hypothesizing that we would see lower BP severity and less cardiac TOI in youth with CKD. This is an interim analysis using baseline data from the SUPERHERO Registry, a multisite retrospective study of youth referred for HTN disorders. Inclusion criteria were age &lt;19 years and HTN disorder identified by ICD-10 codes from 1/1/2015-12/31/2022 at initial visit to a subspecialty clinic. Exclusion criteria were kidney failure on dialysis, kidney transplantation, or pregnancy by ICD-10 codes. Our exposure was presence of CKD by ICD-10 code. Our outcomes were presence of TOI (kidney and/or heart) by ICD-10 codes and BP severity from in-clinic BP measurement. We unadjusted generalized linear models. Of 11,580 participants, 488 (4%) had a diagnosis of CKD (Table). Youth with CKD had significantly higher risk of kidney-specific TOI (RR 2.81; 95% CL 2.23 to 3.52) and significantly lower BP by BP classification (OR 0.68; 95% CL 0.57 to 0.81) and lower systolic BP in adolescents (β -5.7 mmHg; 95% CL -7.4 to -4.0). Our findings could reflect differential management of patients with established subspecialty care who develop HTN and have early TOI screening or are already on anti-hypertensive medication for proteinuria. Future steps include analyzing rates of TOI screening and laboratory and echocardiogram results for precision.

Pengaruh Yoga terhadap Tekanan Darah pada Remaja Putri yang Mengalami Kegemukan di SMPN 2 Jetis Kabupaten Bantul

Teenagers have a greater risk of being overweight than other age groups. Rates of diseases such as heart disease, type 2 diabetes mellitus (DM), and high blood pressure also increase along with obesity, and all three have the potential to become degenerative diseases in the future. Obesity in adolescents is associated with increased blood pressure. Yoga can help hypertensive patients reduce their anxiety and blood pressure. Yoga is one of the best ways to get in shape and reduce your body mass index and waist size. The design in this study uses a quasy experimental design. Using a time series approach with a comparison group (control time series design) with a pretest posttest control group. The sampling technique used purposive sampling with a total sampling of 15 people in the treatment group and 15 people in the control group. Blood pressure measurement using a sphighmomanometer. Data analysis used the Pairet T-test. The study showed that there was an effect of yoga on blood pressure in female adolescents who were overweight both systolic and diastolic with the statistical significance of the Mann Whitney U p-value: 0.010 and 0.016 (&lt;0.05). Conclusion: this study has the effect of yoga on blood pressure in overweight female adolescents at SMPN 2 Jetis, Bantul Regency

Environmental exposures and blood pressure in adolescents and adults in the T1D exchange clinic registry

AimsTo examine the associations between environmental determinants of health and blood pressure and whether age, sex, or race moderated the associations among 18,754 adolescents and adults from the type 1 diabetes (T1D) Exchange Clinic Registry. MethodsWe used multivariable linear regression. Environmental determinants included exposure to ambient fine particulate matter (PM2.5, obtained from an integrated model), nitrogen dioxide (NO2), noise and light pollution, and the normalized difference vegetation index (NDVI, a marker of green space) at the ZIP code level of residence. ResultsHigher exposure to PM2.5 and NO2, and lower NDVI, was associated with higher systolic and diastolic blood pressure, and higher light pollution exposure were similarly associated with higher diastolic blood pressure. These associations between environmental exposures and blood pressure remained significant after accounting for other covariates (age, sex, race/ethnicity, BMI, and T1D duration). With aging, the negative association between NDVI and blood pressure weakened. ConclusionsThese findings emphasize the significance of minimizing exposure to environmental pollutants, including PM2.5 and NO2, as well as ensuring access to areas with higher NDVI, to promote cardiovascular health in individuals with T1D.

Glycemic Control and Metabolic Parameters in Children and Adolescents With Type 1 Diabetes.

The association between glycemic control and metabolic status is poorly defined in children and adolescents with T1D, besides being biologically plausible. We aimed to evaluate the association between glycemic control and body mass index (BMI), blood pressure (BP), and lipid profile in children and adolescents with T1D. Observational cross-sectional study including children and adolescents (5-18 years old) followed in our outpatient clinic with the diagnosis of T1D for at least a year. We used linear regression models (unadjusted and adjusted to sex and age) to evaluate the association between glycated hemoglobin (A1c) and time in range (TIR), several prespecified metabolic parameters, and prespecified demographic and clinical characteristics. We considered a p-value of <0.05 to be statistically significant. A total of 144 patients were included, 51% of whom were female. The population had a mean age of 12.7±3.4 years old. We report a positive association between A1c and BMI, systolic and diastolic BP, total- and LDL-cholesterol and triglycerides. Females and patients diagnosed at a younger age presented with higher A1c values. There is a tendency for a negative association between TIR and the former parameters. Higher A1c levels and lower TIR were associated with higher glycemic variability and were treated with a higher basal insulin per Kg dose. Our results support an important association between worse glycemic control and an unhealthier metabolic profile in children and adolescents with T1D. We can hypothesize that a good glycemic profile is needed to achieve good metabolic control at a young age.