Blood Pressure In Young Children Research Articles

Physical Activity, but Not Body Mass Index Is Associated With Blood Pressure in Young Children.

This study examined associations between physical activity (PA) and obesity with blood pressure (BP) in young children. Furthermore, a possible moderating effect of obesity status was examined. A cross-sectional study was completed with 121 children (3.96 [1.14]y). BP, weight, and height were measured, and body mass index (BMI) was calculated. Z scores were calculated for BMI, systolic, and diastolic values. Accelerometry measured time spent in PA intensities. Correlations and regressions examined relationships among PA intensities, BMI z scores, and BP z scores and to determine if obesity status moderated these relationships. On average, the children spent 52minutes per day in moderate-to-vigorous physical activity, 31% were considered overweight/obese, and 15% were considered hypertensive. After adjusting for confounders, participation in moderate, vigorous, and moderate-to-vigorous physical activity was related with lower systolic and diastolic BP z scores (P < .05). BMI z score was not related to BP values. Obesity status did not moderate the relationships between time spent in PA and BP. Participation in PA, but not obesity, was related to lower BP levels in young children. The impact PA has on BP is the same regardless of obesity status. Thus, young children should be encouraged to be active in different intensities to benefit the cardiovascular system.

Urban environment during early-life and blood pressure in young children

BackgroundThe urban environment is characterised by many exposures that may influence hypertension development from early life onwards, but there is no systematic evaluation of their impact on child blood pressure (BP). MethodsSystolic and diastolic blood pressure were measured in 4,279 children aged 4–5 years from a multi-centre European cohort (France, Greece, Spain, and UK). Urban environment exposures were estimated during pregnancy and childhood, including air pollution, built environment, natural spaces, traffic, noise, meteorology, and socioeconomic deprivation index. Single- and multiple-exposure linear regression models and a cluster analysis were carried out. ResultsIn multiple exposure models, higher child BP, in particular diastolic BP, was observed in association with higher exposure to air pollution, noise and ambient temperature during pregnancy, and with higher exposure to air pollution and higher building density during childhood (e.g., mean change [95% confidence interval] for an interquartile range increase in prenatal NO2 = 0.7 mmHg[0.3;1.2]). Lower BP was observed in association with higher temperature and better street connectivity during childhood (e.g., temperature = -1.1[-1.6;-0.6]). Some of these associations were not robust in the sensitivity analyses. Mother-child pairs were grouped into six urban environment exposure clusters. Compared to the cluster representing the least harmful urban environment, the two clusters representing the most harmful environment (high in air pollution, traffic, noise, and low in green space) were both associated with higher diastolic BP (1.3[0.1;2.6] and 1.5[0.5;2.5]). ConclusionThis first large systematic study suggests that living in a harmful urban environment may impact BP regulation in children. These findings reinforce the importance of designing cities that promote healthy environments to reduce long-term risk of hypertension and other cardiovascular diseases.

Association between general and central adiposity and development of hypertension in early childhood.

To evaluate the association of general and abdominal obesity with high blood pressure in young children. A longitudinal study including 1796 participants from the Madrid region (Spain) with baseline at age 4 years and a follow-up 2 years later. Blood pressure, body mass index and waist circumference were measured during a physical examination. We evaluated the association between obesity at baseline and weight changes between the ages of 4 and 6 years and high blood pressure. Data were analysed using linear and logistic regressions adjusted for covariates. Obese 4 year olds (general or abdominal obesity) experienced an average 4-5 mmHg increase in systolic blood pressure and a 2.5-3 mmHg increase in diastolic blood pressure by the age of 6 years. Compared to children maintaining a non-excess weight (based on body mass index) during follow-up incident and persistent cases of excess weight (overweight or obesity) had an odds ratio (OR) for high blood pressure of 2.49 (95% confidence interval (CI) 1.50-4.13) and OR 2.54 (95% CI 1.27-5.07), respectively. Regarding abdominal obesity we estimated OR 2.81 (95% CI 0.98-8.02) for incident cases and OR 3.42 (95% CI 1.38-8.49) for persistent cases. Similar estimates for the waist-height ratio were observed. Individuals who experienced remission to non-excess weight did not have an increased risk of high blood pressure. We observed an increased risk for high blood pressure among 4-year-olds who presented with persistent or incident cases of excess weight (body mass index) or abdominal obesity after 2 years of follow-up. Children with excess weight or obesity at baseline who remitted to non-excess weight did not exhibit an increased risk of high blood pressure.

The role of a FADS1 polymorphism in the association of fatty acid blood levels, BMI and blood pressure in young children-Analyses based on path models.

BackgroundThe recent obesity epidemic in children also showed an increase in the prevalence of hypertension. As blood pressure (BP) is associated with (long-chain) polyunsaturated fatty acids (LC PUFA), genetic variation in desaturase enzymes being involved in the synthesis of LC PUFA may be associated with BP. This study aimed to investigate the direct effects (independent of mediating variables) and indirect effects (mediated through intermediate variables) of a common variant in the FADS1 gene, rs174546, known to affect delta-5 desaturase (D5D) activity on PUFA level, body mass index (BMI) and BP.MethodsA subsample of the IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) baseline survey including 520 children aged 2 to <10 years from six European countries was included. The association between rs174546 (T<C) and BP z-score as well as the mediating effects of selected key PUFA levels (dihomo-gamma-linolenic acid, DGLA; arachidonic acid, ARA; eicosapentaenoic acid, EPA) or estimated D5D activity (D5D index) and BMI z-score were investigated through path model analyses, adjusting for sex, age, educational level of parents, family history of hypertension, lifestyle factors and blood levels of saturated and monounsaturated fatty acids, triglycerides and low density lipoprotein cholesterol. Whole blood fatty acids were measured by a validated gas chromatographic method and recorded as percentage of weight of all fatty acids detected.ResultsMinor allele carriers of the SNP rs174546 had significantly higher DGLA and lower ARA and EPA levels as well as a lower D5D index. Via ARA and BMI z-score, the polymorphism had an indirect lowering effect on systolic BP z-score for each additional T allele (standardized effect estimate -0.057, p = 0.007). For DGLA, EPA and D5D index, the indirect effects of rs174546 on systolic BP were also negative but did not reach significance. DGLA and EPA had an increasing indirect effect on systolic BP via BMI. Results for diastolic BP were in general similar but effect estimates were lower compared to systolic BP.ConclusionGenetic variation in FADS1 influences BP via ARA and BMI indicating a favorable effect of the minor allele in SNP rs174546. Thus, polymorphisms with an impact on the D5D activity may play a role for the BP level mediated through PUFA and BMI. Therefore, health effects of dietary n-6 and n-3 PUFA may vary depending on genetic FADS1 variants.

Increasing blood pressure and its associated factors in Canadian children and adolescents from the Canadian Health Measures Survey

BackgroundCanada is facing a childhood obesity epidemic. Elevated blood pressure (BP) is a major complication of obesity. Reports on the impact of excess adiposity on BP in children and adolescents have varied significantly across studies. We evaluated the independent effects of obesity, physical activity, family history of hypertension, and socioeconomic status on BP in a nationally representative sample of children and adolescents.MethodsWe analysed cross-sectional data for 1850 children aged 6 to 17 years who participated in the Canadian Health Measures Survey, Cycle 1, 2007–2009. Systolic BP (SBP) and diastolic BP (DBP) were age-, sex-, and height-adjusted to z-scores (SBPZ and DBPZ). Body mass index (BMI) z-scores were calculated based on World Health Organization growth standards. Multivariate linear regression was used to evaluate the independent effects of relevant variables on SBPZ and DBPZ.ResultsFor most age/sex groups, obesity was positively associated with SBP. Being obese was associated with higher DBP in adolescent boys only. The BP effect of obesity showed earlier in young girls than boys. Obese adolescents were estimated to have an average 7.6 mmHg higher SBP than normal weight adolescents. BMI had the strongest effect on BP among obese children and adolescents. Moderately active adolescent boys had higher SBP (3.9 mmHg) and DBP (4.9 mmHg) than physically active boys. Family history of hypertension showed effects on SBP and DBP in younger girls and adolescent boys. Both family income and parent education demonstrated independent associations with BP in young children.ConclusionsOur findings demonstrate the early impact of excess adiposity, insufficient physical activity, family history of hypertension, and socioeconomic inequalities on BP. Early interventions to reduce childhood obesity can, among other things, reduce exposure to prolonged BP elevation and the future risk of cardiovascular disease.

BLOOD PRESSURE IN 2½-YEAR-OLD CHILDREN BORN EXTREMELY PRETERM: 7B.06

Objective: Adolescents and young adults born preterm have elevated blood pressure (BP).1,2 Little is known about the emergence of high BP in young children surviving extremely preterm birth (EXPT). Methods: Population-based cohort study of 76 EXPT (gestational age 23–26 weeks, mean birth weight 814 [161] g) surviving to a corrected postnatal age of 32 [1.3] months, and 76 matched controls born at term (BW 3603[482] g). After 15 min acclimatization in the room and 5 min rest in sitting position, systolic (SBP) and diastolic (DBP) BP were measured in the up-right sitting position using a validated oscillometric BP-device (Omron HEM-907). Data are mean [SD] or proportions (%). Appropriate institutional ethics committee clearance and parents’ informed consent were obtained. Results: Blood pressures were successfully measured in 119 of 152 children (78%). There were no differences in postnatal age, gender distribution or resting heart rate (mean 104 and 105 min-1, respectively) between EXPT and controls. In addition, SBP (mean 99 [11] vs 98 [8] mmHg, p = 0.47) did not differ significantly between EXPT and control s. However, DBP was higher in EXPT (mean 67 [11] compared to controls 63 [9] mmHg, p = 0.01) despite that EXPT were on average 1.9 kg lighter (p < 0.001) and 3.3 cm shorter (p < 0.001) than controls. The proportion of boys with an age, gender and height adjusted SBP > 90th percentile3 was 20/46 (44%) in EXPT and 9/44 (20%) in controls (p = 0.013). The corresponding proportions for girls were 6/31 (19%) and 8/31 (26%) (p = 0.54). Conclusions: Children born extremely preterm, in particular boys, have elevated blood pressure already at 2½ years of age. References Edstedt Bonamy A.K. et al. Pediatr Res 2005; 58, 845-849. Johansson S. et al. Circulation 2005; 112: 3430–3436. The Fourth Report on the Diagnoses, Evaluation and Treatment of High Blood Pressure in Children and Adolescents, National High Blood Pressure Education Program Working group on High pressure in Children and Adolescents. Pediatrics (2004), 114 (2nd Suppl 4th Report): 555-576.

Associations Between Sedentary Behavior and Blood Pressure in Young Children

Associations Between Sedentary Behavior and Blood Pressure in Young Children

Associations Between Sedentary Behavior and Blood Pressure in Young Children

To examine the effect of sedentary behavior on blood pressure (BP) in young children using different indicators of sedentariness. Cross-sectional study. A rural Midwestern US community. Children aged 3 to 8 years (N = 111). Intervention Adiposity was assessed using dual energy x-ray absorptiometry. Objective measurements of sedentary activity were obtained from the accelerometers that participants wore continuously for 7 days. Measurements of television (TV) viewing, computer, and screen time (TV + computer) were obtained via parent report. Systolic and diastolic BP. The sample spent a mean of 5 hours per day in sedentary activities, of which 1.5 hours were screen time. Accelerometer-determined sedentary activity was not significantly related to systolic BP or diastolic BP after controlling for age, sex, height, and percentage of body fat. However, TV viewing and screen time, but not computer use, were positively associated with both systolic BP and diastolic BP after adjusting for potential confounders. Participants in the lowest tertile of TV and screen time had significantly lower levels of systolic and diastolic BP than participants in the upper tertile. Sedentary behaviors, particularly TV viewing and screen time, were associated with BP in children, independent of body composition. Other factors that occur during excessive screen time (eg, food consumption) should also be considered in the context of sedentary behavior and BP development in children.

The Association Between ACE I/D Genotype, Physical Activity, and Blood Pressure in Young Children

The Association Between ACE I/D Genotype, Physical Activity, and Blood Pressure in Young Children

Associations Between Physical Activity, Waist Circumference and Blood Pressure in Young Children

Associations Between Physical Activity, Waist Circumference and Blood Pressure in Young Children

One Less Lead Link?: Exposure–Hypertension Association Not Replicated in Young Children

For two decades, scientists have known that lead exposure can induce hypertension in lab animals. More recent studies suggest it might also promote hypertension in adults. But little was known about the metal’s effects on blood pressure in children. Now researchers who studied 780 lead-exposed children for five years report seeing no indication that lead raises blood pressure in young children [EHP 114:579–583; Chen et al.]. Lead’s most widely documented effects are neurological. Exposure diminishes intelligence and alters behavior. Young children are particularly vulnerable to these effects because their nervous systems are still developing. Children are exposed primarily through paint particles in household dust and outdoor soil contaminated with lead from paint and industrial and motor vehicle emissions. Lead exposure in the United States plummeted after the 1978 ban on lead paint, when the CDC reported that 88% of children aged 1 through 5 had blood lead levels above the level of concern of 10 micrograms per deciliter (μg/dL). By 2000, that rate had dropped to 2.2%. The researchers originally set out to determine whether treatment with the oral chelating agent succimer would improve lead-exposed children’s scores on behavioral and cognitive tests. They recruited 780 children at clinics in Baltimore, Cincinnati, Philadelphia, and Newark. All were between 12 and 33 months of age and had moderately high blood lead levels of 20–44 μg/dL. Succimer was given to 396 children in the randomized, double-blind study. The remaining 384 children were given a placebo. Succimer lowered blood lead levels dramatically, but there was no change in test scores. So the researchers opted to examine the data for blood pressure changes. Clinicians had measured the children’s blood pressure every time they tested blood lead—immediately before the study and 7, 28, and 42 days after the start of each of three 26-day rounds of treatment. Measurements also were taken every three to four months for five years following treatment. The only difference noted was a 1-mmHg increase in systolic blood pressure between one and five years after treatment—but only in the succimer group. The researchers considered this change insignificant. Diastolic pressure remained unchanged for both the succimer and placebo groups. The team acknowledges that lead exposure might still cause hypertension years or even decades after exposure. This, combined with lead’s known neurological effects, renders the metal an important contributor to the global burden of disease.

Associations between adiposity, family history of CHD and blood pressure in 3–8 year-old children

The purpose of this study was to examine the relationships between overall and central adiposity, a family history of coronary heart disease (FHCHD), and blood pressure (BP) in young children. We were specifically interested in determining whether the relationship between adiposity and BP was modified by a FHCHD. Subjects were 130 (68 males, 62 females) young children (mean age 6.0 years). Indicators of adiposity included the body mass index, waist circumference, skinfold thickness, and body composition determined by dual energy X-ray absorbtiometry (DXA). BP was measured by standard procedures. FHCHD was reported by the parent on a questionnaire. Approximately 19% of the total sample was classified as overweight and almost 50% were classified as prehypertensive (22.4%) or hypertensive (24.8%). In the total sample, 21 of 27 correlations were significant and ranged from 0.03 to 0.52. Correlations for systolic blood pressure appeared to be stronger in female subjects. Most of the correlations for diastolic blood pressure and mean arterial pressure were significant in both sexes and, in general, ranged between 0.30 and 0.50. Overweight status was significantly associated with high BP (crude odds ratio=3.65, 95% confidence intervals 1.40-9.49). There were no significant associations between a positive FHCHD and BP, and the correlations between BMI, WC, and BP were similar in magnitude in subjects with and without a FHCHD. In conclusion, both overall and central adiposity are important determinants of resting BP in young children. A FHCHD was not associated with BP and nor were the associations between adiposity and BP modified by a FHCHD.

Blood lead and blood pressure in young children.

We examined associations between blood lead concentration (BPb) and blood pressure in 282 children age 5.5 years, residing in an exposed or unexposed town in Kosovo, Yugoslavia. Mean BPb in the exposed town was 37.3 micrograms per dl (standard deviation = 12.0 micrograms per dl) and in the unexposed town was 8.7 micrograms per dl (standard deviation = 2.8 micrograms per dl). After adjustment, a 10 micrograms per dl increase in BPb was associated with a 0.5 (95% CL = -0.2, 1.3) mmHg increase in systolic and a 0.4 (95%, CL = -0.1, 0.9) mmHg increase in diastolic blood pressure. These associations, although compatible with no relation, are similar to those observed in adults; and the data are most consistent with a small association between BPb and blood pressure.

A prospective study of familial aggregation of blood pressure in young children

In a prospective study, we evaluated familial aggregation of blood pressure in a sample of 175 normotensive familes with children 3 to 6 yr old. Systolic and diastolic blood pressure measurements of parents and children were correlated at 1, 2, and 3 yr intervals. Spearman rank-order correlation coefficients between parents and children were significant for mother-son pairs. In particular, mother-son blood pressure correlation coefficients were significant for systolic blood pressure across all 3 yr and for diastolic blood pressure during yr 2. Further analyses were performed adjusting for body mass index (BMI), age, physical activity, sodium intake, potassium intake, and parental smoking status, and alcohol use. The Spearman correlation coefficients for mother-son pairs remained significant for yr 1 and 3 after adjusting for these blood pressure correlates. These results are consistent with cross-sectional studies and suggest that both genetic and environmental contributions to blood pressure status are important in young children.

Inverse Association of Dietary Calcium With Systolic Blood Pressure in Young Children

To investigate the association of dietary calcium with blood pressure in young children. Cohort. General community. Eighty-nine boys and girls, aged 3 to 6 years, from The Framingham Children's Study. During the first year of the study, we derived nutrient data from multiple food diaries (a mean of 9.6 days of recording for each subject). At the beginning of the second year of the study, we obtained anthropometric data and up to five blood pressure readings (mean, 4.5) on each child at a single sitting. The range of subjects' average daily calcium intake was 4.9 to 19.6 mmol per 4200 kJ, with a mean of 12.8 mmol per 4200 kJ. Subjects' average systolic blood pressure ranged from 73 to 129 mm Hg, with a mean of 95.9 mm Hg; for diastolic blood pressure, the range was 37 to 78 mm Hg, mean 54.6 mm Hg. Multiple linear regression analysis, adjusted for the effects of sex, height, body mass index, and heart rate, showed that for each increment of 2.5 mmol of dietary calcium per 4200 kJ per day, systolic blood pressure was 2.27 mm Hg lower (95% confidence interval, 0.63 to 3.91 mm Hg; P = .008). We found no such association for diastolic blood pressure. Dietary calcium is inversely related to systolic blood pressure in young children.

Inverse association of dietary calcium with systolic blood pressure in young children

Inverse association of dietary calcium with systolic blood pressure in young children