Blood Pressure In Young People Research Articles

Use of activity trackers to improve blood pressure in young people at risk for cardiovascular disease: a pilot randomized controlled trial.

Promoting physical activity among young individuals with cardiovascular disease (CVD) risk factors such as hypertension, diabetes, or chronic kidney disease can lower systolic blood pressure (BP). We sought to determine whether a 6-month intervention using a physical activity tracker was feasible and effective, compared with usual care. Participants were recruited at a single academic medical center. Those aged 8-30years were randomized in a 2:1 ratio to either the intervention (use of a Fitbit physical activity tracker coupled with feedback regarding the participant's step count) or usual care. The primary feasibility outcomes were screening-to-enrollment ratio and 6-month retention rates; the primary clinical outcome was a change in systolic BP from 0-6months. Sixty-three participants were enrolled (57% male; mean age: 18 ± 4years). The screening-to-enrollment ratio was 1.8:1. Six-month retention was 62% in the intervention group and 86% in the control group (p = 0.08). Mean change in systolic BP in the intervention group was not significantly different from the control group at 6months (- 2.3mmHg; 95% CI - 6.5, 1.8 vs. 3.0mmHg; 95% CI - 2.5, 8.4, respectively, p = 0.12). Among children and young adults at elevated CVD risk, the use of a physical activity tracker coupled with tailored feedback regarding their step count progress was feasible but not sustained over time. Physical activity tracker use did not have a statistically significant effect on BP after 6months. Augmented strategies to mitigate risk in young patients at high risk for early-onset CVD should be explored. This trial is registered at ClinicalTrials.gov (NCT03325426).

The problem of timely diagnosis of primary hyperaldosteronism. Clinical case

A clinical case is presented of delayed diagnosis of primary hyperaldosteronism (PHA) due to aldosterone-producing adenoma. Suspicion of PHA arises in case of persistent combination of hypertension with hypokalemia of various severity, a specific neuromuscular syndrome, as well as a high risk of cardiomyopathy, heart failure, and deterioration of kidney function, which are not typical for banal hypertension. Unsatisfactory blood pressure control with a standard combination of pharmacotherapy, an unexpected positive effect of mineralocorticoid receptor antagonists, high blood pressure in young people, as well as a family history of early high blood pressure or stroke at a young age, paroxysmal course of hypertension itself increases the risk of PHA. For a long time, a disease in our patient was considered a banal hypertension, although the diagnostic hypothesis of PHA should appear immediately after severe neuromuscular syndrome, rapid progression of cardiomyopathy and clinically significant heart failure began to dominate in the clinical picture. A 44-year-old female patient came to the attention of rheumatologists with suspicion of inflammatory myopathy due to frequent episodes of muscle weakness whose origin remained unclear. Key complaints of pronounced paroxysmal generalized muscle weakness, especially in the limbs, numbness and paresthesias in the extremities, calf muscle cramps against the background of hypertension were regarded as a neuromuscular syndrome specific to PHA. The PHA hypothesis was supported by the presence of cardiomyopathy, heart failure, clinically significant hypokalemia, and elevated aldosterone level. Computed tomography of the retroperitoneal space confirmed the presence of adrenal adenoma. Unfortunately, with a delay, after 13 years of hypertension, the diagnosis of PHA against the background of aldosterone-producing adenoma was confirmed. Consultation with a surgeon endocrinologist was suggested, as well as administration of eplerenone 50 mg daily in combination with lercanidipine 20 mg daily. Already after 6 weeks of pharmacotherapy, a positive therapeutic effect was obtained regarding the control of hypertension, heart failure, and the severity of neuromuscular syndrome. The differential diagnosis of secondary endocrine hypertension can be successful only with the possession of skills for early clinical detection of endocrine pathology, even in subclinical disease presentation. The diagnosis of PHA makes it possible to offer a patient radical surgical treatment, as well as to choose optimal approaches to pharmacotherapy.

Mathematical model for the prediction of high blood pressure through digital dermatoglyphics

Abstract Background Hypertension is considered not only a disease belonging to the large group of cardiovascular conditions, but also a risk factor that impacts at an economic, social, environmental, and cultural level, among others. Worldwide, it is recognized that arterial hypertension is increasing, with projections that estimate a 30% increase in prevalence by the year 2025. Objective. To develop a mathematical model for the prediction of high blood pressure in young people through digital dermatoglyphics. Methods This study was carried out in a sequence of three activities, which included in the first instance the collection and analysis of all the fingerprints of the upper limbs of each study participant with an image recognition device, to later carry out a characterization. in terms of number and type of footprint on each of the participants’ fingers. Subsequently, a multiple linear regression model was carried out for the right and left hand, which includes information on the type of footprint, number of relevant characteristics and other physical characteristics of everyone with which it is possible to determine an expected value of the pressure. diastolic and systolic arterial pressure, a model that was validated through the estimation of different types of error, the correlation coefficient, and the tracking signal, in a contrast between predicted and observed blood pressure in a second control sample with different participants. those used in the formulation of the mathematical model. Results The model had a significant R-square, allowing to establish a relationship of similarity and explanation of the blood pressure values, from the quantification of the characteristics of the fingerprints of the right and left hand with a significance level of 95%. Conclusions An important advance is presented for the prediction of high blood pressure through genetic markers with a non-invasive and low-cost method. Key messages • This type of research allows progress in the establishment of relationships between the subject's genetic conditions and the potential risk for the development of diseases. • Biotechnology is currently presented as a tool that contributes to the challenges that are generated in different areas such as the health sector.

Characterizing Hypertension Specialist Care in Canada: A National Survey

BackgroundThe hypertension specialist often receives referrals of patients with young-onset, severe, difficult-to-control hypertension, patients with hypertensive emergencies, and patients with secondary causes of hypertension. Specialist hypertension care compliments primary care for these complex patients and contributes to an overall hypertension control strategy. The objective of this study was to characterize hypertension centres and the practice patterns of Canadian hypertension specialists. MethodsAdult hypertension specialists across Canada were surveyed to describe hypertension centres and specialist practice in Canada, including the following: the patient population managed by hypertension specialists; details on how care is provided; practice pattern variations; and differences in access to specialized hypertension resources across the country. ResultsThe survey response rate was 73.5% from 25 hypertension centres. Most respondents were nephrologists and general internal medicine specialists. Hypertension centres saw between 50 and 2500 patients yearly. A mean of 17% (± 15%) of patients were referred from the emergency department and a mean of 52% (± 24%) were referred from primary care. Most centres had access to specialized testing (adrenal vein sampling, level 1 sleep studies, autonomic testing) and advanced therapies for resistant hypertension (renal denervation). Considerable heterogeneity was present in the target blood pressure in young people with low cardiovascular risk and in the diagnostic algorithms for investigating secondary causes of hypertension. ConclusionsThese results summarize the current state of hypertension specialist care and highlight opportunities for further collaboration among hypertension specialists, including standardization of the approach to specialist care for patients with hypertension.

Risk Evaluation of Cardiovascular Diseases among Children??s

Risk factors at the cardiovascular diseases are present in childhood however cardiovascular disease arises during adulthood. This article presents the main studies that describe the importance of investigating the risk factors for cardiovascular diseases in childhood and their internal activities. Significant rates of hypertension, obesity, dyslipidaemia and sedentariness occur in children and adolescents. Blood pressure needs to be measured in childhood. An increase in arterial blood pressure in young people predicts hypertension in adulthood. The death rate from cardiovascular disease is lowest in children with lower cholesterol levels and in individuals who exercise regularly will affect the lower cases only. In addition, there is a high prevalence of sedentariness in both children and adolescents.

Investigation and Treatment of High Blood Pressure in Young People: Too Much Medicine or Appropriate Risk Reduction?

Hypertension among young people is common, affecting 1 in 8 adults aged between 20 and 40 years. This number is likely to increase with lifestyle behaviors and lowering of hypertension diagnostic thresholds. Early-life factors influence blood pressure (BP) although the mechanisms are unclear; BP tracks strongly within individuals from adolescence through to later life. Higher BP at a young age is associated with abnormalities on heart and brain imaging and increases the likelihood of cardiovascular events by middle age. However, diagnosis rates are lower, and treatment is often delayed in young people. This reflects the lack of high-quality evidence that lowering BP in young adults improves cardiovascular outcomes later in life. In this review, we evaluate the current evidence regarding the association between BP in young adult life and adverse cardiovascular outcomes later in life. Following this, we discuss which young people with raised BP should be investigated for secondary causes of hypertension. Third, we assess the current models to assess cardiovascular risk and show a lack of validation in the younger age group. Fourth, we evaluate the evidence for lifestyle interventions in this age group and demonstrate a lack of persistence in BP lowering once the initial intervention has been delivered. Fifth, we address the pros and cons of drug treatment for raised BP in young people. Finally, there are unique life events in young people, such as pregnancy, that require specific advice on management and treatment of BP.

The Effect of Methylphenidate and Atomoxetine on Heart Rate and Systolic Blood Pressure in Young People and Adults with Attention-Deficit Hyperactivity Disorder (ADHD): Systematic Review, Meta-Analysis, and Meta-Regression.

Objectives: This meta-analysis aims to study the effects of atomoxetine and methylphenidate on heart rate (HR), systolic blood pressure (SBP), and a number of adverse cardiac events on patients receiving treatment for attention-deficit hyperactive disorder (ADHD) in comparison to placebo and between atomoxetine and methylphenidate. Methods: We searched the following databases: PubMed, EMBASE, and ScienceDirect. Meta-analysis was performed on studies that examined the relationships between methylphenidate or atomoxetine and HR, SBP, as well as a number of adverse cardiac events. These studies were either placebo-controlled or comparison studies between methylphenidate and atomoxetine. Meta-regression identified patient- and treatment-related factors that may contribute to heterogeneity. Results: Twenty-two studies were included and the total number of participants was 46,107. Children/adolescents and adults treated with methylphenidate had more significant increases in post- vs. pre-treatment HR (p < 0.001) and SBP (p < 0.001) than those treated by placebo. Children and adolescents treated with atomoxetine had more significant increases post- vs. pre-treatment HR (p = 0.025) and SBP (p < 0.001) than those treated with methylphenidate. Meta-regression revealed mean age of participants, mean dose, and duration of atomoxetine and methylphenidate as significant moderators that explained heterogeneity. There were no differences in the number of adverse cardiac events between participants with methylphenidate treatment and placebo or atomoxetine. Conclusions: Children/adolescents and adults treated with methylphenidate resulted in significant increases in post- vs. pre-treatment HR and SBP as compared to placebo. Similarly, children and adolescents treated with atomoxetine had significant increases in post- vs. pre-treatment HR and SBP than those treated with methylphenidate. These findings have potential implications for continuous monitoring of HR and SBP throughout the course of treatment although the risk for adverse cardiac events were insignificant.

High blood pressure and its relationship to adiposity in a school-aged population: body mass index vs waist circumference.

High blood pressure (HBP) is a major concern in pediatric populations. Adiposity is highly related to HBP in youths; however, whether body mass index (BMI) or waist circumference (WC) is more strongly associated with HBP in this population is unclear. This cross-sectional study, involving schoolchildren between 10 and 17 years of age from public and private schools, assessed direct measurements of BMI, WC and blood pressure. The socioeconomic level, sedentary behavior, physical activity, alcohol consumption and smoking history were obtained through a questionnaire. A Pearson's correlation and linear regression were used. In total, 1011 adolescents with a mean age of 13.1 (+2.3) years were evaluated. The prevalence of overweight/obesity was 27.7%, and the percentage of abdominal obesity was 19.3%. Adolescent boys and girls who had overweight/obesity or abdominal obesity had higher systolic and diastolic blood pressure (BP) values compared with eutrophic adolescents or those without abdominal obesity. In general, both BMI and WC were related to BP, but WC was more strongly correlated with BP than BMI. In conclusion, although both BMI and WC were related to HBP, WC was more strongly associated with blood pressure in young people.

Correlation of urinary albumin/creatinine ratio and blood pressure in young people

Objective To explore the correlation of urinary albumin/creatinine ratio (urinary albumin-to-creatinine ratio, UACR)and blood pressure in young people. Methods Totally 200 cases of hypertensive patients (aged 18~50 years old) from January 2012 to March 2014 and 200 healthy volunteers who had medical examination in our hospital were selected with a random sampling method for staff questionnaires, biochemical tests, and physical examinations. Biochemical tests included kidney function, blood glucose, blood lipids, blood uric acid, and UACR. First, 400 cases were divided into four groups (1, 2, 3, and 4 groups) according to UACR quartiles from low to high. Second, 400 cases were divided into three groups according to their blood pressure: normal blood pressure, prehypertension, and hypertension. The correlation of UACR and different groups of blood pressure was analyzed. Results For norm blood pressure group, prehypertension, hypertension, the corresponding UACR level (median: 25%~75% quartile) was 0.8 (0.6~1.2) mg/mmol, 0.9 (0.7~1.4) mg/mmol, 1.0 (0.8~1.7) mg/mmol; positive UACR rate was 0, 2.6%, and 34.7%, three groups UACR levels and positive UACR rate index differences were statistically significant (P<0.05). After age factor was adjusted for 400 cases, both systolic and diastolic blood pressures were positively correlated with UACR levels. After body mass index, age, total cholesterol, and low-density lipoprotein cholesterol were adjusted for 400 cases, compared to group 1, the ratio of prehypertension to hypertension (95% confidence intervals) in groups 2, 3, and 4 was 0.98 (0.80~1.20), 1.29 (1.05~1.58), and 1.86 (1.52~2.28). Conclusions Urinary albumin/creatinine ratio was positively correlated with prehypertension and hypertension in young people. Key words: Albuminuria; Creatinine/UR; Blood pressure; Hypertension/UR

Моделирование динамики движения вектора состояния организма человека в условиях импульсной гипергравитационной физической нагрузки

The effect of hyper-gravity with pulse acceleration was studied in 156 boys and girls by means of device «Power Plate». This paper presents the regularities of behavior parameters quasi-attractors of state vector organism of human being in multidimensional phase space of states in the conditions of pulse hyper-gravitational physical load. The effects were evaluated by means of pulso-metry, rheovasography and the multifunctional complex M35 (USA). Processing of the results was carried out on a license package of statistical programs and methods for neural network to identify the parameters of the order. It is established that a single exposure to a pulsed physical hyper-gravitational activity the regulation of the cardiovascular system is manifested by the change of the distance between the centers of quasi-attractors state vector of the human organism, as well as the volume of m-dimensional parallelepiped, bounding quasi-attractors, due to the factors of gender and the initial level of frequency of cardiac rhythm. Features of change of parameters of the regional hemodynamics and blood pressure in young people with normal cardiac rhythm and tachycardia were identified. Low-amplitude hyper-gravity of an untrained people with normal cardiac rhythm provokes various changes of the quasi-attractors parameters. Informative methods of the theory of chaos and self-organization in the study of the influence of stress on the human body were presented. In the researches, according to multiparameters, on the influence of hyper-gravity on the function of the cardiovascular system greater prognostic importance are the results of data processing by means of the method of multidimensional phase spaces.

Cardiovascular risk factor investigation: a pediatric issue.

ObjectivesTo correlate cardiovascular risk factors (e.g., hypertension, obesity, hypercholesterolemia, hypertriglyceridemia, hyperglycemia, sedentariness) in childhood and adolescence with the occurrence of cardiovascular disease.SourcesA systematic review of books and selected articles from PubMed, SciELO and Cochrane from 1992 to 2012.Summary of findingsRisk factors for atherosclerosis are present in childhood, although cardiovascular disease arises during adulthood. This article presents the main studies that describe the importance of investigating the risk factors for cardiovascular diseases in childhood and their associations. Significant rates of hypertension, obesity, dyslipidemia, and sedentariness occur in children and adolescents. Blood pressure needs to be measured in childhood. An increase in arterial blood pressure in young people predicts hypertension in adulthood. The death rate from cardiovascular disease is lowest in children with lower cholesterol levels and in individuals who exercise regularly. In addition, there is a high prevalence of sedentariness in children and adolescents.ConclusionsStudies involving the analysis of cardiovascular risk factors should always report the prevalence of these factors and their correlations during childhood because these factors are indispensable for identifying an at-risk population. The identification of risk factors in asymptomatic children could contribute to a decrease in cardiovascular disease, preventing such diseases as hypertension, obesity, and dyslipidemia from becoming the epidemics of this century.

An uncommon cause of high blood pressure in young people: retroperitoneal paraganglioma with vascular invasion.

An uncommon cause of high blood pressure in young people: retroperitoneal paraganglioma with vascular invasion.

Sympathetic Neural Mechanisms in Human Blood Pressure Regulation

Sympathetic neural function is essential to human blood pressure regulation, and overactivity of sympathetic nerves may have an important role in the development of hypertension and related cardiovascular disorders. Importantly, there is extensive interindividual variability in sympathetic vasoconstrictor nerve activity, even among healthy, young, normotensive people. Therefore, the relevance of each person's level of sympathetic nerve activity for his or her blood pressure must be evaluated in the context of other factors contributing to the overall level of blood pressure, including cardiac output and vascular adrenergic responsiveness. We include evidence showing that the balance of factors contributing to normal blood pressure in young people is influenced by sex. Hypertension itself can be multifactorial, but it is often associated with elevated sympathetic nerve activity, which can be reversed by some pharmacologic antihypertensive treatments. Although much work remains to be done in this area, an appropriate recognition of the complexity of integrated physiological regulation and of the importance of interindividual variability will be key factors in moving forward to even better understanding and treatment.

Secular stroke trends: early life factors and future prospects

Stroke mortality rates have declined during the second half of the 20th century in developed countries. Possible reasons for this include preventive measures, recent environmental changes impacting on adult health risks, and more distant environmental influences on childhood health. Data from a number of populations in Europe and the USA suggest that a decrease in early life blood pressure, occurring since the beginning of the 20th century, may have been an important determinant of declining stroke incidence rates and cardiovascular disease mortality in general. Advances in stroke epidemiology are increasing the accuracy of case ascertainment, and neuroimaging refinements (particularly MRI) are improving the accuracy of stroke type and subtype diagnoses. Although some risk factors are common to ischaemic and haemorrhagic stroke, there is accumulating evidence of differing aetiology. There is also an increasing recognition that early life factors may influence stroke risk. Despite the encouraging decline in stroke incidence, there is evidence of a recent increase in mean blood pressure in young people observed in the USA and UK, prompting concern that favourable trends in stroke risk may not be maintained. Reducing early life blood pressure in a population and delaying the onset of hypertension, along with effective measures to combat obesity, are required to avoid a reversal in stroke incidence trends in developed countries, and to prevent the anticipated increase in the burden of stroke in developing countries.

Prediction of high blood pressure in young people

Blood pressure was measured in 864 young people aged 16-24 years, 8 years after both of their parents had their blood pressures measured as part of the screening phase of the Medical Research Council Mild Hypertension Trial. Only 29% of offspring with a conventional 'family history of hypertension', defined in terms of having at least one parent with a score in the top 10% of the distribution, had a blood pressure score in the top 20% after 8 years. The positive predictive value was increased to 38% in offspring with two parents in the top 20%, but only 4% of offspring met this definition and only 7% of offspring in the top 20% after 8 years were identified by this method. Sensitivity was increased to 46% in offspring with at least one parent in the top 20%, but 33% of offspring met this definition and 74% of them did not have a blood pressure level in the top 20% after 8 years. It is concluded that parental blood pressure data are of limited value for the prediction of high blood pressure in young people and provide no scientific basis for a high risk strategy of prevention.

Prediction of high blood pressure in young people

Prediction of high blood pressure in young people

Adrenal androgen excretion during adrenarche. Relation to race and blood pressure.

We have previously shown that black children have higher blood pressures than white children. In the present study, we examined whether a possible racial difference in adrenal androgen production during adrenarche might contribute to the racial disparity in blood pressure. Adrenal androgen production was estimated from urinary excretion of adrenal androgen metabolites that showed cross-reactivity with antisera to dehydroepiandrosterone sulfate (DHEA-S). Urine samples were collected overnight in 798 children, one third of whom were black. Analyses were performed for two different age groups, less than 10 years and 10 years or more of age. In children less than 10 years of age, adrenal androgen excretion rates were 17% higher in blacks than in whites (p = 0.0099); adrenal androgen excretion rates tended to be higher in older black children as well, but differences here were not statistically significant. Adrenal androgen excretion rates were positively correlated with diastolic blood pressure in the older age group only (p = 0.014). However, when the relation of race to blood pressure was examined along with adrenal androgen excretion adjusted for age, sex, and weight, race remained an independent contributor to the level of blood pressure, suggesting that a difference in adrenal androgens could not explain the racial differences in blood pressure. In summary, black children produced more adrenal androgen, but this did not explain their higher blood pressures. In older children, where adrenal androgen excretion rates were higher, diastolic blood pressure and adrenal androgen excretion were positively related, suggesting that adrenal androgens participate in establishing the level of blood pressure in young people.

EFFECT OF CALCIUM SUPPLEMENTATION ON DIASTOLIC BLOOD PRESSURE IN YOUNG PEOPLE WITH MILD HYPERTENSION

In a double-blind trial 90 mildly hypertensive subjects aged 16-29 years were randomly assigned to 1 g calcium per day or placebo. Calcium supplementation did not affect systolic blood pressure, but at six and twelve weeks diastolic blood pressure had fallen by 3·1 (p = 0·04) and 2·4 (p = 0·11) mm Hg, respectively, more in the calcium group than it had in the placebo group. Subjects with a baseline plasma parathyroid hormone (PTH) higher than the median showed a 6·1 mm Hg (p = 0·01) greater fall in diastolic blood pressure after six weeks and 5·4 mm Hg (p = 0·01) after twelve than in the placebo group. The fall in diastolic blood pressure was greater in the calcium group than in the placebo group in subjects with a lower than median serum total calcium and in those with a large bodyweight. Calcium supplementation may lower blood pressure in young people with mildly raised blood pressure, particularly in those with high plasma PTH and/or low serum total calcium.