Blood Pressure Levels In Children Research Articles

Molybdenum Concentration and the Risk of Spontaneous Preterm Birth: A Nested Case-Control Study - Beijing Municipality, China, 2018-2020.

The level of molybdenum (Mo) in a mother's urine has been linked to the growth rate of the fetus and the blood pressure levels in children. We evaluated the variations in maternal plasma Mo concentrations throughout pregnancy and their potential association with the risk of spontaneous preterm birth (SPB). Future research must determine the Mo levels in pregnant women across various regions in China. Moreover, particular attention needs to be given to the potential increase in Mo concentration throughout pregnancy and its possible adverse impacts on the health of both the mother and the fetus.

Urban greenspaces and child blood pressure in China: Evidence from a large population-based cohort study

BackgroundWith the world's population steadily shifting toward urban living, children's engagement with the natural environment seems to be diminishing. This raises significant concerns about the influence of urban greenspaces on the cardiovascular health of children. ObjectiveTo assess the association between urban greenspaces exposure and blood pressure (BP) in Chinese primary schoolchildren. MethodsThis prospective cohort study used data from the Children's growth environment, lifestyle, physical, and mental health development (COHERENCE) project in Guangzhou, China. Participants included 164,853 primary schoolchildren starting from 2016/17 to 2019/20 academic year. We assessed the surrounding greenspaces at home and school by using Sentinel-2 satellite data on the normalized difference vegetation index. Prehypertension and hypertension status were defined with BP above 90th to less than the 95th percentile, at or above the 95th percentile, respectively. The association of surrounding greenness with children's BP levels and risk of prehypertension/hypertension were examined using linear mixed-effects models and Cox proportional hazards model. ResultsAmong 164,853 eligible children aged 7.21 (0.74) years, 89,190 (54.1%) were boys. Our results showed that average systolic and diastolic BP increased by 0.48 and 0.42 standard deviations, respectively, over the 3-year follow-up. We identified 23,225 new cases of prehypertension and 35,067 of hypertension status. An interquartile range increase both in home-, school- and home-school NDVI100m was significantly associated with a reduction of 0.018–0.037 in BP z-scores and a 2.7%–7.6% lower risk of hypertension. Additionally, family socioeconomic status modified the impact of home-school greenness on BP levels. Air pollution exhibited mediating effects solely in school-greenness-BP associations, while physical activity and children's BMI mainly mediated the relationships between home-greenness and BP. ConclusionThe findings of this large cohort study suggest that surrounding greenspaces are associated with lower BP levels and a decreased risk of prehypertension and hypertension in Chinese schoolchildren.

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.

Characteristics of blood pressure level in children with different body weight

BACKGROUND: Essential arterial hypertension (AH) develops more often in children with accompanying risk factors — obesity, overweight, positive heredity and genetic predisposition.AIM: Study of peculiarities of arterial hypertension clinical course in adolescents with normal body weight, overweight and obesity.MATERIALS AND METHODS: The study was conducted on children with arterial hypertension who received treatment in two hospitals in Voronezh in 2016–2020. A retrospective analysis of the children’s case histories was carried out taking into account the anamnesis, clinical laboratory and instrumental examination data and the pharmacotherapy. Some children underwent polymerase chain reaction genetic testing to determine pathological alleles of genes regulating blood pressure (BP).RESULTS: 96 patients aged 9 to 17 took part in the study. The group with normal body weight included 38 children (39.6%), median age 16.4 (aged 10.7; 17.9), with overweight — 33 people (34.4%), median age 15.2 (aged 12.0; 17.9), with obesity — 25 children (26.0%), median age 14.5 (aged 9.2; 17.9). Obese children developed arterial hypertension at earlier age (p = 0.023). According to blood pressure daily monitoring (BPDM), pathological values of systolic blood pressure (SBP) during the day (above the 95th percentile) among children with normal body weight were observed in 17 patients (44.7%), with excess body weight — in 14 people (42.4%), with obesity — in 16 people (64%), p = 0.031. Accurate difference values between the groups were obtained in terms of time index (TI) of SBP at night (p = 0.006). Time index of diastolic BP during the day > 50% was observed only in the obese children group — 4 people (16%) (p = 0.042). Pathological alleles of the angiotensinogen gene (AGT: 704 T>C), aldosterone synthase gene (CYP11B2: -344 C>T) and endothelial nitrogen synthase type 3 (NOS3: -786 T> C) were identified most frequently during genetic testing in some patients.CONCLUSION: Children with obesity developed earlier arterial hypertension compared to the same-age children with normal body weight and more often had unfavorable type of arterial hypertension according to BPDM. These results can be used to choose individual therapy and to develop special attention as regards certain target organs damage.

Features of anxiety and arterial pressure level in children with chronic gastroduodenal pathology

Context: The children of the school-age are most prone to the development of hypertension, which is determined by the characteristic disorders of the autonomic function for this period of childhood, which is accompanied by an increased level of anxiety. Aims: The aim of this study was to assess the level of anxiety in the background of fluctuations of blood pressure (BP) in schoolchildren with chronic gastroduodenal pathology. Settings and Design: This was a cross-sectional study done in city children's clinical hospital conducted for 8 months. Subjects and Methods: One hundred and twenty children with chronic gastroduodenal pathology were examined. To assess the level of arterial hypertension by tonometry. Spielberger-Hanin scale was used to assess the level of personal and situational anxiety. Statistical Analysis Used: Statistical analysis was performed using descriptive and inferential statistics and software used in the analysis was Statistica 12 (Statsoft, USA) and P < 0.05 was considered as the level of statistical significance. Results: In assessing the level of BP in children by percentile tables, it was found that in the second group there is a greater tendency to hypertension than in the first group, and in the children of second group, there were higher rates of both systolic and diastolic BP. In addition, children of the second group experienced an increase in both the personal and situational levels of anxiety. Conclusions: Children with chronic hyperplastic and erosive gastroduodenitis more often observed an increase in BP, also they experience significantly higher levels of both personal and situational anxiety.

Associations between birth outcomes with blood pressure level and risk of high blood pressure in childhood

To explore the associations between birth outcomes and blood pressure, and study the sex dimorphism of these associations. With a multistage cluster random sampling method, 62 168 children were recruited in seven provinces of China in September of 2013, with 32 064 boys and 30 104 girls, median age of 10.74 years and mean birth weight of 3.3 kg, 49 843 single birth(97%), 1339 twin(2.6%), 180 triplet or more(0.4%). Questionnaire investigation and physical examination were conducted in the present study. Weight, height and blood pressure were measured in the physical examination. Demographic characteristics, birth outcomes(including birth weight and number of births), dietary behavior, physical activities were measured by questionnaire. The widely used age-, gender-and height-specific high blood pressure standard developed by American CDC was used for the present study. Multivariate linear and logistic regression analysis were conducted to study the associations between birth outcomes and blood pressure level or high blood pressure(HBP), and also sex dimorphism of these associations was explored. A total of 5933 children were categorized as having high blood pressure in the 62 168 participants(9.5%). With stratified analyses by birth weight category, only in the low-birth-weight strata birth weight was significantly inversely associated with systolic blood pressure(SBP) and diastolic blood pressure(DBP) with potential covariates adjusted(SBP: b=-1.628, 95%CI-2.571--0.685, P=0.001; DBP: b=-1.463, 95%CI-2.186--0.740, P&lt;0.001). While compared with the non-low birth weight children, low birth weight was not associated with higher risk of HBP(P&gt;0.05). Compared with those boys born as singleton, boys born as one of the twins have a 36.4% higher risk of HBP(OR=1.364, 95%CI 1.049-1.774), while in girls no such significant association was found. Additionally, compared with a term birth, overdue birth and preterm birth was not associated with higher risk of HBP(P&gt;0.05). Birth weight and singleton or not were associated with childhood blood pressure levels and higher risk of high blood pressure, and some associations were sex specific. Gender differences should be paid attention to in the prevention and control of high blood pressure in children and adolescents in the future, and the prevention and control should be focused on low-birth weight children or twin boys.

75561 Association of childhood hypertension with early adulthood obesity and hypertension

ABSTRACT IMPACT: This study establishes the association between childhood hypertension and health outcomes in early adulthood, identifying the need to understand blood pressure during early life for primary prevention of hypertension and cardiovascular disease. OBJECTIVES/GOALS: There is evidence that blood pressure level in early life can influence hypertension and other cardiovascular risk factors later in life. We examined whether hypertension before the age of 18 is associated with higher odds of obesity and hypertension after the age of 18. METHODS/STUDY POPULATION: We studied 19,367 children and adolescents from the Vanderbilt University Medical Center’s Synthetic Derivative, a de-identified version of the electronic medical record. Childhood hypertension was defined as systolic blood pressure (SBP) ≥130 mmHg or diastolic blood pressure (DBP) ≥80 mmHg at three or more outpatient visits before the age of 18. Obesity and hypertension in early adulthood were the primary outcomes. Obesity was defined as being above normal weight for adulthood height at age 30 based on the NIH’s body mass index tables. Hypertension was defined as SBP ≥130 mmHg or DBP ≥80 mmHg at three or more outpatient visits after the age of 18. Odds ratios and 95% confidence intervals (CIs) were computed from logistic regression models adjusted for demographics, medication use, and childhood weight. RESULTS/ANTICIPATED RESULTS: Most subjects were female (63%) and white (80%). During childhood, 17% of participants had hypertension. Approximately 58% of this group were obese at age 30, and 38% had hypertension as adults. Compared to females with no childhood hypertension, females with childhood hypertension had 1.35 times higher odds of being obese at age 30 (95% CI: 1.15, 1.58) and 3.56 times higher odds of having hypertension over the age of 18 (95% CI: 3.09, 4.09). Males with childhood hypertension, compared to males without, had 1.28 times higher odds of being obese at age 30 (95% CI: 1.08, 1.52) and 2.74 times higher odds of having hypertension over the age of 18 (95% CI: 2.35, 3.20). Associations between childhood hypertension, early adulthood obesity, and hypertension significantly differed by gender (p-for-interaction for both: &lt;0.01). DISCUSSION/SIGNIFICANCE OF FINDINGS: Childhood hypertension is associated with obesity and hypertension in early adulthood. Understanding blood pressure levels in childhood and adolescence may help target efforts to reduce early adulthood cardiovascular risk factors.

The relationship between body mass index and blood pressure: A study among school going children of Rajasthan, India

Objectives: Hypertension has become common in children and generally remains undiagnosed and untreated. The present study aims to find the prevalence of high blood pressure (BP) and examines the relationship between body mass index (BMI) and BP among school going children. Materials and Methods: A cross-sectional study was conducted among 240 school going children aged between 10 years and 17 years of Udaipur district of Rajasthan. Data were collected using interview schedules and somatometric measurements were taken based on standardized protocols established by the International Society for the Advancement of Kinanthropometry. Data were analyzed using Statistical Package for the Social Sciences software version 20. Hypertension is considered when BP (systolic BP [SBP] and/or diastolic BP [DBP]) level is ≥95th percentile for height, age, and sex according to the Fourth Report on the Diagnosis, Evaluation, and Treatment of High BP in Children and Adolescents (2004). Results: It was found that 49% children were underweight, 3% were overweight, and 2% were obese. Hypertension was seen in 39 (16.2%) children (5.4% systolic hypertension, 5.8% diastolic hypertension, and 5% both systolic and diastolic hypertension). Children who were overweight/obese were more likely to have hypertension than those who were normal or underweight. Conclusion: The findings of the present study indicate that BMI is a crucial factor affecting BP levels. Simple measurements of body weight and height to determine BMI as a routine assessment in schools would help in controlling BP levels in children that might cause adulthood morbidity and mortality due to hypertension.

Stability of Blood Pressure and Diagnosis of Hypertension in Childhood.

* Abbreviations: AAP — : American Academy of Pediatrics BP — : blood pressure CPG — : Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents Longitudinal tracking studies as well as multiple long-term cohort studies have demonstrated that blood pressure (BP) in childhood tracks into adulthood and that individuals with high BP levels in childhood are more likely to develop intermediate markers of cardiovascular disease by adulthood than those with normal BP.1 What is less well understood is what happens to childhood BP levels over shorter periods of time: weeks, months, or just a few years? This question is relevant to making a diagnosis of hypertension because the 2017 American Academy of Pediatrics (AAP) Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents (CPG) recommends repeat BP measurements over a period of weeks to months (depending on how high the BP category) before making a diagnosis of hypertension.2 This recommendation is based on the known lability of childhood BP over short time periods, a point that was established by Ogborn and Crocker over 30 years ago.3 In their study reported in this issue of Pediatrics , … Address correspondence to Joseph T. Flynn, MD, MS, Division of Nephrology, Seattle Children’s Hospital, 4800 Sand Point Way NE, M/S OC.9.820, Seattle, WA 98105. E-mail: joseph.flynn{at}seattlechildrens.org

Prevalence of Hypertension and Its Association with Body Mass Index and Waist Circumference Among Adolescents in Turkey: A Cross-Sectional Study

PurposeThis study examined the prevalence of hypertension in adolescents, with the aim of determining a link between blood pressure and body composition measurements. Design and methodsThis cross-sectional study included adolescents aged 14–19 years attending schools. Their body mass index (BMI) and waist circumference (WC) measurements were recorded. Blood pressure (BP) was taken three or more times, with an average systolic BP and/or diastolic BP ≥ the 95th percentile was regarded as hypertension. ResultsThe prevalence rates of pre-hypertension and hypertension were 11.2% and 14.8%, respectively. Obese and overweight adolescents had a higher prevalence of hypertension compared with those of normal weight (41.6% and 15.5% versus 6.2%, respectively). Following adjustment for BMI status and WC, significant correlations were observed between overweight/obesity and hypertension. After adjusting for BMI status and WC, abdominal obesity was not associated with hypertension. ConclusionsA comparatively high prevalence of hypertension was found among the adolescents. Obesity and overweight were highly correlated with hypertension. Practice implicationsSchool nurses and doctors must describe and address high or raised blood pressure levels in children and adolescents. Because of the high prevalence of hypertension in the obese and overweight adolescents, this study emphasizes the need for the early prevention and control of obesity and hypertension among children.

Air pollution-associated blood pressure may be modified by diet among children in Guangzhou, China.

To assess the associations between long-term air pollution exposure and blood pressure in children, and to explore the modifying effects of diet on prehypertension and hypertension. We evaluated 7225 primary school children aged 6-12 years from Guangzhou, China, in 2017. The blood pressure was measured objectively. The individual 1-year average concentration of particles with an aerodynamic diameter of 2.5 μm or less or 10 μm or less (PM2.5, PM10), sulfur dioxide (SO2), and ozone (O3) before each blood pressure measurement were calculated by inverse distance weighting interpolation according to each home address. Generalized linear mixed-effects models were used to examine the health effects and potential effect modifications by diet factors after adjusting for covariates. The results showed that the estimated increase in mean SBP was 0.92 mmHg (95% CI 0.05-1.79) per interquartile range increase in O3. An interquartile range increase in the 1-year mean of SO2 and O3 was associated with odds ratios of 1.26 (95% CI 1.04-1.52) and 1.20 (95% CI 1.06-1.35) for prehypertension, respectively. In addition, an interquartile range increase in PM2.5, SO2, and O3 exposure was positively associated with hypertension, with odds ratios of 1.33 (95% CI 1.11-1.61), 1.70 (95% CI 1.33-2.16), and 1.48 (95% CI 1.20-1.83), respectively. Stronger effect estimates between PM2.5, SO2, and O3 concentration on prehypertension were exhibited among subgroups of children with a higher intake of sugar-sweetened beverages. Long-term exposure to PM2.5, SO2, and O3 were associated with higher blood pressure levels in children, and dietary intake might modify these associations.

The predictive value of repeated blood pressure measurements in childhood for cardiovascular risk in adults: the Hanzhong Adolescent Hypertension Study.

There is currently a lack of strong evidence linking childhood elevated blood pressure to long-term cardiovascular risk in adulthood. Repeated observations of abnormal blood pressure in childhood may enhance the prediction of cardiovascular risk in adulthood compared with a single observation. The study included 1738 individuals in rural areas of Hanzhong City, Shaanxi, who had been followed for 30 years since baseline (1987, at which time participants were aged 6-15 years). According to four independent measurements of blood pressure in 1987, 1989, 1992, and 1995, childhood elevated blood pressure was defined as 2 in-person examinations with blood pressure values above the 90th percentile. Arterial stiffness and left ventricular hypertrophy in adulthood were assessed by brachial-ankle pulse wave velocity and the Cornell product index, respectively. Childhood elevated blood pressure was associated with an increased risk of adult hypertension (OR, 2.01; 95% CI, 1.53-2.65), arterial stiffness (OR, 1.69; 95% CI, 1.32-2.16) and left ventricular hypertrophy (OR, 1.86; 95% CI, 1.13-3.05) (all P < 0.05). Cardiovascular risk in adults increased with increasing childhood blood pressure levels. In addition, two abnormal childhood blood pressure observations predicted an increased likelihood of hypertension in adulthood (0.77 for 2 versus 0.70 for 1 observation, P < 0.001). Our study provides strong evidence that elevated blood pressure in childhood predicts cardiovascular risk in adults. The prediction was enhanced by two observations of abnormal blood pressure in childhood compared with a single measurement. We emphasize the importance of childhood blood pressure monitoring and control in the prevention of cardiovascular diseases.

Prevalence and Risk Factors of Childhood Hypertension in Urban-Rural Areas of China: A Cross-Sectional Study.

Objective The increased blood pressure level in children and adolescents is recognized as an essential predictor of adulthood cardiovascular disease. This study aimed to ascertain the prevalence and the urban-rural disparity of childhood hypertension in the southwest of China. Methods Using stratified cluster sampling in urban and rural areas, a total of 13597 primary school children aged 6∼12 years living in the Southwest of China were included. The prevalence of hypertension was analyzed. The risk factors were collected by questionnaires, and the risk factors of childhood hypertension were analyzed by the logistic regression model. Results The prevalence of hypertension was 13.75%, 9.02%, and 17.47% in total, urban, and rural children, respectively, and the urban-rural difference was 8.44% (95%CI: 7.32%, 9.56%). Children with obesity, maternal gestational hypertension, >10 months of breastfeeding, or low family income had a significantly increased prevalence of hypertension (29.4%, 20.00%, 16.31%, and 16.25%, respectively). Rural residence, intake of more pickle (in rural), maternal gestational hypertension (in urban), low birth weight (in rural), obesity, increased heart rate, and red blood cell counts were the risk factors of childhood hypertension. The adjusted R2 values were 13.61%, 23.25%, 10.88%, 11.12%, 12.23%, and 25.04% in the full models excluding and including serum indexes for total, urban, and rural children, respectively. Conclusions The prevalence of childhood hypertension is significant in the Southwest of China and alarming in rural areas, which requires community intervention. Children living in rural areas combined with obesity, low social economic status, dietary imbalance, and abnormal lipid metabolism were associated with an increased risk of hypertension, and routine care programs should be conducted to prevent childhood hypertension.

Exercise program and blood pressure in children: The moderating role of sedentary time

ObjectivesThe aim of the present study was to test a before-school physical activity intervention (Active-Start intervention) on blood pressure in children and examine whether sedentary time moderates the effect of the intervention on blood pressure. DesignRandomized controlled trial. MethodsThe Active-Start intervention comprising 170 children (8–10 years old) from three public schools with low socioeconomic status in Santiago (Chile). The exercise intervention was delivered daily, before starting the first school-class (8:00–8:30 a.m.), for 8 weeks. The intervention was mainly a program of cooperative physical games at moderate-vigorous intensity. Resting systolic and diastolic blood pressure was determined from the average of two measurements at baseline and at the end of intervention. Moderate-to-vigorous physical activity and sedentary time was assessed using a GENEActiv tri-axial accelerometer prior to the program intervention. ResultsThe Active-Start intervention decreased blood pressure levels in children (p<0.01) but did not change relative to the control group. Johnson–Neyman analysis revealed a significant relationship between the effect of intervention on systolic blood pressure and mean arterial pressure when sedentary time was below, but not at or above, 657 and 659min per day (i.e., the effect of physical exercise disappears), respectively. ConclusionsThe effect of physical activity on blood pressure could disappear in children with excessive sedentary time, which highlights the need to reduce total levels of sedentary time in the day-to-day life of young people in and out of schools.

Hypertension in children in sub-Saharan Africa: primordial prevention is crucial

Hypertension in children in sub-Saharan Africa: primordial prevention is crucial

Blood Pressure Status in Children with Vitamin D Insufficiency

Background: The growing prevalence of hypertension in children and adolescents is commonly associated with hypertension in adulthood and various long-term complications. Objectives: Since previous studies have found that vitamin D deficiency is responsible for hypertension in some individuals, this study was conducted to evaluate blood pressure levels in children suffering from low levels of vitamin D. Methods: This descriptive study was conducted on 65 children under the age of 11 suffering from vitamin D deficiency. The blood pressure of children was measured by the digital blood pressure monitor citizen (REFCH-311B) after obtaining informed consent, according to the standards of blood pressure assessment in children and was then plotted on blood pressure graphs. Results: In this study, 50.8% of the children were girls, and 49.2% were boys. The mean age of these children was 6.16 ± 2.51 years. Systolic blood pressure were pre-HTN in 3.1% of children, HTN grade I in 1.5% of children, and normal in other patients. Diastolic blood pressure was pre-HTN in 4.6% of children and normal in other patients. Conclusions: According to the results of this study, it seems that the blood pressure status in children with low levels of vitamin is not linked to the level of this vitamin.

FEATURES OF INDICATORS OF ARTERIAL PRESSURE IN CHILDREN WITH CHRONIC GASTRODUODENAL PATHOLOGY

Over the past 25 years, the prevalence of cardiovascular diseases, includinghypertension, has tripled among children in Ukraine. The children of the school age aremost prone to the development of arterial hypertension, which is determined by thecharacteristic disorders of the vegetative function for this period of childhood.The aim of our study - to evaluate the peculiarities of the blood pressure level in childrenof school age with chronic gastroduodenal pathology.Material and methods. 120 children who were hospitalized in the gastroenterologicaldepartment of the Сity children's clinical hospital were examined. All children weredivided into two groups: the 1-st group (60 children) included children with chronicsuperficial gastritis and gastroduodenitis; the 2-nd group (60 children) consisted ofchildren with chronic hyperplastic and erosive gastroduodenitis.To assess the level of blood pressure, children underwent tonometry three times, with aninterval of 3 minutes, on the brachial artery of the left hand. Results were evaluated bypercentile nomograms relative to age, gender and height.Results. In most children of the 1-st group, the systolic blood pressure level was in therange of 105-120 mm Hg and the level of diastolic blood pressure was 50-60 mm Hg. In alarger number of children of the 2-nd group, the systolic blood pressure level was within110-120 mm Hg, diastolic - was in the range of 50-70 mm Hg. In children of the 2-ndgroup, in contrast to children of the 1-st group, significantly more cases of increasedindicators of both systolic and diastolic blood pressure were determined. When assessingthe blood pressure level in children according to percentile tables, it has been foundthat in the 2-nd group there is a greater tendency to arterial hypertension than in the 1-st group. Thus, in children of the 2-nd group more often were observed: 1) a significantincrease in the level of systolic blood pressure and diastolic blood pressure 2) a greaternumber of children with an increased level of blood pressure comparing to the childrenof the 1-st group.Conclusions. This may be due to the presence of a more pronounced organic lesion ofthe mucous membrane of the stomach and duodenum.

Maternal and gestational influences on childhood blood pressure

Exposures that contribute to a sub-optimal intrauterine environment can have an effect on the developing fetus. Impaired fetal growth that results in low birth weight is an established risk factor for cardio-metabolic disorders later in life. Recent epidemiologic and prospective cohort studies that include the maternal and gestational period have identified maternal and gestational conditions that confer increased risk for subsequent cardio-metabolic disorders in the absence of low birth weight. Maternal pre-conception health status, including chronic obesity and type 2 diabetes, increase risk for childhood obesity and obesity-related higher blood pressure (BP) in child offspring. Maternal gestational exposures, including gestational diabetes, gestational hypertension, and preeclampsia, are associated with higher BP in offspring. Other maternal exposures such as cigarette smoke and air pollution also increase risk for higher BP in child offspring. Recent, but limited, data indicate that assisted reproductive technologies can be associated with hypertension in childhood, despite otherwise normal gestation and healthy newborn. Gestational exposures associated with higher BP in childhood can be related to familial lifestyle factors, genetics, or epigenetic modification of fetal deoxyribonucleic acid (DNA). These factors, or combination of factors, as well as other adverse intrauterine conditions, could induce fetal programing leading to health consequences in later life. Current and developing research will provide additional insights on gestational exposures and fetal adjustments that increase risk for higher BP levels in childhood.

The role of body fat in the relationship of cardiorespiratory fitness with cardiovascular risk factors in Brazilian children

Abstract Aims: To analyze the association between the percentage of body fat and cardiorespiratory fitness (CRF) with cardiovascular risk factors in children, and; to examine whether percentage of body fat acts as a mediator on the association between CRF and cardiovascular risk factor. Methods: This cross-sectional study included 128 children aged 7-11 years (Mean 8.54, SD: 1.42). The following variables were evaluated: the percentage of body fat, CRF, diastolic and systolic blood pressure, glucose, triglycerides (TG) and total cholesterol. For statistical analysis were performed Partial correlation and mediation analysis. All analysis was adjusted for sex, age and height. Results: CRF, the percentage of body fat, mean arterial pressure (MAP) and TG showed a correlation between each other. Percentage of body fat mediated the association between CRF and MAP (Indirect Effect= -0.008; IC: -0.0159 -0.0030), explaining 29% of this association. However, it was found that the percentage of body fat was not a mediator of the association between CRF and TG. Conclusion: The percentage of body fat mediates the association between CRF and MAP. Our findings show that the importance of a healthy body composition for the prevention of high blood pressure levels in childhood as well as the relevance of physical activity on these parameters.

The Association of Vitamin A and Vitamin D with Hypertension in Children: A Case-Control Study.

Background The prevalence of hypertension in children increases rapidly. This paper is to investigate the association of vitamin A and serum 25(OH)D level with hypertension and to explore the risk factors of hypertension in children. Methods 164 children (age: 6-12 years, females: 49.39%) were included in this case-control study. The serum vitamin A and serum 25(OH)D level, the transcription level of RARs and RXRs, 25(OH)D receptor, and the retinol acyltransferase (LRAT), an indicator of vitamin A storage function, were measured. Results The serum vitamin A level in hypertensive subjects was not significantly different compared to control, but the serum 25(OH)D level was significantly lower in hypertensive subjects compared to control (38.22±12.00umol/L vs. 43.28±12.33 umol/L, P=0.02). The transcription levels of RARα, RARβ, and RARγ were not significantly different between the two groups; but the LRAT was lower in the hypertensive group than that in the control (P<0.001). Compared with control group, the level of 25(OH)D receptor was lower in hypertension children (P=0.003). Logistic regression model showed that LRAT, HDL, and breastfed duration were negatively associated with blood pressure, and waist circumference was positively associated with blood pressure. Conclusions The LRAT, serum 25(OH)D, and 25(OH)D receptor were significantly associated with blood pressure level, and both breastfed and HDL-C were independent protective factors of blood pressure level in children.