Blood Pressure Regulation In Children Research Articles

The impact of air temperature and humidity on Children’s blood pressure mediated by Lipids: A prospective cohort study

ObjectivesFew studies illustrate the mechanism between air temperature and blood pressure (BP) in childhood. This study aims to investigate the associations between air temperature, humidity exposure, and BP trajectories in children and adolescents, and explore the potential mediating roles of lipid profiles in these relationships. MethodsThis prospective cohort study included 5,971 children with 10,800 person-times measurements at baseline from the Chongqing Health Cohort, with evaluations conducted in 2014–2015 (baseline) and follow-ups in 2016 (urban areas) and 2019 (urban and rural areas). Multilevel mixed-effects models were used to analyse the impacts of air temperature and humidity on BP levels and the incidence of elevated BP, while accounting for potential confounders. Mediation analyses were performed to evaluate the mediating effects of lipid profiles, including low-density lipoprotein (LDL), total cholesterol (TC), and specific lipid species. ResultsAfter adjusting for covariates, higher air temperature quartiles were associated with both decreased BP levels and elevated BP risk (RR: 0.83; 95 % CIs: 0.78, 0.89; P = 0.028). Conversely, higher humidity quartiles exhibited a U-shaped relationship with BP levels. Greater variability in air temperature was linked to increase BP levels. The cumulative effects of air temperature exposure on BP were significant from pregnancy to age 10, with females exhibiting larger effects (β:-3.291, 95 % CIs: −4.242,-2.340, P < 0.001). LDL and TC partially mediated the associations between air temperature and BP levels, particularly in males. Specific lipid species, including SM (d21:1), LPC (17:0), and PC (O-36:3), also exhibited significant mediating effects. ConclusionsThis study provides novel insights into the intricate interplay between air temperature, humidity, lipid metabolism, and blood pressure regulation in children. Lower average temperatures and extreme humidity levels were associated with increased risks of elevated BP, potentially mediated by lipid profiles. Early interventions targeting air temperature exposure and lipid metabolism could mitigate hypertension risk, promoting improved cardiovascular outcomes in children.

Urban environment during early-life and blood pressure in children

Background. The urban environment is characterised by many exposures that may influence hypertension development, but studies evaluating multiple urban exposures from pregnancy onwards are lacking. Methods. Using a sample of 4,279 children enrolled in four European mother-child cohorts, associations between urban environmental factors and systolic and diastolic blood pressure (BP) measured at 4-5 years old were evaluated. The urban environment was characterized during pregnancy and childhood and included air pollution, built environment, natural spaces, traffic, noise, meteorology, and socioeconomic deprivation. Single- and multiple-exposure linear regression models adjusted for potential confounders were performed, together with a cluster analysis to identify groups of mother-child pairs sharing similar exposure patterns. Results. In multiple-exposure models (considering 27 prenatal and 30 postnatal exposures), higher BP, in particular diastolic BP, was observed in association with higher exposure levels to air pollution, noise and ambient temperature during pregnancy, and with higher exposure levels to air pollution and higher building density during childhood (e.g., mean BP change [95% confidence interval] for an interquartile range increase in prenatal NO2=0.9mmHg[0.4;1.3]). Lower BP was observed in association with higher temperature the day before the BP measurement and better transport connectivity during childhood (e.g., postnatal temperature=-1.6[-2.2;-0.9]). The cluster analysis identified six clusters of mother-child pairs, among which two clusters represented a more harmful urban environment during pregnancy and childhood: one with higher air pollution, traffic and noise exposures, and the other with higher air pollution, greater urbanisation and lack of green spaces. Compared to the cluster representing the least harmful urban environment, these were both associated with higher diastolic BP (1.3[0.1;2.6] and 1.5[0.5;2.5]). Conclusion. This longitudinal study suggests that the urban environment, from the prenatal period onwards, may impact BP regulation in children. These findings reinforce the importance of designing cities that promote healthy environments to reduce long-term risk of cardiovascular diseases.

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.

Abnormal circadian blood pressure regulation in children with nocturnal enuresis

Introduction: To investigate autonomic nervous system function in enuretic children by performing ambulatory blood pressure monitor (ABPM) for 24 h. Methods: Twenty-eight children ranging in age from 6 to 15 years with primary nocturnal enuresis and 27 age-matched healthy controls were enrolled and they get 24 h ABPM. Hypertension was defined as standard deviation score (SDS) > 1.64 (i.e., >95th percentile) adjusted for gender and height. Urinalysis, urine electrolyte levels, urinary culture, and urinary system ultrasound were carried out in all children. They have also requested to have a diary about daily fluid intake and urine volume. Results: Although the mean 24-h and daytime diastolic blood pressure (BP) did not differ between the groups, systolic BP (SBP) was significantly higher in enuretic children (p < 0.05). The mean night-time SBP, DBP values, SDS and BP loads were found to be significantly higher than those in the controls (p < 0.01). A lack of nocturnal decrease was more prevalent in the enuretic children compared with the control subjects, the difference was statistically significant for DBP but not for SBP. Patients with elevated night-time BP load was found to have higher frequency of urinary incontinence per week as well as per night when compared with enuretic children with normal night-time BP load (r = 0.72, r = 0.69, p < 0.01, respectively). Conclusion: Subtle abnormalities of circadian BP regulation in enuretic children indicated by a selective elevation of nocturnal SBP, DBP, and MAP, and attenuated nocturnal dipping may reflect sympathetic hyper activation and its possible role in pathogenesis of enuresis.