Hypertension In Adolescents Research Articles

Cord Blood Insulin Concentration and Hypertension Among Children and Adolescents Enrolled in a US Racially Diverse Birth Cohort.

Although insulin resistance is closely related to hypertension, the debate continues as to whether insulin resistance is a cause or a consequence of hypertension. This study investigated the associations of cord blood insulin concentration with blood pressure (BP) and hypertension in childhood and adolescence. This study included 951 children enrolled from 1998 to 2012 and followed from birth onwards at the Boston Medical Center, Boston, MA. Cord blood insulin concentration was measured using a sandwich immunoassay. Hypertension in childhood and adolescence was defined based on the 2017 American Academy of Pediatrics Clinical Practice Guidelines. The median (interquartile range) for cord blood insulin concentration was 12.1 (7.2-19.0) µIU/mL. The age range of BP measurements was 3 to 18 years (median, 10.6 years). Cord blood insulin concentration was positively associated with systolic and diastolic BP as well as the risk of hypertension at age 3 to 18 years. Compared with the lowest tertile of cord blood insulin concentration, the top tertile insulin concentration was associated with a 5.18 (95% CI, 1.97-8.39) percentile increase in systolic BP, 4.29 (95% CI, 1.74-6.84) percentile increase in diastolic BP, and 1.62-fold (95% CI, 1.27-2.08) higher risk of hypertension. The association between insulin and hypertension was stronger among children born preterm (P for interaction=0.048). Furthermore, preterm birth and childhood overweight or obesity enhanced the associations. Our results suggest that elevated insulin concentration at birth plays a critical role in the early life origins of hypertension and support the hypothesis implicating insulin resistance in the etiology of hypertension.

Epicardial Adipose Tissue: A Piece of The Puzzle in Pediatric Hypertension

Epicardial adipose tissue (EAT) is a metabolically active tissue located on the surface of the myocardium, which might have a potential impact on cardiac function and morphology. The aim of this study was to evaluate whether EAT is associated with essential arterial hypertension (AH) in children and adolescents. Prospective cardiovascular magnetic resonance (CMR) study and clinical evaluation were performed on 72 children, 36 of whom were diagnosed with essential AH, and the other 36 were healthy controls. The two groups were compared in volume and thickness of EAT, end-diastolic volume, end-systolic volume, stroke volume, left ventricular (LV) ejection fraction, average heart mass, average LV myocardial thickness, peak filling rate, peak filling time and clinical parameters. Hypertensive patients have a higher volume (16.5 ± 1.9 cm3 and 10.9 ± 1.5 cm3 (t = -13.815, p < 0.001)) and thickness (0.8 ± 0.3 cm and 0.4 ± 0.1 cm, (U = 65.5, p < 0.001)) of EAT compared to their healthy peers. The volume of EAT might be a potential predictor of AH in children. Our study indicates that the volume of EAT is closely associated with hypertension in children and adolescents.

Early-Life Cardiovascular Risk Factor Trajectories and Vascular Aging in Midlife: A 30-Year Prospective Cohort Study.

Vascular aging, as assessed by structural and functional arterial properties, is an independent predictor of cardiovascular outcomes. We aimed to explore the associations of individual cardiovascular risk factors from childhood to midlife and their accumulation over a 30-year span with vascular aging in midlife. Using data from the ongoing cohort of Hanzhong Adolescent Hypertension study, 2180 participants aged 6 to 18 years at baseline were followed for over 30 years. Distinct trajectories of systolic blood pressure (SBP), body mass index (BMI), and heart rate from childhood to midlife were identified by group-based trajectory modeling. Vascular aging was assessed by carotid intima media thickness or brachial-ankle pulse wave velocity. We identified 4 distinct SBP trajectories, 3 distinct BMI trajectories, and 2 distinct heart rate trajectories from childhood to midlife. Persistently increasing SBP, high-increasing BMI, and high-stable heart rate were all shown to have a positive association with brachial-ankle pulse wave velocity in midlife. For carotid intima-media thickness, similar associations were observed for persistently increasing SBP and high-increasing body mass index. After further adjustment for SBP, body mass index and heart rate at the time of vascular assessment in 2017, associations were also observed for cardiovascular risk factor trajectories accumulation with brachial-ankle pulse wave velocity (β, 0.656 [95% CI, 0.265-1.047]) and with carotid intima media thickness (β, 0.045 [95% CI, 0.011-0.079]) in adulthood. Longitudinal exposure to individual cardiovascular risk factors from childhood to midlife and cardiovascular risk factor accumulation were associated with an increased risk of vascular aging in midlife. Our study lends support for early targeting of risk factors in order to prevent cardiovascular disease later in life.

Elevated Blood Pressure and Worsening Cardiac Damage During Adolescence

To examine the longitudinal course for the development of elevated blood pressure (BP)/hypertension and cardiac damage in adolescents. From the Avon Longitudinal Study of Parents and Children, UK birth cohort, 1856 (1011 female) 17-year-old adolescents were followed up for 7years. BP and echocardiography were assessed at ages 17 and 24years. Elevated/hypertensive BP was defined as ≥130mm Hg systolic and ≥85mm Hg diastolic. Left ventricular (LV) mass indexed for height2.7 (LVMI2.7) ≥51g/m2.7 was defined as LV hypertrophy (LVH) and LV diastolic function (LVDF) E/A <1.5 as LVD dysfunction (LVDD). Data were analyzed with generalized logit mixed-effect models and cross-lagged structural equation temporal path models adjusting for cardiometabolic and lifestyle factors. Over follow-up, the prevalence of elevated systolic BP/hypertension increased from 6.4% to 12.2%, LVH from 3.6% to 7.2%, and LVDD from 11.1% to 16.3%. Cumulative elevated systolic BP/hypertension was associated with worsening LVH in female participants (OR 1.61, CI 1.43-1.80 P<.001) but not in male participants. Elevated systolic BP/hypertension was associated with worsening LVDD in male and female participants. Elevated diastolic BP/hypertension was associated with worsening LVH in male and female participants. In cross-lagged temporal path models, higher baseline systolic BP was associated with LVDF (β=0.09, SE=0.002, P=.029) but not LVMI2.7 at follow-up. Higher baseline cardiac indices were not associated with follow-up systolic BP. Higher baseline diastolic BP was associated with follow-up higher cardiac indices except LVDF. Baseline LVMI2.7 was not associated with follow-up diastolic BP. Elevated BP/hypertension may temporally precede premature cardiac damage in youth.

Prevalence and associated factors for prehypertension and hypertension among Indonesian adolescents: a cross-sectional community survey

ObjectiveTo estimate the prevalence and determine the associated factors for developing prehypertension and hypertension among Indonesian adolescents.DesignNational cross-sectional study.SettingThis study was conducted in all the provinces in Indonesia.ParticipantsThe population in...

Vücut Kitle Indeksi, Bel Çevresi, Kalça Çevresi, Bel-Boy Oranı: Hangisi Adölesanlarda Hipertansiyonu Daha Çok Etkiler?

Introduction: To determine the prevalence of hypertension in adolescents, its relationship with obesity, and which of the BMI, waist circumference (WC), hip circumference (HC), and waist-height ratio (WHtR) affect adolescent hypertension more.&#x0D; Material and Methods: In this cross-sectional study, the weights, heights, WC, HC, blood pressure and sociodemographic data measured in May 2019 for students aged 14-18 were analyzed retrospectively. Among the 4580 high school students aged 14-18, 4529 students with complete data were included in the study. Weight, height, waist circumference, hip circumference, blood pressure were measured in students. The predictive values of the variables causing high blood pressure were measured.&#x0D; Results: The prevalence of hypertension in 4529 students included in the study was 14.3% as 36.5% in the obese and 12.3% non-obese (p

Effects of Overweight and Obesity on Hypertension in Adolescents: A Meta-Analysis

Background: Hypertension is currently starting to show a trend in prevalence that continues to increase at a younger age and is a major cause of premature death in the world. In adolescents, hypertension is more common who are overweight or obese. This study aims to examine the effect of overweight and obesity on the incidence of hypertension in adolescents using a meta-analysis.Subjects and Method: Meta-analysis was carried out using the PRISMA flow chart and the PICO model. Population: adolescents aged 10 to 19 years. Intervention: overweight and obesity. Comparison: normoweight. Outcome: hypertension). The databases used are PubMed, Science Direct, Springer Link, and Google Scholar with the keywords (hypertension OR "High Blood Pressure") AND "BMI Status" AND (adolescent OR teenager) AND "cross sectional". There were 9 cross-sectional studies published in 2012-2022 with odds ratio (OR) effect size that met the inclusion criteria. Analysis was performed with RevMan 5.3.Results: A meta-analysis was conducted on 9 articles with a cross-sectional study design originating from China, South Korea, India, Turkey, Tunisia, Lithuania and Poland involving 63,239 adolescents aged 10-19 years. The results of the meta-analysis showed that overweight adolescents were 2.44 times more likely to experience hypertension compared to normal weight adolescents (aOR= 2.44; 95%CI= 1.87 to 3.19; p&lt;0.001), and obese adolescents were more likely to experience hypertension 4.53 times compared with normal weight adolescents (aOR= 4.53; 95% CI= 3.10 to 6.61; p&lt;0.001).Conclusion: Being overweight and obese can increase the risk of developing hypertension in adolescents. Keywords: overweight, obesity, hypertension, adolescents, meta-analysis Correspondence: Nurussyifa Afiana Zaen. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: nurussyifaaz20@gmail.com. Mobile: +6287723131415.

Incidence of Arterial Hypertension is Associated with Adiposity in Children and Adolescents.

The increase of hypertension in children and adolescents has attracted the attention of the scientific community largely due to its association with the obesity epidemic. To describe the incidence of hypertension and its relationship with the cardiometabolic and genetic profile in children and adolescents from a city in southern Brazil in a three-year period. This longitudinal study followed 469 children and adolescents, aged 7-17 years old (43.1% boys), assessed at two-time points. We evaluated systolic and diastolic blood pressures (SBP and DBP), waist circumference (WC), body mass index (BMI), body fat percentage (%BF), lipid profile, glucose, cardiorespiratory fitness (CRF), and rs9939609 Polymorphism ( FTO ). Cumulative incidence of hypertension was calculated, and multinomial logistic regression was conducted. The statistical significance was established as p < 0.05. After three years, the incidence of hypertension was 11.5%. Overweight or obese individuals were more likely to become borderline hypertensive (overweight OR: 3.22, 95% CI: 1.08-9.55; obesity OR: 4.05, 95% CI: 1.68-9.75), and obese individuals were more likely to become hypertensive (obesity OR: 4.84, 95% CI: 1.57-14.95). High-risk WC and %BF values were associated with hypertension development (OR: 3.41, 95% CI: 1.26-9.19; OR: 2.49, 95% CI: 1.08-5.75, respectively). We found a higher incidence of hypertension in children and adolescents as compared with previous studies. Individuals with higher values of BMI, WC and %BF at baseline were more likely to develop hypertension, suggesting the importance of adiposity in the development of hypertension even in such a young population.

Effects of Long-Term Intervention with Losartan, Aspirin and Atorvastatin on Vascular Remodeling in Juvenile Spontaneously Hypertensive Rats

Hypertension in adolescents is associated with adverse cardiac and vascular events. In addition to lowering blood pressure, it is not clear whether pharmacological therapy in early life can improve vascular remodeling. This study aimed to evaluate the effects of long-term administration of losartan, aspirin, and atorvastatin on vascular remodeling in juvenile spontaneously hypertensive rats (SHRs). Losartan, aspirin, and atorvastatin were administered via gavage at doses of 20, 10, and 10 mg/kg/day, respectively, on SHRs aged 6-22 weeks. Paraffin sections of the blood vessels were stained with hematoxylin-eosin (H&E) and Sirius Red to evaluate the changes in the vascular structure and the accumulation of different types of collagen. The plasma levels of renin, angiotensin II (Ang II), aldosterone (ALD), endothelin-1 (ET-1), interleukin-6 (IL-6), and neutrophil elastase (NE) were determined using ELISA kits. After the 16-week treatment with losartan, aspirin, and atorvastatin, the wall thickness of the thoracic aorta and carotid artery decreased. The integrity of the elastic fibers in the tunica media was maintained in an orderly manner, and collagen deposition in the adventitia was retarded. The plasma levels of renin, ALD, ET-1, IL-6, and NE in the SHRs also decreased. These findings suggest that losartan, aspirin, and atorvastatin could improve vascular remodeling beyond their antihypertensive, anti-inflammatory, and lipid-lowering effects. Many aspects of the protection provided by pharmacological therapy are important for the prevention of cardiovascular diseases in adults and older adults.

A Novel and Noninvasive Risk Assessment Score and Its Child-to-Adult Trajectories to Screen Subclinical Renal Damage in Middle Age

This study aimed to develop a noninvasive, economical and effective subclinical renal damage (SRD) risk assessment tool to identify high-risk asymptomatic people from a large-scale population and improve current clinical SRD screening strategies. Based on the Hanzhong Adolescent Hypertension Cohort, SRD-associated variables were identified and the SRD risk assessment score model was established and further validated with machine learning algorithms. Longitudinal follow-up data were used to identify child-to-adult SRD risk score trajectories and to investigate the relationship between different trajectory groups and the incidence of SRD in middle age. Systolic blood pressure, diastolic blood pressure and body mass index were identified as SRD-associated variables. Based on these three variables, an SRD risk assessment score was developed, with excellent classification ability (AUC value of ROC curve: 0.778 for SRD estimation, 0.729 for 4-year SRD risk prediction), calibration (Hosmer-Lemeshow goodness-of-fit test p = 0.62 for SRD estimation, p = 0.34 for 4-year SRD risk prediction) and more potential clinical benefits. In addition, three child-to-adult SRD risk assessment score trajectories were identified: increasing, increasing-stable and stable. Further difference analysis and logistic regression analysis showed that these SRD risk assessment score trajectories were highly associated with the incidence of SRD in middle age. In brief, we constructed a novel and noninvasive SRD risk assessment tool with excellent performance to help identify high-risk asymptomatic people from a large-scale population and assist in SRD screening.

The Associations Between Cumulative Effects of Blood Pressure From Childhood to Adulthood and Adult Subclinical Renal Damage: Hanzhong Adolescent Hypertension Cohort Study

Abstract Background To investigate the impact of cumulative effects of systolic and diastolic blood pressures (SBP and DBP) from childhood to adulthood on adult subclinical renal damage (SRD). Methods A baseline survey on height, bodyweight, and blood pressure (BP) of 6- to 15-year-old school students in Hanzhong, Shaanxi, was conducted in 1987. Follow-up was conducted in 1989, 1992, 1995, 2005, 2013, and 2017. A total of 1,553 individuals who had been followed at least 4 times since baseline were included in the study. Blood and urine biochemical indexes were detected during the follow-up period. Renal function was assessed with estimated glomerular filtration rate and urine albumin-to-creatinine ratio. The logistic regression analysis was used to analyze the relationships between cumulative effects or longitudinal trends of BP and adult SRD. Results The proportion of adult SRD in the groups with high BP cumulative effects or longitudinal trends was significantly higher than that in the normal group (cumulative effects: SBP 20.6% vs. 10.3%, P &amp;lt; 0.001 and DBP 22.2% vs. 9.8%, P &amp;lt; 0.001; longitudinal trends: SBP 17.8% vs. 11.2%, P = 0.001 and DBP 19.1% vs. 10.8%, P &amp;lt; 0.001). Multivariate logistic regression showed that the risk of adult SRD in the group with high BP cumulative effects (SBP: OR = 2.07, 95% CI 1.45–2.96, P &amp;lt; 0.001; DBP: OR = 2.25, 95% CI 1.59–3.19, P &amp;lt; 0.001) or high BP longitudinal trends (SBP: OR = 1.43, 95% CI 1.00–2.05, P = 0.049; DBP: OR = 1.50, 95% CI 1.05–2.13, P = 0.026) was significantly higher than that in the normal group, after adjusting for gender, age, body mass index, blood glucose, blood lipid, uric acid and other confounding factors. Conclusions The cumulative effects and longitudinal trends of BP from children to adults significantly increase the risk of adult SRD. Monitoring and controlling BP from childhood is important for long-term kidney health.

Vortex Formation Time is a Novel Measure for Early Detection of Diastolic Abnormalities in Adolescents with Hypertension.

Pediatric hypertension (HTN) has demonstrated an upward trend in recent years. Adolescent HTN has been linked to adult HTN, cardiovascular disease, and other health conditions. Thus, it is essential that HTN and its associated cardiac abnormalities be diagnosed and treated early to minimize lifelong adverse effects. In this study, we evaluated whether vortex formation time (VFT), a validated echocardiogram measure of left ventricular diastolic dysfunction, correlated with ambulatory blood pressure monitoring (ABPM) and HTN in adolescents. Echocardiogram data including systolic and diastolic function indices and ABPM data from 2015 to 2022 in adolescents age 13-21years were analyzed retrospectively. We found that VFT was significantly lower in adolescents with HTN compared to those without HTN (3.69 ± 1.39 vs. 4.50 ± 1.73, p = 0.02). Standard echocardiographic indices of systolic and diastolic function were similar between the two groups, except indexed left atrial volume. Higher overall systolic blood pressure (SBP) (β = -0.01, CI -0.02, -2.2 × 10-3, p = 0.02), mean wake SBP (β = -0.01, CI -0.02, -9.4 × 10-4, p = 0.03), and mean sleep SBP (β = -0.01, CI -0.02, -1.2 × 10-3, p = 0.03) were significantly associated with lower VFT. This study demonstrates that VFT correlates to ABPM data and can be used a novel diagnostic measure in adolescents with HTN.

Waist-to-height-ratio is associated with sustained hypertension in children and adolescents with high office blood pressure.

Waist-to-height-ratio (WHtR) has been proposed as another indicator for cardiometabolic risk factors including hypertension. Normally, hypertension can be diagnosed in the office setting by detecting high blood pressure for three occasions. However, patients with high office blood pressure may not exhibit high blood pressure outside the office. Ambulatory blood pressure monitoring (ABPM) is a procedure to measure blood pressure over 24-h. Sustained hypertension is characterized as hypertension detected by both office measurement and ABPM. This study aimed to evaluate the performance of WHtR in the diagnosis of sustained hypertension in patients with high office blood pressure. Demographic data, height, body weight, body mass index (BMI), and waist circumference were retrospectively reviewed in children and adolescents who underwent ABPM due to persistently high office blood pressure. Patients were separated into two groups: a sustained hypertension group and a normal ABPM group. BMI was adjusted to z-score using the WHO Anthroplus software. WHtR was calculated by the formula: waist circumference (cm)/height (m). The performances of different parameters were analyzed using the receiver operating characteristic (ROC) curve and multivariate logistic regression. Sixty patients (63% male) with a mean age of 12.9 ± 3.7 years had persistently high office blood pressure. Twenty-nine (48.3%) had high ambulatory blood pressure parameters so-called "sustained hypertension." The sustained hypertension group had a higher mean BMI z-score (2.32 vs. 1.31, p = 0.01) and a higher mean WHtR (57.7 vs. 49.2 cm/m, p < 0.001) than those of the normal ABPM group. For the diagnosis of sustained hypertension, the ROC analysis revealed that WHtR had a greater area under the ROC curve (AUC) than that of BMI z-score (0.772 vs. 0.723). WHtR remained associated with sustained hypertension (OR 1.2, 95% CI 1.022-1.408, p = 0.026) after adjusting for age, gender, and BMI z-score. Apart from being a more user-friendly metric, WHtR tended to outperform BMI z-score in predicting sustained hypertension in children and adolescents with persistently high office blood pressure.

Static cutoffs or tables for the diagnosis of hypertension? Effect on identification of organ damage in youths with obesity

Background and aimRecently, the European Society of Cardiology task force released a Consensus document (ESC-CD) on pediatric hypertension (HTN) supporting the use of normative tables (age range 6–16 years) for the diagnosis of HTN, while the Hypertension Canada Guidelines (HTN-CGs) proposed static cutoffs. We aimed to assess the prevalence of HTN by ESC-CD or HTN-CGs and their association with glomerular function and left ventricular (LV) geometry in youths with overweight/obesity (OW/OB). Methods and resultsData of 3446 youths were analyzed. HTN by was defined using normative tables (ESC-CD) or static cutoffs of BP ≥ 120/80 in children (age <12 years) and ≥130/85 mmHg in adolescents (age ≥12 years) (HTN-CGs). Mildly reduced glomerular filtration rate was defined by GFR <90 ≥ 60 mL/min/1.73 m2. Concentric LV hypertrophy (cLVH) was assessed in 500 youths and defined by LVH and high relative wall thickness as proposed by ESC-CD. Prevalence of HTN was 27.9% by ESC-CD and 22.7% by HTN-CGs. The association with mildly reduced glomerular filtration rate was significant only in hypertensive adolescents classified by HTN-CGs [Odds Ratio (OR), 95%Cl] 2.16 (1.44–3.24), whereas the association with cLVH was significant using both criteria: children OR 2.18 (1.29–3.67) by ESC-CD and 2.27 (1.32–3.89) by HTN-CGs; adolescents OR 2.62 (1.17–5.84) by ESC-CD and 2.83 (1.14–7.02) by HTN-CGs. ConclusionAlthough static cutoffs may represent a simplification for HTN identification, tables by ESC-CD detect a higher number of hypertensive youths before a clear appearance of glomerular impairment, which offers advantages in terms of primary cardiovascular prevention.

S-43-1: THE CHANGING EPIDEMIOLOGY OF HYPERTENSION IN CHILDREN AND ADOLESCENTS

Some scientific concepts take time to overcome initial disbelief before they are finally embraced by the research community. One of these concepts is hypertension in children and adolescents. Little was known about childhood hypertension until the early 1980 s, mainly because blood pressure was not commonly measured in pediatric clinical practice. In the few cases blood pressure levels were determined to be abnormal in children, they were considered to be secondary hypertension resulting from an underlying condition. Even though secondary causes of hypertension tend to occur more often in hypertensive children than in adults, its prevalence is only about 1 percent overall, leaving primary hypertension especially in adolescents as the most frequent type. Even when there are many studies that have assessed the prevalence of hypertension in children and adolescents, scientists have faced difficulties to state this prevalence for three main reasons. To begin with, blood pressure normally changes with increasing age and body size. This makes establishing a fixed cutoff for values of systolic and diastolic blood pressure elevation rather challenging. This difficulty has led to the use of percentiles based on age, sex, and height to define the normal distribution, with a hypertensive level of blood pressure in the 95th percentile or higher. Another obstacle is that there is a variety of different definitions of hypertension used by the three most recent clinical practice guidelines coming from Europe, the United States and Canada. The last challenge is focused on the beat-to-beat blood pressure variability, the definition of hypertension requires that systolic and/or diastolic blood pressure to be persistently higher than the established thresholds on three separate occasions. Many cross-sectional studies with only one single measurement of blood pressure have not been able to define the prevalence of hypertension. The epidemiology of hypertension in childhood and adolescence can be linked to the worldwide obesity epidemic. Hypertension is more prevalent than before, with primary hypertension being the main type. It is well known that the factors related to primary hypertension can be modified, therefore childhood is a period in which prevention could be effective. If prevention is followed throughout childhood, it could contribute to a healthier young adulthood in the long run. Therefore, primordial prevention is an opportunity not to be missed.

S-43-7: HYPERTENSION IN ADOLESCENTS AND YOUNG PEOPLE: OPPORTUNITIES FOR INTERVENTION IN SOUTH AFRICA

Hypertension in adolescents and young people is a rising concern across the world. In South Africa the cardiovascular epidemic is simultaneous to the HIV and TB epidemics. Sub-Saharan Africa has a large proportion of young people compared to many developed regions but poor access to healthcare. This presentation will discuss the epidemiology of hypertension in young people, the causes of hypertension and the approach to diagnosis and causes. There will be discussion about how this age group is the optimal age in which to introduce screening and lifestyle changes and how to address this age group.

S-43-6: HYPERTENSION FROM CHILDHOOD TO ADULTHOOD: THE BT20+ STUDY

Background: Hypertension is a major risk factor for cardiovascular diseases and its prevalence among the Sub-Saharan African population has risen extremely in the last decades. Moreover, there is growing evidence that suggest that hypertension has its roots in childhood and adolescence and persist into adulthood. However, the epidemiology of hypertension in the young in a Low to Middle Income Country (LMIC) setting is not fully understood due to paucity of longitudinal data. Thus, we sought to investigate prevalence and new cases of hypertension and to identify risk factors that predict the incidence of hypertension from early childhood in urban black South-African children. Methods: We used data from the Birth to Twenty (BT20+) cohort in Johannesburg, South Africa. This cohort comprised of children born in 1990 and who had their growth, development and blood pressure measured at six follow-up periods over the course of 13 years. Hypertension status was classified using the fourth report of the National High Blood Pressure Education Program. Hypertension incidence rate was calculated using staggered entry survival analysis. We identified risk factors for incident hypertension using multivariable cox proportional hazard regressions. Results: Over a follow-up period of 13 years, the overall point prevalence of hypertension ranged from 8.4 to 24.4 % and cumulative incidence of hypertension was 54.3% (95% CI: 51.8 to 56.8). The overall hypertension incidence rate was 57.0 cases per 1000 person-years (95% CI: 53.2 to 61.1). Furthermore, the risk for incident hypertension increased with a rapid relative weight gain in early childhood (aHR = 1.11, 95% CI: 1.00 to 1.22), in mid childhood (aHR = 1.13, 95% CI: 1.03 to 1.24) and in adolescence (aHR = 1.21, 95% CI: 0.99 to 1.47). An increase in maternal parity significantly increased the risk for incident hypertension (aHR = 1.08, 95% CI: 1.01 to 1.15). Conclusion: Rapid weight gain relative to height and higher parity are prominent risk factors for incident hypertension in urban black South African children and adolescents. In order to reduce the high incidence and the disease burden of hypertension, national health programs should focus on promoting healthy lifestyle in early stages of life to curb rapid weight gain. Further research is required to check whether incident hypertension in childhood predict clinical outcomes in adulthood.

Hipertenzija kod dece i adolescenata

Until recently, secondary hypertension used to be the most common form of hypertension in the paediatric population. Due to the increasing prevalence of obesity-related hypertension in children and adolescents, the share of secondary hypertension has decreased from 85% to 9%. Today, primary hypertension has become the dominant form of hypertension in the paediatric population. The purpose of this paper is to show the prevalence of various forms of hypertension and the prevalence of primary hypertension in children and adolescents relative to sex, age and body weight category in the General Hospital "Dr. Laza K. Lazarević" in Šabac. In children with secondary hypertension, the impact of body weight was not assessed since an organic cause of hypertension had been identified in these patients. All children from the age of a new-born to the age of 18 years with a diagnosis of hypertension (International Classification of Diseases, tenth revision (IDC-10), code I10-I15) in the period from 1 January 2013 to 31 December 2022 were selected from the medical digital database. This analysis included all children who showed blood pressure values above 95th percentile for age, sex and height in children under 13 and above 120/80 mmHg in children over 13, upon repeated measurements of blood pressure in the General Hospital, who were presumed to have hypertension. These children were referred to further evaluation at tertiary healthcare institutions, where a diagnosis of hypertension was made. Of the 134 children referred to the General Hospital due to elevated blood pressure levels measured in the primary care physician's office, hypertension was diagnosed in almost one in four subjects (24.6%). Primary hypertension was diagnosed in 18 (54.5%), secondary hypertension in 8 (24.2%) and white coat hypertension in 7 (21.2%) children. Primary hypertension was more common in boys (70.6%) than girls (37.5%). Among children with primary hypertension, overweight and obese children represented 66.7% of the group at the time of diagnosis. Statistical data analysis did not find a statistically significant difference in the prevalence of primary hypertension among the body weight or age categories. Since primary hypertension is the most significant and potentially reversible factor for the development of cardiovascular disease, early detection and treatment of primary hypertension in children is crucial in the prevention of cardiovascular disease in adults.

PS-BPC11-8: ASSOCIATION OF CARDIOMETABOLIC INDEX AND SUBCLINICAL RENAL DAMAGE: A CROSS SECTIONAL STUDY

Objective: Subclinical renal damage (SRD) has become a major health issue due to its dormant onset and poor prognosis. Recent studies have found that cardiometabolic index (CMI) is closely related to diabetes, hypertension, stroke and cardiovascular disease. However, the correlation between CMI and SRD among adults without diabetes still remain unclear. The present study is aimed to investigate the association between CMI and SRD among non-diabetic individuals in a Chinese cohort. Design and method: A total of 2222 participants (male n = 1208) from our previously established cohort of Adolescent Hypertension Study were included in the cross-sectional survey. CMI was calculated by triglyceride to high density lipoprotein cholesterol ratio multiply waist-to-height ratio. Renal function was assessed with estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (uACR). The participants were divided into three groups according to CMI scores. The logistic regression model was established to analyze the relationship between CMI and the risk of SRD. Results: CMI was positively correlated with SRD. Compared to participants in the lowest tertile of CMI, those in the highest tertile of CMI had higher risk of SRD(OR:1.918, 95%CI:1.391–2.643,P &lt; 0.001). The association remained significantly after adjusting related factors such as sex, age, history of hypertension, smoking, alcohol use, heart ratio and fasting blood glucose(OR:1.458, 95%CI:1.023–2.079, P &lt; 0.05). Conclusions: Our study showed that cardiometabolic index was significantly associated with the risk of SRD in Chinese adults without diabetes. CMI may be used as a simple marker for detection of subclinical renal damage in non-diabetic subjects.

PS-P10-4: A NOVEL AND NONINVASIVE RISK ASSESSMENT SCORE AND ITS CHILD-TO-ADULT TRAJECTORIES TO SCREEN SUBCLINICAL RENAL DAMAGE IN MIDDLE AGE

This study aimed to develop a noninvasive, economical and effective subclinical renal damage (SRD) risk assessment tool to identify the high-risk asymptomatic people from large-scale population and improve current clinical SRD screening strategies. 2303 participants were included from Hanzhong Adolescent Hypertension Cohort, an ongoing prospective study followed for 30 years. Three noninvasive prediction factors (SBP, DBP and BMI) were identified as SRD-associated variables. Based on these three variables., an SRD risk assessment score with excellent classification ability (AUC value of ROC curve: 0.778 for SRD estimation, 0.729 for 4-year SRD risk prediction), calibration (Hosmer-Lemeshow goodness-of-fit test P = 0.62 for SRD estimation, P = 0.34 for 4-year SRD risk prediction) and more potential clinical benefits was developed. In addition, we identified three child-to-adult SRD risk assessment score trajectories: increasing, increasing-stable and stable. Further difference analysis and logistic regression analysis also showed these SRD risk assessment score trajectories were highly associated with the incidence of SRD in middle age. In brief, we developed a novel and noninvasive SRD risk assessment tool with excellent performance to help identify high-risk asymptomatic people from large-scale population and assist in SRD screening. JOURNAL/jhype/04.03/00004872-202301001-01109/figure1/v/2023-10-24T163949Z/r/image-jpeg