ABSTRACT Artificial light at night (ALAN) is related to various diseases, such as cancer, obesity, and coronary heart disease. However, its impact on blood pressure in adolescents is not well understood. To investigate this, we conducted a cross-sectional study with a nationwide sample of college students in China, who were freshmen from four disperse universities during Sep. and Oct. 2018. Mean levels of ALAN at participants’ residential addresses during 2013–2018 were estimated using time-varying satellite data. The association of the 6-y average of ALAN with blood pressure was estimated by using generalized linear mixed models. A total of 17 046 participants (18.2 ± 0.7 y of age, 46.79% female) from 2,412 counties and cities were included in the final analysis. After a full adjustment for potential confounders, ALAN was positively associated with systolic blood pressure (β = 0.20, p = 0.032) and pulse pressure (β = 0.28, p = 0.001), but there was no association between ALAN and diastolic blood pressure (β = -0.08, p = 0.213). In the sensitivity analysis, the results consistent with the main analysis were observed. The blood pressure of males and those with a BMI ≤24 kg/m2 were more susceptible to ALAN exposure. Our findings highlight the importance of ALAN management for blood pressure control, particularly among male and normal-weight individuals.

BACKGROUND:Inflammatory processes have been suggested as a culprit of vascular damage in pediatric hypertension. We aimed to investigate transcriptional changes of immune modulators and determine their association with office blood pressure in adolescents who were not diagnosed with hypertension at the time of the study visit.METHODS:Office blood pressure measurements and blood samples were taken from adolescents of 2 German birth cohorts, GINIplus (The German Infant Study on the Influence of Nutrition Intervention Plus Air Pollution and Genetics on Allergy Development; discovery cohort, n=1219) and LISA (Influences of Lifestyle-related factors on the Immune System and the Development of Allergies in Childhood; validation cohort, n=809), during the 15-year follow-up visit and categorized based on the European Society of Hypertension Guideline. Hs-CRP (high-sensitivity C-reactive protein) and expression of 51 genes encoding cytokines/receptors and transcription factors were analyzed.RESULTS:The prevalence of elevated systolic blood pressure (overweight/obese) was 14.0% (5.1%) and 16.4% (5.2%) in the discovery and validation cohorts, respectively. An enhanced cytotoxic (GZMB, PRF1, IL2RB) and proinflammatory (FOS, IL1B, hs-CRP) immune profile was observed in association with the hypertension class in both cohorts. Expression of hs-CRP and IL1B was driven by overweight with IL1B being identified as a mediator between body mass index and elevated systolic blood pressure (adj.β/95% CI, 0.01/0.0002–0.02). The association of GZMB (adjusted odds ratio/95% CI, 1.67/1.26–2.21; P=0.0004) and PRF1 (adjusted odds ratio/95% CI, 1.70/1.26–2.29; P=0.0005) in the hypertension class remained significant in normal-weight individuals without parental predisposition. These effects were confirmed in LISA.CONCLUSIONS:Adolescent hypertension is not limited to known risk groups. As adolescents in the hypertension class show an inflammatory profile similar to that of established hypertension in adults, blood pressure monitoring at a young age is critical to ensure early intervention and prevention of adverse sequelae.

Parents’ divorce is one of the life events that elicit pressure in adolescents, to such an extent that parents’ divorce is a predictor of depressive disorder in adolescents. Coping strategy plays an important role in the relationship between pressure and depression. This research aimed to examine coping strategies (problem-focused, emotion-focused, and dysfunctional coping) and specific coping behaviours which affect adolescents with divorced parents’ depressive symptoms. Participants are 80 adolescents with divorced parents from several cities in Indonesia, aged between 13 to 19 years old (mean=16.6 years, SD=1.62 with 76% female and 24% male). Depressive symptoms were measured using the children’s depression inventory, and specific coping behaviour was measured with Brief-COPE or coping orientation to problems experienced. In this research, it was found that 38% of the adolescents had depression. On the multiple linear regression, only problem-focused coping and dysfunctional coping significantly affected depression and not emotion-focused coping. Furthermore, among 14 specific coping behaviours, only instrumental support and behaviour disengagement affect depressive symptoms. These findings indicate that intervention focused on increasing the utilization of problem-focused coping and reducing dysfunctional coping might be beneficial to minimize depressive symptoms in adolescents with divorced parents.

Environmental exposures and blood pressure in adolescents and adults in the T1D exchange clinic registry

Background: Anthropometry is emerging as a useful tool in assessing the future risk of chronic diseases such as type 2 diabetes mellitus (and diabetic nephropathy, diabetic neuropathy, diabetic retinopathy), hypercholesterolemia, atherosclerosis, coronary artery diseases, nonalcoholic fatty liver disease (NAFLD). Body mass index (BMI) and waist-hip ratio (WHR) are used extensively in the forecast of cardio-vascular diseases. The main risk factor for such diseases is hypertension and the correlation of hypertension with BMI and/or WHR gives one the ability to forecast the diseases as risk assessment from a young age and proper techniques can be utilized to delay them. The aim of this study was to correlate BMI and WHR with hypertension in young adults and adolescents. Material and methods: A cross sectional, record-based study of adolescents from age group 17-19 (n = 946) was done and analyzed. Results: Data of a total of 465 males and 481 females (n = 946) were analyzed. In both males and females, mean blood pressure [both systolic (SBP) and diastolic blood pressure (DBP)] showed a positive correlation with increasing ranges of BMI and WHR. Values of Pearson correlation coefficient and p-value: Males: SBP -> BMI = 0.236 (p < 0.0001); DBP -> BMI = 0.187 (p < 0.0001); Males: SBP -> WHR = 0.194 (p < 0.0001); DBP -> WHR = 0.148 (p < 0.0001); Females: SBP -> BMI = 0.249 (p <0.0001); DBP -> BMI = 0.267 (p < 0.0001); Females: SBP -> WHR = 0.090 (p < 0.0001); DBP -> WHR= 0.116 (p < 0.0001). The correlation between BMI and WHR in males was 0.234 (p < 0.0001) and in females, it was 0.172 (p < 0.0001). A steady increase in SBP and DBP is correlated with an increase in BMI and WHR. This leads to the efficacy of these methods in assessing future risks. It was found that hypertension was correlated with BMI and WHR; there was also a correlation between BMI and WHR.

Juvenile fibromyalgia (JFM) is a chronic widespread pain condition that primarily affects adolescent girls. Previous studies have found increased sensitivity to noxious pressure in adolescents with JFM. However, the underlying changes in brain systems remain unclear. The aim of this study was to characterize pain-evoked brain responses and identify brain mediators of pain hypersensitivity in adolescent girls with JFM. Thirty-three adolescent girls with JFM and 33 healthy adolescent girls underwent functional magnetic resonance imaging scans involving noxious pressure applied to the left thumbnail at an intensity of 2.5 or 4 kg/cm 2 and rated pain intensity and unpleasantness on a computerized Visual Analogue Scale. We conducted standard general linear model analyses and exploratory whole-brain mediation analyses. The JFM group reported significantly greater pain intensity and unpleasantness than the control group in response to noxious pressure stimuli at both intensities ( P < 0.05). The JFM group showed augmented right primary somatosensory cortex (S1) activation to 4 kg/cm 2 (Z > 3.1, cluster-corrected P < 0.05), and the peak S1 activation magnitudes significantly correlated with the scores on the Widespread Pain Index ( r = 0.35, P = 0.048) with higher activation associated with more widespread pain. We also found that greater primary sensorimotor cortex activation in response to 4 kg/cm 2 mediated the between-group differences in pain intensity ratings ( P < 0.001). In conclusion, we found heightened sensitivity to noxious pressure stimuli and augmented pain-evoked sensorimotor cortex responses in adolescent girls with JFM, which could reflect central sensitization or amplified nociceptive input.

High particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) exposure levels posed a great risk to human health, but the protection effects of environmental protection on cardiovascular disease have not been systematically evaluated. This study aims to illustrate the effect of the decreased concentration of PM2.5 on blood pressure level in adolescents after enacting the protection measures of environment from a cohort study. A quasi-experimental study including 2415 children from the Chongqing Children's Health Cohort, aged 7.32 ± 0.60 years with normal blood pressure at baseline, with 53.94% males, were analysed. Both the generalised linear regression model (GLM) and Poisson regression model were used to calculate the impact of the declining exposure level of PM2.5 on blood pressure and the incidence of prehypertension and hypertension. The annual mean PM2.5 concentration in 2014 and in 2019 were 65.01 ± 6.46 µgmes per cubic metre (μg / m3), 42.08 ± 2.04 μg / m3 respectively, and the decreased PM2.5 concentration between 2014 and 2019 was 22.92 ± 4.51 μg / m3. The effect of decreased PM2.5 concentration by 1μg / m3 on systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and the difference of blood pressure (BP) indexes between 2014 and 2019 were all significant (P < 0.001). The absolute differences of SBP (-3.598 mmHg; 95% confidence interval (CI) = -4.47,-2.72 mm Hg), DBP (-2.052 mmHg; 95% CI = -2.80,-1.31 mm Hg) and MAP (-2.568 mmHg; 95% CI = -3.27,-1.87 mm Hg) in the group with a decreased level of ≥25.56 μg / m3 were more significant than those in a decreased concentration of PM2.5 for <25.56 μg / m3 (P < 0.001). And the incidence of prehypertension and hypertension for three occasions blood pressure diagnose was 2.21% (95% CI = 1.37%-3.05%, P = 0.001) in children with PM2.5 decreased level ≤25.56 μg / m3 (50%), which was significant higher than its' counterparts 0.89% (95% CI = 0.37%-1.42%, P = 0.001). Our study found the etiological relationship between the declining PM2.5 concentration and the BP values and the incidence of prehypertension and hypertension in children and adolescents, suggesting continuous environmental protection measures in China have achieved remarkable health benefits.

AimHypertension increases complication risk in type 1 diabetes (T1D). We examined blood pressure (BP) in adolescents and young adults with T1D from the Australasian Diabetes Data Network, a prospective clinical diabetes registry in Australia and New Zealand.MethodsThis was a longitudinal study of prospectively collected registry data. Inclusion criteria: T1D (duration ≥ 1 year) and age 16–25 years at last visit (2011–2020). Hypertension was defined as (on ≥ 3 occasions) systolic BP and/or diastolic BP > 95th percentile for age < 18 years, and systolic BP > 130 and/or diastolic BP > 80 mmHg for age ≥ 18 years. Multivariable Generalised Estimating Equations were used to examine demographic and clinical factors associated with BP in the hypertensive range across all visits.ResultsData from 6338 young people (male 52.6%) attending 24 participating centres across 36,655 T1D healthcare visits were included; 2812 (44.4%) had BP recorded at last visit. Across all visits, 19.4% of youth aged < 18 years and 21.7% of those aged ≥ 18 years met criteria for hypertension. In both age groups, BP in the hypertensive range was associated with male sex, injection (vs. pump) therapy, higher HbA1c, and higher body mass index.ConclusionsThere is a high proportion of adolescents and young adults reported with BP persistently in hypertensive ranges. Findings flag the additive contribution of hypertension to the well-established body of evidence indicating a need to review healthcare models for adolescents and young adults with T1D.

Although insufficient sleep has been shown to contribute to obesity-related elevated blood pressure, the circadian timing of sleep has emerged as a novel risk factor. We hypothesized that deviations in sleep midpoint, a measure of circadian timing of sleep, modify the association between visceral adiposity and elevated blood pressure in adolescents. We studied 303 subjects from the Penn State Child Cohort (16.2±2.2 years; 47.5% female; 21.5% racial/ethnic minority). Actigraphy-measured sleep duration, midpoint, variability, and regularity were calculated across a 7-night period. Visceral adipose tissue (VAT) was measured with dual-energy X-ray absorptiometry. Systolic blood pressure (SBP) and diastolic blood pressure levels were measured in the seated position. Multivariable linear regression models tested sleep midpoint and its regularity as effect modifiers of VAT on SBP/diastolic blood pressure levels, while adjusting for demographic and sleep covariables. These associations were also examined as a function of being in-school or on-break. Significant interactions were found between VAT and sleep irregularity, but not sleep midpoint, on SBP (P interaction=0.007) and diastolic blood pressure (P interaction=0.022). Additionally, significant interactions were found between VAT and schooldays sleep midpoint on SBP (P interaction=0.026) and diastolic blood pressure (P interaction=0.043), whereas significant interactions were found between VAT and on-break weekdays sleep irregularity on SBP (P interaction=0.034). A delayed and an irregular sleep midpoint during school and during free-days, respectively, increase the impact of VAT on elevated blood pressure in adolescents. These data suggest that deviations in the circadian timing of sleep contribute to the increased cardiovascular sequelae associated with obesity and that its distinct metrics require measurement under different entrainment conditions in adolescents.

The increasing prevalence of high blood pressure in adolescents is an alarming global health problem, coupled with the rise in obesity and sedentary lifestyles. The aim of this study was to examine the associations between overweight, obesity, and pre-hypertension, and hypertension among adolescents aged 15 - 17 years in Hai Phong city. The case-control study was conducted on 1,000 students at Dong Hoa High School, Hai Phong city. The control group consisted of 730 students with normal systolic and diastolic blood pressure. The case group included 270 students with pre-hypertension and hypertension according to the diagnostic criteria of the American Academy of Pediatrics. The study results showed that the proportion of students with pre-hypertension and hypertension was quite high, 12.2% and 14.8%, respectively. The prevalence of pre-hypertension and hypertension in male students was significantly higher than in female students (P &lt; 0.001). After adjusting for age and sex, overweight and obesity were statistically significantly associated with the risk of pre-hypertension, and hypertension with OR values of 2.2 (95%CI: 1.4-3.4) and 7.1 (95%CI: 3.0 - 16.5), respectively. Thus, overweight and obesity increases the risk of pre-hypertension and hypertension in adolescents aged 15 - 17 at Dong Hoa High School, Hai Phong city.

Background Pediatric hypertension is an emerging health issue due to its increasing prevalence. Age-, gender-, and height-specific blood pressure percentiles have been widely used as a primary tool for detection of hypertension in the pediatric population. However, this method is too complicated to be used in general pediatric practice. The blood pressure to height ratio has been proposed as a practical tool to detect hypertension in children.&#x0D; Objective To evaluate the accuracy of blood pressure to height ratio to be used as a tool for screening high blood pressure in Indonesian adolescents.&#x0D; Methods This diagnostic test study using data from the 2013 Indonesia Basic Health Research (Riset Kesehatan Dasar/RISKESDAS) report included 39,057 adolescents aged 15-18 years with complete data on age, gender, weight, height, and blood pressure. Blood pressure values were classified using the 2017 American Academy of Pediatrics (AAP) hypertension clinical guidelines. Blood pressure to height ratio was calculated as mmHg/cm body height. A receiver-operator characteristics (ROC) curve analysis was performed to assess the accuracy of systolic blood pressure to height ratio (SBPHR) and diastolic blood pressure to height ratio (DBPHR) for screening high blood pressure in adolescents. The optimal cut-off points, sensitivity, and specificity of SBPHR and DBPHR were calculated.&#x0D; Results The optimal cut-off points for defining elevated blood pressure in male adolescents aged 13-18 years were SBPHR 0.69 for male adolescents (sensitivity 96%, specificity 80%) and DBPHR 0.46 (sensitivity 97%, specificity 84%). In female adolescents, the optimal cut-offs were SBPHR 0.72 (sensitivity 97%, specificity 82%) and DBPHR 0.48 (sensitivity 98% and specificity 79%).&#x0D; Conclusion Blood pressure to height ratio is a practical method with high sensitivity and specificity for detecting elevated blood pressure in Indonesian adolescents aged 15 to 18 years.

Birthweight, postnatal growth and blood pressure in adolescents of low socioeconomic condition: a cohort study in Northeast Brazil

This article evaluates somatometric indicators and the functional state of the cardiovascular system in adolescents living in the Republic of Karakalpakstan. The study involved 61 adolescents from the Muynak district, an area that is considered environmentally critical, near the dried-up coast of the Aral Sea, and 68 adolescents from the Ellikkala district, an area that is considered relatively safe from an ecological point of view. Statistically significant differences in the values of body length and body weight of adolescents were revealed (p&lt;0.05). It was found that systolic blood pressure and heart rate values in adolescents in Muynak are higher than in their peers living in Ellikkala (p&lt;0.05). There were no statistically significant differences in the values of chest circumference and diastolic blood pressure in adolescents (p&gt;0.05). In the course of the study, initial data on the morphofunctional status of adolescents living in the Republic of Karakalpakstan were obtained.

The incidence of hypertension in adulthood begins with an increase in blood pressure since adolescence and high blood pressure in adolescents is also associated with an increased risk of Chronic Heart Disease (CHD) as an adult. Consumption of natrium may lead positively associated with an increase in blood pressure in adolescence. The novelty of this study is because it examines the relationship between sodium consumption and blood pressure in adolescent girls. This study aims to analyze the relationship between sodium consumption and blood pressure in adolescent girls in Tasikmalaya, West Java. This research is an observational study with a cross-sectional study design. The population in this study were all female adolescents aged 12-18 years. The independent variables in this study were total sodium consumption, sodium consumption in snacks, sodium consumption in the main menu and sodium contribution from snacks. The natrium intake was measured by non consecutive recall method. The dependent variable was blood pressure measured by sphygmomanometer Omron HEM8712. The data were analyze by Pearson product moment test. The average total sodium consumption is 506.6mg and blood pressure is 113mmH. There was a positive relationship between total daily sodium (p=0.00; r=0.240), sodium in snacks (p=0.002; 0.162), and sodium in daily menus (p=0.001; r-0.182) with blood pressure. The conclusion natrium intake was correlated with blood pressure in adolescent girls, therefore, they should aware with high sodium food.Keywords : Sodium; Blood pressure; Snacks; Adolescent girls.

In response to the global coronavirus disease 2019 (COVID-19) pandemic, vaccines were developed and approved quickly. However, numerous cardiovascular adverse events have been reported. We present two adolescent cases who developed a hypertensive crisis following NT162b2 mRNA COVID-19 vaccination. Patient 1 was an 18-year-old male and his systolic blood pressure was 230 mmHg one day after the second vaccine. He was obese. No secondary cause of hypertension other than the vaccine was identified. Patient 2 was an 18-year-old male who complained with palpitation after the first vaccine. His blood pressure was 178/109 mmHg. He had autosomal dominant polycystic kidney disease. Both were treated with continuous infusion of labetalol followed by losartan, and blood pressure was controlled. Patient 2 received second vaccination and his blood pressure did not rise. It is warranted to measure blood pressure in adolescents at high risk of hypertension after NT162b2 mRNA COVID-19 vaccination.

Sodium intake is very important in the mechanism of increasing blood pressure [1]. The effect of sodium intake in increasing blood pressure is through an increase in plasma volume (body fluid) and blood pressure [2]. The research was conducted in the form of an analytic survey with a cross-sectional study design. The data were processed using the SPSS program. The population is all students of SMAN 1 Amurang, South Minahasa District, the sample is taken by total sampling. From 67 samples, the minimum sodium content was 137 mEq/L and the maximum sodium content was 164. The average Na content was 143.54 mEq/L. The average systolic blood pressure was 119.04 mmHg and the average diastolic blood pressure was 79.70 mmHg. Based on the results of the Spearman correlation test, the correlation coefficient value (R = 0.069) with a significance of 0.579 for the correlation between sodium levels and systolic pressure. These results indicate that there is no statistically significant relationship between Na levels and systolic blood pressure. For the other Spearman correlation test results, the correlation coefficient value (R=-0.089) with a significance of 0.473 for the correlation between sodium levels and diastolic pressure. These results also show that there is no statistically significant relationship between sodium levels and diastolic blood pressure. It can be concluded that there is no relationship between serum sodium levels and blood pressure in adolescents in Amurang, South Minahasa District.

de Lima, TR and Silva, DAS. Handgrip strength is not associated with high blood pressure and does not have good discriminatory power for high blood pressure in adolescents. J Strength Cond Res 37(1): 46-54, 2023-Muscle strength measured by handgrip strength (HGS) was inversely and independently associated with high blood pressure (HBP). In addition, HGS has been used as a valuable indicator for monitoring pediatric health. This study aimed to investigate the association between HGS indexes and HBP, verify the discriminatory capacity of HGS to identify HBP in adolescents, and propose cut-points for HGS to be used in the early identification of HBP if good discriminatory power is identified between the variables. This was a cross-sectional study comprising 811 adolescents (male: 48.9%; age: 16.4 ± 1.3 years) from southern Brazil. Blood pressure was measured by the oscillometric method. Handgrip strength was assessed by a hand dynamometer and 3 different approaches were adopted: (a) HGS in kilogram-force, (b) normalized HGS (HGS/body mass), and (c) allometric HGS (HGS/body mass-0.67). Binary logistic regression was used to verify the association between HGS indexes and HBP, and the receiver operating characteristic (ROC) was used to determine the possible use of HGS as a diagnostic tool for HBP. Handgrip strength indexes were not associated with HBP (p > 0.05), and ROC analyses showed a nonsignificant discriminating accuracy for most of the HGS indexes analyzed (p > 0.05) in identifying HBP in boys and girls. The area under curve (AUC) values ranged from 0.499 (95% CI [0.403-0.596] for allometric HGS among overweight or obese boys) to 0.595 (95% CI [0.546-0.643] for HGS among boys). Handgrip strength was not associated with HBP, and its use in the screening of HBP in adolescents is not recommended.

Introduction: Hypertension in adolescents can increase mortality and morbidity rates, affecting productivity decline in adolescents. The prevalence of hypertension in adolescents is increasing and is often not realized by adolescents. This study aimed to identify risk factors for increased blood pressure in adolescents in rural areas. Methods: This study uses a cross-sectional study design carried out in May 2022 in one of the senior high schools in Manggarai Regency, East Nusa Tenggara. The sample in this study was students aged 13-18 years (n=44) based on the inclusion criteria. The sampling technique used was convenience sampling with data analysis using Chi-Square.

BackgroundAlthough preterm birth predisposes for cardiovascular disease, recent studies in children indicate normal blood pressure and arterial stiffness. This prospective cohort study therefore assessed blood pressure and arterial stiffness in adolescents born very preterm due to verified fetal growth restriction (FGR).MethodsAdolescents (14 (13–17) years; 52% girls) born very preterm with FGR (preterm FGR; n = 24) and two control groups born with appropriate birth weight (AGA), one in similar gestation (preterm AGA; n = 27) and one at term (term AGA; n = 28) were included. 24-hour ambulatory blood pressure and aortic pulse wave velocity (PWV) and distensibility by magnetic resonance imaging were acquired.ResultsThere were no group differences in prevalence of hypertension or in arterial stiffness (all p ≥ 0.1). In boys, diastolic and mean arterial blood pressures increased from term AGA to preterm AGA to preterm FGR with higher daytime and 24-hour mean arterial blood pressures in the preterm FGR as compared to the term AGA group. In girls, no group differences were observed (all p ≥ 0.1).ConclusionsVery preterm birth due to FGR is associated with higher, yet normal blood pressure in adolescent boys, suggesting an existing but limited impact of very preterm birth on cardiovascular risk in adolescence, enhanced by male sex and FGR.ImpactVery preterm birth due to fetal growth restriction was associated with higher, yet normal blood pressure in adolescent boys.In adolescence, very preterm birth due to fetal growth restriction was not associated with increased thoracic aortic stiffness.In adolescence, very preterm birth in itself showed an existing but limited effect on blood pressure and thoracic aortic stiffness.Male sex and fetal growth restriction enhanced the effect of preterm birth on blood pressure in adolescence.Male sex and fetal growth restriction should be considered as additional risk factors to that of preterm birth in cardiovascular risk stratification.

The relationship between ochratoxin A and blood pressure in adolescents