Obesity, metabolic syndrome, and primary hypertension

Pediatric Nephrology, Journal Year: 2020, Volume and Issue: 36(4), P. 825 - 837

Published: May 9, 2020

Primary hypertension is the dominant form of arterial in adolescents. Disturbed body composition with, among other things, increased visceral fat deposition, accelerated biological maturation, metabolic abnormalities typical for syndrome, and adrenergic drive constitutes intermediary phenotype primary hypertension. Metabolic syndrome observed 15-20% adolescents with These features are also obesity-related closely associated both severity risk target organ damage. However, even though mass index main determinant blood pressure general population, not every hypertensive adolescent obese patient suffers from or syndrome. Thus, concepts metabolically healthy obesity, normal weight unhealthy, unhealthy phenotypes have been developed. The damage increases exposure to factors which determined by disturbed obesity. Due fact that present similar pathogenesis, principles treatment same focused only on lowering pressure, but normalizing abnormalities.

Language: Английский

---

Risk of Target Organ Damage in Children With Primary Ambulatory Hypertension: A Systematic Review and Meta-Analysis

Hypertension, Journal Year: 2023, Volume and Issue: 80(6), P. 1183 - 1196

Published: Feb. 21, 2023

Target organ damage (TOD) such as left ventricular hypertrophy (LVH), abnormal pulse wave velocity, and elevated carotid intima-media thickness are common among adults with hypertension associated overt cardiovascular events. The risk of TOD children adolescents confirmed by ambulatory blood pressure monitoring is poorly understood. In this systematic review, we compare the risks to normotensive individuals.A literature search was conducted include all relevant English-language publications from January 1974 March 2021. Studies were included if patients underwent 24-hour ≥1 reported. Ambulatory defined society guidelines. Primary outcome TOD, including LVH, mass index, compared those normotension. Meta-regression calculated effect body index on TOD.Of 12 252 studies, 38 (n=3609 individuals) for analysis. Children had an increased LVH (odds ratio, 4.69 [95% CI, 2.69-8.19]), (pooled difference, 5.13 g/m2.7; 3.78-6.49]), velocity 0.39 m/s 0.20-0.58]), 0.04 mm 0.02-0.05]), children. showed a significant positive thickness.Children have adverse profiles, which may increase their future disease. This review highlights importance optimizing control screening in hypertension.URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42020189359.

Language: Английский

---

Pediatric and Adult Ambulatory Blood Pressure Thresholds and Blood Pressure Load as Predictors of Left Ventricular Hypertrophy in Adolescents

Hypertension, Journal Year: 2021, Volume and Issue: 78(1), P. 30 - 37

Published: May 10, 2021

[Figure: see text].

Language: Английский

---

Origins of Primary Hypertension in Children

Hypertension, Journal Year: 2020, Volume and Issue: 76(5), P. 1400 - 1409

Published: Sept. 28, 2020

Although relatively rare in childhood, primary hypertension (PH) is thought to have originated childhood and may be even determined perinatally. PH prevalence increases school-age children affects 11% of 18-year-old adolescents. Associated with metabolic risk factors, elevated blood pressure carried into adulthood. Analysis the phenotype hypertensive has revealed that a complex anthropometric neuro-immuno-metabolic abnormalities, typically found adults. Children shown signs accelerated biological development, which are closely associated further development PH, syndrome, cardiovascular disease At time diagnosis, were reported significant arterial remodelling expressed as significantly increased carotid intima-media thickness, stiffness large arteries, lower area microcirculation, decreased endothelial function. These changes indicate their age 4 5 years older than normotensive peers. All these abnormalities typical features early vascular aging described adults PH. However, observed subjects, it seems not only an event, but also maturation phenomenon.

Language: Английский

---

Pediatric Ambulatory Blood Pressure Classification: The Case for a Change

Hypertension, Journal Year: 2021, Volume and Issue: 78(5), P. 1206 - 1210

Published: Oct. 4, 2021

In 1997, Soergel et al1 published the first set of normative values for ambulatory blood pressure monitoring (ABPM) in children. Since then, clinical utility ABPM has increased dramatically, and now, is accepted as standard method to confirm diagnosis hypertension Despite significant progress field pediatric ABPM, many important questions remain unanswered. One most controversial issues how define The purpose this review discuss limitations current classification scheme provide justification rationale a new classification.

Language: Английский

---

The impact of decreased SIRT1 levels on pediatric primary hypertension and left ventricular hypertrophy: a case-control study

BMC Pediatrics, Journal Year: 2025, Volume and Issue: 25(1)

Published: April 30, 2025

Language: Английский

---

Arterial Stiffness and Chronic Kidney Disease Progression in Children

Clinical Journal of the American Society of Nephrology, Journal Year: 2022, Volume and Issue: 17(10), P. 1467 - 1476

Published: Aug. 26, 2022

CKD has been linked to increased arterial stiffness in adults, but data children with remain conflicting. We aimed investigate the longitudinal dynamics and determinants of pulse wave velocity its association progression.We performed an analysis Cardiovascular Comorbidity Children Chronic Kidney Disease (4C) study, which prospectively followed aged 6-17 years stages 3-5. Follow-up was censored at time KRT initiation. Two separate analyses were performed: absolute (primary outcome) standardized height (z score; restricted participants ≤17 years) as a sensitivity analysis.In total, 667 patients mean baseline eGFR 27 ml/min per 1.73 m2 included. Pulse above 95th percentile observed 124 (20%) baseline. Absolute gradually over median follow-up 2.7 (interquartile range, 0.7-4.4) years, whereas z score remained relatively stable. associated time; older age; higher pressure, LDL cholesterol, albuminuria; lower ferritin. (n=628) same variables additionally, diastolic BP score, younger age, girls. Of 628 patients, 369 reached composite end point progression (50% loss, <10 m2, or start KRT) during 2.4 0.9-4.6) years. did not associate by univariable multivariable proportional hazard correcting for established predictors eGFR, proteinuria, BP.Pulse is does progression.

Language: Английский

---

Ambulatory hemodynamic patterns, obesity, and pulse wave velocity in children and adolescents

Pediatric Nephrology, Journal Year: 2020, Volume and Issue: 35(12), P. 2335 - 2344

Published: July 14, 2020

Language: Английский

---

Systolic and diastolic left ventricular function in children with primary hypertension: a systematic review and meta-analysis

Journal of Hypertension, Journal Year: 2022, Volume and Issue: 41(1), P. 51 - 62

Published: Nov. 2, 2022

Objective: Evaluation of left ventricular function provides early evidence target-organ damage in children with primary hypertension. We performed a systematic review and meta-analysis systolic diastolic adolescents Methods: Literature search was PubMed database out 718 articles (published between 2000 2021) 22 studies providing comparison parameters hypertension normotensive controls were selected. Results: Overall, 3460 (5–21 years) analyzed. Meta-analysis showed that hypertensive patients when compared normotensives, had an increased heart rate (mean difference [MD] 5.59; 95% confidence interval [CI] 3.28, 7.89; 10 studies) fractional shortening (MD 1.04; CI 0.48, 1.60; 9 but did not differ ejection fraction −0.03; −1.07, 1.02; 12 studies). Stroke volume higher one three studies, whereas no differences cardiac output found two available data. Hypertensive also lower E/A values −0.21; −0.33, −0.09; 14 studies), greater E/e′ 0.59; 0.36, 0.82; 8 global longitudinal stress 2.50; 2.03, 2.96; 4 to those normotension. Conclusion: Our results indicate present signs hyperkinetic the ventricle, demonstrate strain impaired controls.

Language: Английский

---

Evolution of isolated systolic hypertension with normal central blood pressure in adolescents—prospective study

Pediatric Nephrology, Journal Year: 2020, Volume and Issue: 36(2), P. 361 - 371

Published: Sept. 3, 2020

Abstract Background The clinical significance of isolated systolic hypertension with normal central blood pressure known as spurious (sHT) in adolescents and its evolution over time is not known. Methods aim this study was to analyze changes office, ambulatory (ABPM), (cSBP), hemodynamic parameters, target organ damage (TOD) a 1-year follow-up group non-obese children sHT. Results Of 294 patients referred for primary hypertension, 138 (31 girls; 22%) had confirmed by ABPM. 48/138 (35%) (7 15%) were diagnosed sHT (elevated office BP, but cSBP); 43 them (6 14%) followed 12 ± 3 months during non-pharmacological therapy. At baseline 7 (16%) borderline values cIMT or LVMi indicating mild TOD. After months, 10/43 (3 23%) developed sustained HT BP cSBP), 11/43 (1 girl; 26%) maintained sHT, 22/43 (2 51%) evolved white coat normotension. cSBP increased 27 (4 63%), the average remained range. Prevalence TOD did change observation. multivariate regression analysis showed that only predictor serum uric acid level. Conclusions In conclusion, after 1 year treatment, 23% main being acid.

Language: Английский

---