Long-Term Cardiovascular Outcomes in Children and Adolescents With Hypertension

JAMA Pediatrics, Journal Year: 2024, Volume and Issue: 178(7), P. 688 - 688

Published: May 6, 2024

Importance Hypertension affects 6% of all children, and its prevalence is increasing. Childhood hypertension tracks into adulthood associated with subclinical cardiovascular disease; however, there a lack evidence linking childhood to outcomes, which may contribute underdiagnosis undertreatment. Objective To determine the long-term risk major adverse cardiac events (MACE) among children diagnosed hypertension. Design, Setting, Participants This was population-based, retrospective, matched cohort study conducted from 1996 2022. The included (aged 3-18 years) alive in Ontario, Canada, 2021, who were identified using provincial administrative health databases. Children prior kidney replacement therapy excluded. Exposure Incident diagnosis, by validated case definitions diagnostic physician billing claims. Each 5 controls without age, sex, birth weight, maternal gestational hypertension, comorbidities (chronic disease, diabetes, surgery), propensity score for Main Outcomes Measures primary outcome MACE (a composite death, stroke, hospitalization myocardial infarction or unstable angina, coronary intervention). Time evaluated Kaplan-Meier method Cox proportional hazards regression. Results A total 25 605 (median [IQR] 15 [11-17] years; 14 743 male [57.6%]) 128 025 Baseline covariates balanced after matching, uncommon (hypertension vs control cohort: malignancy, 1451 [5.7%] 7908 [6.2%]; congenital heart 1089 [4.3%] 5408 [4.2%]; 482 [1.9%] 2410 [1.9%]). During median (IQR) 13.6 (7.8-19.5) years follow-up, incidence 4.6 per 1000 person-years 2.2 (hazard ratio, 2.1; 95% CI, 1.9-2.2). at higher intervention, congestive failure, but not compared nonhypertensive controls. Conclusions Relevance had Improved detection, pediatric reduce adult disease.

Language: Английский

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Associations of metabolic disorders with hypertension and cardiovascular disease: recent findings and therapeutic perspectives

Hypertension Research, Journal Year: 2024, Volume and Issue: 47(12), P. 3338 - 3344

Published: May 29, 2024

Language: Английский

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Measurement of Blood Pressure in Children and Adolescents Outside the Office for the Diagnosis of Hypertension

Current Cardiology Reports, Journal Year: 2025, Volume and Issue: 27(1)

Published: Jan. 18, 2025

Language: Английский

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Hypertension, Obesity, and Target Organ Injury in Children: An Emerging Health Care Crisis

Current Hypertension Reports, Journal Year: 2025, Volume and Issue: 27(1)

Published: Feb. 27, 2025

To review data regarding the association between hypertension and childhood obesity on target organ damage. We will also impact of intervening The prevalence are rising in children despite efforts to address these risk factors. Health disparities play a role contributing rise prevalence. Hypertension promote pro-inflammatory cytokines that activate renin-angiotensin-aldosterone system sympathetic nervous which result adverse effects blood pressure regulation renal function. Adverse cardiac, vascular, renal, neurocognitive, retinal changes can be seen with elevated pressure. Recent intervention studies few, but adequate treatment improvement have significant impacts upon organs. Interventions decrease treat associated reductions left ventricular hypertrophy, measures systolic diastolic function, outcomes. Appropriate screening management conditions lessen potential future cardiovascular impact.

Language: Английский

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Accelerometer‐based sedentary time, light physical activity, and moderate‐to‐vigorous physical activity from childhood with arterial stiffness and carotid IMT progression: A 13‐year longitudinal study of 1339 children

Acta Physiologica, Journal Year: 2024, Volume and Issue: 240(5)

Published: March 21, 2024

Abstract Aims We examined the longitudinal associations of sedentary time (ST), light physical activity (LPA), and moderate‐to‐vigorous PA (MVPA) from childhood with carotid‐femoral pulse wave velocity (cfPWV), a measure arterial stiffness carotid intima‐media thickness (cIMT). Methods studied 1339 children, aged 11 years Avon Longitudinal Study Parents Children, UK, followed up for 13 years. Accelerometer‐based ST, LPA, MVPA were assessed at ages 11, 15, 24 clinic visits. cfPWV cIMT measured Vicorder ultrasound, respectively, 17 Results Among [56.4% female] participants, mean ST increased through years, while LPA decreased. Persistently high tertile was associated progression, effect estimate 0.047 m/s; [(95% CI 0.005 to 0.090); p = 0.030], but not progression. category decreased progression in males −0.022 [(−0.028 −0.017); < 0.001] females −0.027 [(−0.044 −0.010); 0.001]. Cumulative exposure odds progressively worsening [Odds ratio 0.994 (0.994–0.995); 0.0001] cIMT. Persistent ≥60 min/day paradoxically 0.053 [(0.030 0.077); 0.012 [(0.002 0.022); 0.016]. inversely −0.017 mm; [(−0.026 −0.009); Conclusion >3 h/day may attenuate vascular damage youth.

Language: Английский

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Prevalence of Pediatric Masked Hypertension and Risk of Subclinical Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

Hypertension, Journal Year: 2023, Volume and Issue: 80(11), P. 2280 - 2292

Published: Sept. 22, 2023

Masked hypertension (MH) occurs when office blood pressure is normal, but confirmed using out-of-office measures. Hypertension a risk factor for subclinical cardiovascular outcomes, including left ventricular hypertrophy, increased mass index, carotid intima media thickness, and pulse wave velocity. However, the factors ambulatory monitoring defined MH its association with outcomes are unclear. A systematic literature search on 9 databases included English publications from 1974 to 2023. Pediatric prevalence was stratified by disease comorbidities compared general pediatric population. We also of mean differences in velocity between versus normotensive patients. Of 2199 screened studies, 136 studies (n=28 612; ages 4-25 years) were included. The population 10.4% (95% CI, 8.00-12.80). Compared population, ratio (RR) significantly greater children coarctation aorta (RR, 1.91), solid-organ or stem-cell transplant 2.34), chronic kidney 2.44), sickle cell 1.33). patients had patients, higher index (mean difference, 3.86 g/m2.7 [95% 2.51-5.22]), hypertrophy (odds ratio, 2.44 1.50-3.96]), 0.30 m/s 0.14-0.45]). elevated among various comorbidities. Children have evidence which increases their long-term disease.

Language: Английский

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Increasing trend in hypertension prevalence among Korean adolescents from 2007 to 2020

BMC Public Health, Journal Year: 2024, Volume and Issue: 24(1)

Published: Feb. 26, 2024

Abstract Background The purpose of this study was to examine the prevalence hypertension in Korean adolescents, its long-term trends, and factors associated with development hypertension. Methods Data Korea National Health Nutrition Examination Survey (KNHANES) from 2007 2020 were combined into three time periods (2007–2011, 2012–2016, 2017–2020). A total 11,146 adolescents aged 10–18 included analysis. definition based on 2017 American Academy Pediatrics guidelines for Results age-adjusted 5.47%, 7.85%, 9.92% 2007–2011, 2017–2020, respectively. Long-term trend analysis using Joinpoint over observation period showed a significantly increasing mean annual percentage change 6.4%. Boys, those 13–15, 16–18, overweight/obese, living urban areas more likely develop (OR 1.980, 1.492, 3.180, 2.943, 1.330, respectively). Conclusion higher than global an increase 13–year period. Targeted strategies prevention early detection are needed population.

Language: Английский

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Pulse wave velocity in children and adolescents with chronic kidney disease: a scoping review

Arterial’naya Gipertenziya (Arterial Hypertension), Journal Year: 2025, Volume and Issue: 30(5), P. 418 - 440

Published: Jan. 21, 2025

Objective . The purpose of the study is to systematize published data answer main research question: how often there an increase in pulse wave velocity (PWV) children and adolescents with chronic kidney disease (CKD), compared control group (and/or reference values adopted study)? was carried out show relevance further scientific this field. Design methods search included PubMed database, Cochrane Library, electronic library eLIBRARY.RU, specialized Pediatric Nephrology journal, Google Scholar system lists relevant articles. Results Of 473 identified publications, 35 articles were study. Significant differences found for determining PWV (n = 4), devices 9), implementation techniques, used 4). mean Z-score CKD patient groups ranged from –0,13 1,89. Among CKD, prevalence ≥ 95th percentile varied 1% 61% across studies. In most groups, detected every fifth more often. When healthy children, higher patients observed half studies (14/25; 56%). Most often, determined G5 on dialysis therapy, hypertension, after transplantation. Conclusions majority therapy have increased PWV. For G1-G4, conclusions are mixed, given significant variability results There a need standardize measurement adolescents, achieve consensus decisions assessing obtained, followed by multicenter studies, including Russian population.

Language: Английский

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Youth Blood Pressure and Target Organ Injury Markers: The SHIP AHOY Study

Hypertension, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 27, 2025

BACKGROUND: Hypertension in adolescence is associated with subclinical target organ injury. We aimed to determine whether different blood pressure thresholds were an increasing number of injury markers healthy adolescents. METHODS: A total 244 participants (mean age 15.5±1.8 years, 60.1% male) studied. Participants divided based on systolic clinic and awake ambulatory into low- (<75th percentile), mid- (75th–90th high-risk (>90th percentile) groups. The phenotype was classified as normotensive, white-coat, masked, or sustained hypertension. Target assessments included left ventricular mass, diastolic function, vascular stiffness. multivariable general linear model constructed evaluate the association participant characteristics higher numbers markers. RESULTS: 31.2% had 1, 11.9% 2, 3.7% 3, 0.8% 4 increased according risk groups: percentage >1 marker low-, mid-, groups 6.7%, 19.1%, 21.8% ( P =0.02) 9.6%, 15.8%, 32.2% <0.001), pressure, respectively. white-coat (23%), masked (35%), hypertension (32%) significantly than normotensives (8%, <0.001). results unchanged multivariate analysis. CONCLUSIONS: High values, well phenotypes (white-coat, hypertension), independently cardiovascular

Language: Английский

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Ambulatory Blood Pressure Phenotype and Cardiovascular Risk in Youth: The SHIP-AHOY Study

The Journal of Pediatrics, Journal Year: 2025, Volume and Issue: unknown, P. 114601 - 114601

Published: April 1, 2025

Language: Английский

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