A large body of literature suggests an inverse relationship between birth weight and blood pressure in children, adolescents and adults. The most persistent findings have been observed in children with a history of low birth weight or intrauterine growth restriction, while a large number of studies carried out in populations with normally distributed birth weight have shown conflicting results. A recently reported strong direct association between high birth weight and blood pressure, and the significant positive effect of postnatal growth on blood pressure suggests that the fetal origins of adult disease hypothesis should be expanded to include the role of excessive fetal and postnatal growth. In this paper, we review recent studies on the relationship between birth weight and blood pressure in childhood, with a focus on confounding variables that may explain the conflicting results of published work in this field.
Serum NT-pro-BNP is a good predictor for complications after cardiac surgery, and is as good as euroSCORE and better than EF.
3The purpose of the study was to investigate blood pressure (BP) distribution, prevalence of hypertension, and correlation between BP and body mass index (BMI) in 9-to 10-year-old Icelandic children. Two manual and two automated BP measurements were performed in 1071 Icelandic children. Children with elevated BP underwent a second BP screening, and a third screening was performed if the BP was elevated at the second visit. Hypertension was defined as BP !95th percentile at all three visits. White-coat hypertension was diagnosed in hypertensive children with normal 24-hour ambulatory BP. Of 970 children with complete data, 489 were girls (50.4%). The mean BP was 111 ⁄ 63 mm Hg in girls and 112 ⁄ 64 mm Hg in boys (P<.001). The prevalence of elevated BP was 13.1%, 6.0%, and 3.1% after the first, second, and third screen, respectively. The prevalence of sustained hypertension was 2.5% and an additional 0.6% had white-coat hypertension. A significant correlation between BMI and BP was observed (r=0.338, P<.001) and 8.6% of the obese children had hypertension. The prevalence of hypertension in 9-to 10-year-old Icelandic children is lower than indicated in recent reports and is associated with obesity.
Limited data exist on the comparison of blood pressure (BP) measurements using aneroid and oscillometric devices. The purpose of the study was to investigate the difference in BP obtained using oscillometric and aneroid BP monitors in 9-to 10-year-old children. A total of 979 children were divided into group O, which underwent two oscillometric BP readings followed by two aneroid readings, and group A, which had BP measured in the reverse order. No significant difference was found between the mean (AEstandard deviation) of the two systolic BP readings obtained using the oscillometric and aneroid devices (111.5AE8.6 vs 111.3AE8.1 mm Hg; P=.39), whereas the mean diastolic BP was lower with the oscillometric monitor (61.5AE8.0 vs 64.5AE6.8 mm Hg; P<.001). A significant downward trend in BP was observed with each consecutive measurement, and agreement between the two monitors was limited. Multiple BP measurements are, therefore, recommended before the diagnosis of elevated BP or hypertension is made with either method. J Clin Hypertens (Greenwich). 2013;15:776-783. ª2013 Wiley Periodicals, Inc.Measurement of blood pressure (BP) is an essential component of physical examination in both children and adults. In spite of a low prevalence of hypertension in children, 1-4 early and accurate detection of elevated BP is nonetheless very important for preventing future end-organ damage. [5][6][7] While normative data on BP in children are based on manual BP readings using mercury sphygmomanometer, automated oscillometric BP monitors are now widely used in pediatric clinics and hospitals.8 Studies comparing oscillometric and mercury BP monitors have yielded inconsistent findings where the oscillometric method has been found to either overestimate or underestimate the BP. 9-13Two recent US studies 14,15 have investigated the difference between BP measurements obtained by aneroid and mercury sphygmomanometers in children and found no or minimal difference between these measurement methods. To date, the only published study comparing an aneroid sphygmomanometer with an oscillometric BP monitor was carried out in a population of 235 children with chronic kidney disease (CKD). 16 The oscillometric monitor was found to overestimate both the systolic and diastolic BP and limited agreement was found between the two methods in classification of BP status.Although mercury sphygmomanometers have been widely replaced with aneroid BP devices, no studies have compared aneroid sphygmomanometers and automated oscillometric BP monitors in population-based samples. The aim of this study was to compare BP measurements obtained using aneroid sphygmomanometer and automated oscillometric device and to analyze factors contributing to the differences between these two methods in 9-to 10-year-old Icelandic school children. METHODSThe study was a part of a population-based, crosssectional study of BP in healthy 9-to 10-year-old Icelandic school children carried out in the year 2009. 4 Of the 1472 children invited to participate, the parents of 10...
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