Blood Pressure at Different Life Stages Over the Early Life Course and Intima-Media Thickness

Meng, Yaxing; Sharman, James E.; Koskinen, Juhani S.; Juonala, Markus; Viikari, Jorma S. A.; Buscot, Marie-Jeanne; Wu, Feitong; Fraser, Brooklyn J.; Rovio, Suvi P.; Kähönen, Mika; Rönnemaa, Tapani; Jula, Antti; Niinikoski, Harri; Raitakari, Olli T.; Pahkala, Katja; Magnussen, Costan G.

doi:10.1001/jamapediatrics.2023.5351

Cited by 3 publications

References 52 publications

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Differences between brachial and aortic blood pressure in adolescence and their implications for diagnosis of hypertension

Hughes,

Davey Smith,

Howe

et al. 2024

Journal of Hypertension

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Objectives: Blood pressure (BP) is the leading global cause of mortality, and its prevalence is increasing in children and adolescents. Aortic BP is lower than brachial BP in adults. We aimed to assess the extent of this difference and its impact on the diagnosis of hypertension among adolescents. Methods: We used data from 3850 participants from a UK cohort of births in the early 1990s in the Southwest of England, who attended their ∼17-year follow-up and had valid measures of brachial and aortic BP at that clinic [mean (SD) age 17.8 (0.4) years, 66% female individuals]. Data are presented as mean differences [95% prediction intervals] for both sexes. Results: Aortic systolic BP (SBP) was lower than brachial SBP [male, −22.3 (−31.2, −13.3) mmHg; female, −17.8 (−25.5, −10.0) mmHg]. Differences between aortic and brachial diastolic BP (DBP) were minimal. Based on brachial BP measurements, 101 male individuals (6%) and 22 female individuals (1%) were classified as hypertensive. In contrast, only nine male individuals (<1%) and 14 female individuals (<1%) met the criteria for hypertension based on aortic BP, and the predictive value of brachial BP for aortic hypertension was poor (positive-predictive value = 13.8%). Participants with aortic hypertension had a higher left ventricular mass index than those with brachial hypertension. Conclusion: Brachial BP substantially overestimates aortic BP in adolescents because of marked aortic-to-brachial pulse pressure amplification. The use of brachial BP measurement may result in an overdiagnosis of hypertension during screening in adolescence.

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Differences between brachial and aortic blood pressure in adolescence and their implications for diagnosis of hypertension

Hughes,

Davey Smith,

Howe

et al. 2024

Journal of Hypertension

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Changes in the Cardiovascular Risk Profile in Children Approaching Kidney Replacement Therapy

Khandelwal,

Hofstetter,

Azukaitis

et al. 2024

Preprint

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Cognitive performance in children and adolescents with primary hypertension and the role of body mass

Azukaitis,

Puteikis,

Kinciniene

et al. 2024

Front. Pediatr.

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ObjectivePrimary hypertension has been shown to affect cognitive functions in adults but evidence in the pediatric population remain scarce and equivocal. We aimed to compare cognitive functioning between children diagnosed with primary hypertension and normotensive controls, with a focus on the role of different blood pressure (BP) parameters and body mass.MethodsWe conducted a single-center, prospective, cross-sectional study of children and adolescents (6–17 years old) with primary hypertension and age- and sex-matched normotensive controls. All participants underwent office BP, ambulatory BP monitoring (ABPM), and central BP measurements using an oscillometric device. Neurocognitive assessment consisted of evaluation of (i) intelligence quotient (IQ), (ii) categorical and phonemic fluency, (iii) verbal memory (verbal-logical story recall), and (iv) non-verbal computerized cognitive assessment.ResultsThe study included a total of 59 patients with primary hypertension (14 ± 3 years) and 37 normotensive controls (14 ± 3 years). Participants in the primary hypertension group had a significantly higher body mass index z-score (BMIz: 2.1 ± 1.4 vs. 0.7 ± 0.9, p < 0.001), and 85% received antihypertensive therapy. Participants with primary hypertension showed worse performance in the domains of reaction speed, attention and processing speed, visual memory, new learning, and phonemic fluency. After adjusting for BMIz, only the differences in the reaction speed tasks remained significant. None of the BP parameters was associated with cognitive outcomes after adjustment for age, sex, and BMIz. BMIz associated with tasks of visual memory, new learning, spatial planning, and working memory, independent of age and sex.ConclusionChildren and adolescents diagnosed with primary hypertension exhibit worse performance in the cognitive domains of reaction speed, attention, processing speed, visual memory, and new learning. These differences to healthy controls can be partially attributed to accompanying increase of body mass.

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Blood Pressure at Different Life Stages Over the Early Life Course and Intima-Media Thickness

Cited by 3 publications

References 52 publications

Differences between brachial and aortic blood pressure in adolescence and their implications for diagnosis of hypertension

Differences between brachial and aortic blood pressure in adolescence and their implications for diagnosis of hypertension

Changes in the Cardiovascular Risk Profile in Children Approaching Kidney Replacement Therapy

Cognitive performance in children and adolescents with primary hypertension and the role of body mass

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