Determination of Blood Pressure Percentiles in Normal-Weight Children: Some Methodological Issues

Rosner, Bernard; Cook, Nancy R.; Portman, Ron; Daniels, Steven R.; Falkner, Bonita

doi:10.1093/aje/kwm348

Cited by 357 publications

(318 citation statements)

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“…This method reduced the influence of outliers and did not assume the linearity of the relation (20). Biomarker measures were standardized for the batch effect as described by Rosner et al (21). Briefly, the mean b coefficients from a linear regression model for each biomarker with a batch indicator variable was calculated.…”

Section: Discussionmentioning

confidence: 99%

Dietary patterns and cardiometabolic and endocrine plasma biomarkers in US women

AlEssa

Malik

Yuan

et al. 2017

The American Journal of Clinical Nutrition

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Background: Healthful dietary patterns have been associated with lower risks of type 2 diabetes and coronary artery disease, but their relations with intermediate markers of cardiometabolic and endocrine health are less established. Objective: We evaluated the Dietary Approaches to Stop Hypertension (DASH), the alternate Mediterranean diet (aMED), and the Alternate Healthy Eating Index (aHEI) diet-quality scores with cardiometabolic and endocrine plasma biomarkers in US women. Design: The trial was a cross-sectional analysis of 775 healthy women in the Women's Lifestyle Validation Study that was conducted within the NHS (Nurses' Health Study) and NHS II longitudinal cohorts. Multiple linear regression models adjusted for potential confounders were used to estimate associations between quartiles of dietary pattern-adherence scores that were derived from a food-frequency questionnaire and plasma biomarker concentrations that were collected simultaneously. Results: In multivariable models in which highest and lowest quartiles of dietary pattern scores were compared, 1) DASH was significantly associated with higher concentrations of high-density lipoprotein (9%) and sex-hormone binding globulin (SHBG) (21%), and lower concentrations of leptin (28%), triglycerides (19%), and C-peptide (4%) (all P-trend # 0.04); 2) the aMED was associated with 19% higher SHBG and 16% lower triglycerides (P-trend = 0.02 and 0.003, respectively); and 3) the aHEI was associated with significantly higher concentrations of insulin (16%) and SHBG (19%) and lower concentrations of leptin (18%) (all P-trend # 0.02). Further adjustment for body mass index (BMI) attenuated these associations but remained significant for 1) DASH with leptin and triglycerides and 2) the aMED with triglycerides (all P-trend # 0.03). Conclusions: Adherence to healthful dietary patterns is associated with favorable concentrations of many cardiometabolic and endocrine biomarkers. These relations are mediated in part by BMI. Am J Clin Nutr 2017;105:432-41.

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Section: Discussionmentioning

confidence: 99%

Dietary patterns and cardiometabolic and endocrine plasma biomarkers in US women

AlEssa

Malik

Yuan

et al. 2017

The American Journal of Clinical Nutrition

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“…These findings are in close agreement with previous studies dealing with the relationship between BMI and BP in childhood. 12,27,28 Since the first description by Barker et al 29,30 of the association of low birth weight with high BP in adult life nearly 2 decades ago, the hypothesis of prenatal priming of postnatal BP was essentially confirmed by a majority of studies, albeit with variable effect size. 31,32 Our study adds to this body of evidence.…”

Section: Simonetti Et Al Blood Pressure and Passive Smoking In Childrmentioning

confidence: 99%

Determinants of Blood Pressure in Preschool Children

et al. 2011

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Background-Hypertension is the leading risk factor for cardiovascular disease. Although accumulating evidence suggests tracking of blood pressure from childhood into adult life, there is little information regarding the relative contributions of genetic, prenatal, biological, behavioral, environmental, and social determinants to childhood blood pressure. Methods and Results-Blood pressure and an array of potential anthropometric, prenatal, environmental, and familial risk factors for high blood pressure, including parental smoking habits, were determined as part of a screening project in 4236 preschool children (age 5.7Ϯ0.4 years). Smoking was reported by 28.5% of fathers and 20.7% of mothers, and by both parents 11.9%. In addition to classic risk factors such as body mass index, prematurity, low birth weight, and parental hypertension, both systolic (ϩ1.0 [95% confidence interval, ϩ0.5 to ϩ1.5] mm Hg; Pϭ0.0001) and diastolic blood pressure (ϩ0.5 [ϩ0.03 to ϩ0.9] mm Hg; Pϭ0.03) were higher in children of smoking parents. Parental smoking independently affected systolic blood pressure (Pϭ0.001) even after correction for other risk factors, such as body mass index, parental hypertension, or birth weight, increasing the likelihood of having a systolic blood pressure in the top 15% of the population by 21% (2% to 44%; Pϭ0.02). Conclusions-In healthy preschool children, parental smoking is an independent risk factor for higher blood pressure, adding to other familial and environmental risk factors. Implementing smoke-free environments at home and in public places may provide a long-term cardiovascular benefit even to young children. (Circulation. 2011;123:292-298.)

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“…4 The full AAP CPG 7 contains new BP tables, figures, and supporting information designed to assist clinicians in diagnosing, evaluating, and managing elevated BP and hypertension in children and adolescents. 9 Considering these finding and the known effects of obesity on BP, the AAP commissioned development of a new set of normative BP values for the new CPG that are based only on data from normal weight children in the NHBPEP database. The new tables provide systolic and diastolic BP values at the 50th, 90th, and 95th percentiles, and the 95th percentile+12 mm Hg (to denote stage 2 hypertension) according to sex, age, and height.…”

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confidence: 99%

New Clinical Practice Guideline for the Management of High Blood Pressure in Children and Adolescents

2017

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A substantial body of clinical data on elevated blood pressure (BP) in children and adolescents have been published during the past decade. In response to the need to update management guidelines on pediatric hypertension, the American Academy of Pediatrics (AAP) supported development and publication of a new clinical practice guideline on high BP in childhood. Before 1977, there was no consistent definition of hypertension in childhood, and BP was not commonly measured in asymptomatic children or adolescents. Consequently, childhood hypertension had been considered rare and, if detected, the assumption was that it would be secondary to an underlying disorder. In the mid-1970s, the National High Blood Pressure Education (NHBPEP) of the National Heart Lung and Blood Institute (NHLBI) convened a task force to examine available BP data on healthy children to determine the normal BP distribution in children and define the upper limits of BP according to age. Although available BP data at that time were limited by current standards, it was clear that BP levels in children were related to age, with a progressive increase from early childhood through adolescence. In the absence of longterm outcome data, it was not possible to link a level of childhood BP to risk of later cardiovascular events. Therefore, the task force defined hypertension as the BP level that exceeded the 95th percentile on age-related BP distribution curves. The recommendations of this task force on detection, evaluation, and management of hypertension in children and adolescents were published in 1977.1 In addition to providing a framework on diagnosis of hypertension, the publication included information on proper BP measurement in children, diagnostic evaluation for children with elevated BP, and management of BP in hypertensive children.That report of that NHBPEP Task Force 1 constituted the first clinical practice guideline (CPG) for childhood hypertension. Major updates were published in 1987, 1996, and 2004. 2-4 Minor updating of antihypertensive drug dosing for children, but no new recommendations related to evaluation or management of high childhood BP, was incorporated into the 2011 NHLBI integrated guideline on pediatric cardiovascular health.5 Since the 2004 Working Group report, findings of many new studies related to childhood hypertension have been published, including data on epidemiology, hypertension-related risk factors, BP management, and target organ damage (TOD). The childhood obesity epidemic during this time period also lead to increased recognition of obesity-associated hypertension in childhood. Considering the knowledge gained from the body of publications since 2004, it was recognized that the pediatric hypertension guidelines needed to be updated.Several prominent investigators in the field of pediatric hypertension began developing the case with the NHLBI to support an update of the pediatric hypertension CPG. However, the 2013 announcement by the NHLBI 6 that it would no longer sponsor the development of new CPGs pro...

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Determination of Blood Pressure Percentiles in Normal-Weight Children: Some Methodological Issues

Cited by 357 publications

References 16 publications

Dietary patterns and cardiometabolic and endocrine plasma biomarkers in US women

Dietary patterns and cardiometabolic and endocrine plasma biomarkers in US women

Determinants of Blood Pressure in Preschool Children

New Clinical Practice Guideline for the Management of High Blood Pressure in Children and Adolescents

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