Isolated systolic hypertension, obesity, and hyperkinetic hemodynamic states in children

Sorof, Jonathan M.; Poffenbarger, Tim; Franco, Kathy; Bernard, Lillian; Portman, Ronald J.

doi:10.1067/mpd.2002.125228

Cited by 282 publications

(215 citation statements)

References 32 publications

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“…This type of analysis (Figures 1a and b) verified: (i) the previously described predominance of systolic over diastolic hypertension in these age groups [12][13][14][15][16] and (ii) the important role of obesity on both systolic and diastolic hypertension. On the other hand it showed that: (i) although the prevalence of systolic hypertension was consistently higher than the prevalence of diastolic hypertension, this was clearly observed for OBP readings (reaching the level of statistical significance) but not for HBP readings, and (ii) that it cannot be totally attributed to the effect of obesity on BP, as it was observed in lean subjects as well.…”

Section: Discussionsupporting

confidence: 78%

“…Firstly, the present results verified the predominance of this phenotype in OBP readings; it was however less pronounced as far as HBP is concerned, implying that it might, at least in part, be attributed to the technique (home or office) of BP recording and to the well-described white coat effect in children as well. 30,31 However the role of obesity needs to be further investigated as there is a close relation between obesity and: (i) the sympathetic nervous system hyperactivity, which contributes to the pathogenesis of isolated systolic hypertension in these age groups, 16 as well as (ii) the white coat phenomenon, which has high prevalence (6%) among obese youths. 30 Finally, another potential limitation of this study is the lower than expected prevalence of overweight and obese subjects (around 14%) and the size of the population.…”

Section: Perspectives and Limitationsmentioning

confidence: 99%

“…10,11 Moreover, studies in children and adolescents consistently showed a higher prevalence of systolic rather than diastolic hypertension. [12][13][14][15][16] For these reasons the association between weight (obesity) and the level of SBP and DBP level in children and adolescents needs to be further elucidated.…”

Section: Introductionmentioning

confidence: 99%

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Home and office blood pressure in children and adolescents: the role of obesity. The Arsakeion School Study

et al. 2009

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Obesity is related to office blood pressure (OBP). Important discrepancies exist between OBP and home blood pressure (HBP), providing complementary information for the management of hypertension. The association between obesity and HBP has not been investigated in children. The evidence on the role of obesity in the predominance of systolic blood pressure (SBP) over diastolic (DBP) in paediatric hypertension is limited. A total of 778 healthy subjects aged 6-18 years were recruited in this study. OBP and HBP were measured using electronic devices validated in children. Anthropometric measurements were measured and expressed as z-scores for height or age. Among all indices of obesity (z-scores), body mass index (BMI) showed the best association with BP. The effect of obesity (BMI) was more pronounced on: (i) SBP than DBP and (ii) H-SBP than O-SBP (O-SBP: r 2 ¼ 0.09, O-DBP: r 2 ¼ 0.05, H-SBP: r 2 ¼ 0.12, H-DBP: r 2 ¼ 0.06). The prevalence of systolic hypertension was higher than that of diastolic hypertension. This difference was significant only in office readings and independent from obesity (normal weight: 6.3% systolic hypertension versus 1.2% diastolic; obese: 37.9% versus 6.9%, Po0.05 for both). These data imply that in children and adolescents the z-score of BMI is the most appropriate index of the association between BP and obesity. It also suggests that obesity is probably more closely associated with home than office BP. Finally, although obesity appears to affect SBP more than DBP, these results suggest that the predominance of systolic hypertension in children and adolescents might not be only related to obesity but also to the measurement setting (office).

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Section: Discussionsupporting

confidence: 78%

Section: Perspectives and Limitationsmentioning

confidence: 99%

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Home and office blood pressure in children and adolescents: the role of obesity. The Arsakeion School Study

et al. 2009

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“…6 Prevalence of hypertension in overweight children underline the role of adiposity in increasing blood pressure in children. 3,[7][8][9] There is evidence of a concordant increase in body mass index (BMI) and systolic blood pressure (SBP) among adolescents and children. 10 Excessive BMI gain at any life stage is known to be associated with higher blood pressure in later life.…”

Section: Introductionmentioning

confidence: 99%

Body mass index trend and its association with blood pressure distribution in children

et al. 2010

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The aim of the study was to examine the association of a trend in body mass index (BMI) status with current blood pressure in a cohort of school children from South India. A population of 25 228 children was selected using stratified random sampling method. Height and weight were measured in [2003][2004]. Height, weight and blood pressure were measured in [2005][2006]. A total of 12 129 children aged 5-16 years having paired data were analysed. Blood pressure and BMI values were converted to Z scores using International paediatric reference values. An increase in Z BMI meant that the child is moving to a higher BMI level with respect to his or her age and sex. In the cohort, 62.4% children had a higher Z BMI at follow-up than at baseline. Children with higher Z BMI at follow-up were labelled as positive BMI status group (PBSG) and the remaining as negative BMI status group (NBSG). The positive trend in BMI was more in rural areas, government schools and girls. In all subgroups, PBSG showed significantly higher systolic blood pressures (SBPs) than NBSG. PBSG showed significantly higher diastolic blood pressures (DBPs) in urban area, government schools and girls when compared with NBSG. Prevalence of first instance systolic hypertension was more in PBSG in all the subgroups except in rural children. Prevalence of diastolic hypertension was significantly higher in PBSG in urban subgroup only. BMI status trends are associated with blood pressure distribution in children.

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“…12 Previous studies have shown that obesity is associated with cardiovascular abnormalities, such as hypertension [13][14][15][16][17][18] and high resting heart rate (HR). 19,20 Hypertension is a strong predictor of cardiovascular diseases and death 21,22 and is also an important component of the metabolic syndrome, 23 which is a risk factor for coronary heart disease. 24,25 Several studies [26][27][28][29] have also shown that a high resting HR is a strong predictor for death especially from cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

Relationship of body mass index with haemodynamic variables and abnormalities in young adults

Dimkpa

Oji

2009

J Hum Hypertens

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We aimed at investigating whether the degree of adiposity is related to haemodynamic variables such as systolic blood pressure (SBP), diastolic blood pressure (DBP) and resting heart rate (HR), and to haemodynamic abnormalities such as hypertension and resting tachycardia. A cross-sectional study was carried out among young students in Ebonyi State University, Nigeria. A total of 710 subjects (350 males and 360 females) aged 20-25 years were recruited for the study. Resting blood pressure and HR of subjects were measured and the body mass index (BMI) was calculated from height and weight measurements. The observed prevalences in this study were as follows: overweight, 20% in males and 26% in females; obesity, 8% in males and 6% in females; hypertension, 17% in males and 14% in females; and resting tachycardia, 22% in males and 24% in females. In both genders, BMI showed significant correlations (Po0.001 or Po0.01 or Po0.05) with SBP, DBP and HR after controlling for age and physical activity status, and SBP indicated the strongest association with BMI. Furthermore, the prevalence of hypertension and tachycardia increased with an increase in BMI level, whereas overweight/obese subjects indicated significantly higher risk of hypertension than did the non-overweight/obese controls. The present findings therefore strengthen the previously reported usefulness of BMI in predicting cardiovascular risks and add to our understanding of the early development of obesity-related cardiovascular abnormalities in young adults and the need to prevent obesity early in life and to avoid its unfavourable lifethreatening consequences later in life.

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Isolated systolic hypertension, obesity, and hyperkinetic hemodynamic states in children

Cited by 282 publications

References 32 publications

Home and office blood pressure in children and adolescents: the role of obesity. The Arsakeion School Study

Home and office blood pressure in children and adolescents: the role of obesity. The Arsakeion School Study

Body mass index trend and its association with blood pressure distribution in children

Relationship of body mass index with haemodynamic variables and abnormalities in young adults

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