Target Organ Abnormalities in Pediatric Hypertension

Urbina, Elaine M.; Lande, Marc B.; Hooper, Stephen R.; Daniels, Stephen R.

doi:10.1016/j.jpeds.2018.07.026

Cited by 31 publications

(21 citation statements)

References 93 publications

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“…3,45 Persistent hypertension has been associated with CV target organ damage in both adults and children. 49 CVD causes significant morbidity and mortality in patients with CKD. 6 Given the adverse effects of hypertension and those of CKD on CV health including ventricular hypertrophy, vascular calcification, and arterial stiffness, it is imperative to identify and intervene.…”

Section: Resultsmentioning

confidence: 99%

Are My Pediatric Patients at Increased Risk of Developing Chronic Kidney Disease?

Primack

Kleeman

Boineau

et al. 2020

Clin Pediatr (Phila)

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Chronic kidney disease (CKD) is an underrecognized and often undiagnosed cause of morbidity and mortality. Many children and adolescents are at increased risk of developing CKD as they mature and age, secondary to conditions commonly cared for by pediatric health professionals. Prematurity, diabetes mellitus, hypertension, congenital heart disease, sickle cell disease and trait, severe obesity, cancer chemotherapy, other drug toxicities, and systemic situations that may cause acute kidney injury such as sepsis or extracorporeal membrane oxygenation therapy predispose to potential CKD. Clinicians should be aware of these conditions in order to screen for CKD, choose non-nephrotoxic treatments for these children whenever possible, and treat or refer those who have early signs of CKD.

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Section: Resultsmentioning

confidence: 99%

Are My Pediatric Patients at Increased Risk of Developing Chronic Kidney Disease?

Primack

Kleeman

Boineau

et al. 2020

Clin Pediatr (Phila)

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“…Several mechanisms link obesity and high blood pressure, including upregulation of pro‐inflammatory adipokines due to adipose tissue dysfunction, increased sympathetic nervous system, abnormal kidney function associated with increased tubular sodium reabsorption, and increasing arterial stiffness 25‐31 . It has also been hypothesized that obesity‐related changes in the composition and function of gut microbiota might be associated with hypertension 32 .…”

Section: Discussionmentioning

confidence: 99%

“…Results from our study suggest that the prevention of central obesity may play an important role in the prevention of hypertension in adolescents and young adults with type 1 or type 2 diabetes. This may prevent obesity‐related metabolic changes involved in the development of hypertension 25‐31 . However, previous analyses also showed that microvascular complications of diabetic kidney disease, retinopathy, and peripheral neuropathy were higher among youths and young adults with type 2 diabetes compared to those with type 1 even after adjustment for central obesity, glycemic control, and other factors over time 6 .…”

Section: Discussionmentioning

confidence: 99%

Progression to hypertension in youth and young adults with type 1 or type 2 diabetes: The SEARCH for Diabetes in Youth Study

Koebnick

Imperatore

Jensen

et al. 2020

J of Clinical Hypertension

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Central obesity may contribute to the development of hypertension in youths with diabetes. The SEARCH for Diabetes in Youth Study followed 1518 youths with type 1 diabetes (T1D) and 177 with type 2 diabetes (T2D) diagnosed when <20 years of age for incident hypertension. Incident hypertension was defined as blood pressure ≥95th percentile (or ≥130/80 mm Hg) or reporting antihypertensive therapy among those without hypertension at baseline. Poisson regression models were stratified by diabetes type and included demographic and clinical factors, clinical site, and waistto-height ratio (WHtR). Youths with T2D were more likely to develop hypertension than those with T1D (35.6% vs 14.8%, P < .0001). For each 0.01 unit of annual increase in WHtR, adjusted relative risk for hypertension was 1.53 (95% CI 1.36-1.73) and 1.20 (95% CI 1.00-1.43) for youths with T1D and T2D, respectively. Effective strategies targeted toward reducing central obesity may reduce hypertension among youths with diabetes.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. ET Jensen, JM Stafford, and RB D'Agostino, Jr. performed statistical analysis. D Dabelea, RB D'Agostino, Jr., and JM Lawrence obtained funding. | 895 KOEBNICK Et al.

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“…Evaluation of arterial stiffness and common carotid artery intima-media thickness (cIMT) are included in the assessment of hypertension-mediated organ damage in children [ 5 , 6 ]. Increased cIMT and excessive arterial stiffness are common among pediatric patients with PH [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Serum Periostin as a Potential Biomarker in Pediatric Patients with Primary Hypertension

Szyszka

Skrzypczyk

Stelmaszczyk-Emmel

et al. 2021

JCM

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Experimental studies suggest that periostin is involved in tissue repair and remodeling. The study aimed to evaluate serum periostin concentration as potential biomarker in pediatric patients with primary hypertension (PH). We measured serum periostin, blood pressure, arterial damage, biochemical, and clinical data in 50 children with PH and 20 age-matched healthy controls. In univariate analysis, children with PH had significantly lower serum periostin compared to healthy peers (35.42 ± 10.43 vs. 42.16 ± 12.82 [ng/mL], p = 0.038). In the entire group of 70 children serum periostin concentration correlated negatively with peripheral, central, and ambulatory blood pressure, as well as with aortic pulse wave velocity (aPWV). In multivariate analysis, periostin level significantly correlated with age (β = −0.614, [95% confidence interval (CI), −0.831–−0.398]), uric acid (β = 0.328, [95%CI, 0.124–0.533]), body mass index (BMI) Z-score (β = −0.293, [95%CI, −0.492–−0.095]), high-density lipoprotein (HDL)-cholesterol (β = 0.235, [95%CI, 0.054–0.416]), and triglycerides (β = −0.198, [95%CI, −0.394–−0.002]). Neither the presence of hypertension nor blood pressure and aPWV influenced periostin level. To conclude, the role of serum periostin as a biomarker of elevated blood pressure and arterial damage in pediatric patients with primary hypertension is yet to be unmasked. Age, body mass index, uric acid, and lipid concentrations are key factors influencing periostin level in pediatric patients.

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Target Organ Abnormalities in Pediatric Hypertension

Cited by 31 publications

References 93 publications

Are My Pediatric Patients at Increased Risk of Developing Chronic Kidney Disease?

Are My Pediatric Patients at Increased Risk of Developing Chronic Kidney Disease?

Progression to hypertension in youth and young adults with type 1 or type 2 diabetes: The SEARCH for Diabetes in Youth Study

Serum Periostin as a Potential Biomarker in Pediatric Patients with Primary Hypertension

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