Vertex-corrected blood pressure in black girls. Relation to obesity, glucose, and cations.

Abstract

SUMMARY Correlates of resting blood pressure (BP) were explored among 32 inner-city, black girls, ages 11.7 to 13.9 years, a sample drawn from the second and fourth quartiles of the BP distribution in an earlier school survey. Customary BP measurements in the seated position were corrected for the height of the arterial column extending from the BP cuff to the top (vertex) of each girl's head. This vertex correction procedure has previously been shown to eliminate the childhood association between mean arterial pressure and age. Vertex-corrected systolic BP was correlated individually (p<0.03) with serum fasting glucose, ionized calcium, sodium, and calculated osmolality. The BP association with serum glucose did not persist after an oral sucrose challenge. Vertexcorrected diastolic BP was correlated individually (jo<0.02) with serum ionized calcium and four indices of obesity, the best correlated of which was the subscapular skinfold (r = 0.66, p = 0.0001). Vertex-corrected BPs generally provided stronger correlations than customary (uncorrected) BPs with the variables of interest. Correlations with seated BPs were generally stronger than those with supine BPs. By multiple regression analysis, seated vertex-corrected systolic BP was related directly to serum fasting glucose and ionized calcium and inversely to pulse rate (Jt 2 = 0.53). Seated vertexcorrected diastolic BP was related directly to subscapular skinfold and calculated osmolality (R 2 = 0.54). Vertex correction may facilitate clinical or epidemiological studies of early hypertension. O UR interest in the childhood origins of primary hypertension led us to a cross-sectional, clinical study of 32 black girls ranging in age from 11.7 to 13.9 years. We systematically chose our sample from participants in a previous blood pressure (BP) survey of black schoolchildren in Atlanta, excluding subjects from the lowest quartile of their community's BP distribution. The resulting study population was considered likely to yield a substantial number of hypertensive adults in subsequent years.In this clinical study we explored correlations between the girls' average resting BPs and various measures of their obesity, glucose metabolism, and catFrom the Departments of Community Health (H.S. Kahn) and Biometry (R.P. Bain), Emory University School of Medicine, Atlanta, Georgia.Supported by grants from the Georgia Affiliate of the American Heart Association, the Emory University Research Fund, and the Clinical Research Center Program of the National Institutes of Health, U.S. Public Health Service (Grant 2-M01-RR00O39).Address for reprints: H.S. Kahn, M.D., 735 Gatewood Road, Emory University School of Medicine, Atlanta, GA 30322.Received May 6, 1986; accepted October 28, 1986. ions. We also probed the utility within this age range of correcting customary systolic and diastolic BP measurements for the height of the arterial column extending from the BP cuff to the top (vertex) of each subject's head. In the large school-based survey from which these girls were drawn (...

A population-based comparison of BMI percentiles and waist-to-height ratio for identifying cardiovascular risk in youth

“…17,18 It suggests that the higher blood pressures identified by an increased BMI percentile are physiologically appropriate to the participants' taller stature and unlikely to represent a cardiovascular hazard. 19 What WHtR characteristics are likely to explain its observed association with cardiovascular risk factors? A large WHtR is an estimator of the visceral (intra-abdominal) mass of adipose tissue (documented for adults 20 ) along with the subcutaneous truncal fat mass.…”