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S Machado IB, Tofanelli MR, Saldanha da Silva AA, Simões E Silva AC. Factors Associated with Primary Hypertension in Pediatric Patients: An Up-to-Date. Curr Pediatr Rev 2021; 17:15-37. [PMID: 33430749 DOI: 10.2174/1573396317999210111200222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Arterial hypertension in children is considered a common alteration nowadays, mainly because obesity is a growing worldwide problem closely related to increased blood pressure. Childhood hypertension can be classified as primary or secondary, depending on the etiology. Primary or essential hypertension still has its pathophysiology not fully elucidated, and there is no consensus in the literature on most underlying mechanisms. In this review, genetic and environmental factors, including sodium and potassium intake, socioeconomic status, ethnicity, family structure, obesity, sedentary lifestyle, prematurity and low birth weight, prenatal and postnatal exposures are highlighted. OBJECTIVE The present study aimed to perform an update on primary hypertension in childhood, providing clinicians and researchers an overview of the current state of the literature regarding the influence of genetic and environmental factors. METHODS This integrative review searched for articles on genetic and environmental factors related to primary hypertension in pediatric patients. The databases evaluated were PubMed and Scopus. RESULTS The studies have provided insights regarding many genetic and environmental factors, in addition to their association with the pathophysiology of primary hypertension in childhood. Findings corroborated the idea that primary hypertension is a multifactorial disease. Further studies in the pediatric population are needed to elucidate the underlying mechanisms. CONCLUSION The study of primary hypertension in pediatrics has utmost importance for the adoption of preventive measures and the development of more efficient treatments, therefore reducing childhood morbidity and the incidence of cardiovascular diseases and other health consequences later in life.
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Affiliation(s)
- Isabella Barreto S Machado
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Matheus Rampinelli Tofanelli
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ariadna A Saldanha da Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões E Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Reliability of normative tables in assessing elevated blood pressure in children. J Hum Hypertens 2019; 34:241-247. [DOI: 10.1038/s41371-019-0290-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 11/08/2019] [Accepted: 11/11/2019] [Indexed: 11/09/2022]
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Zhang Z, Ma J, Wang Z, Dong Y, Yang Z, Dong B, Ma Y. Parental smoking and blood pressure in children and adolescents: a national cross-sectional study in China. BMC Pediatr 2019; 19:116. [PMID: 30999873 PMCID: PMC6474055 DOI: 10.1186/s12887-019-1505-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 04/10/2019] [Indexed: 11/13/2022] Open
Abstract
Background Current evidence on the health effects of passive smoking on childhood blood pressure is limited and inconsistent. We investigated the associations between exposure to parental smoking and blood pressure in children and adolescents. Methods A cross-sectional analysis was performed in a national sample of 42,745 children and adolescents (50.2% boys) aged 7–18 years from seven provinces in China. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured. Information on parental smoking was collected through questionnaire. Multivariable linear regression and logistic regression was used to investigate the associations of parental smoking with blood pressure and prevalent hypertension, respectively. Results The reported parental smoking rates were 49.7 and 50.2% in boys and girls, respectively. After adjustment for a range of potential confounders, exposure to parental smoking was associated with 0.44 [95% confidence interval (CI): 0.16, 0.72] mmHg and 0.26 (95% CI: 0.04, 0.47) mmHg higher SBP and DBP in girls. Girls exposed to parental smoking were also more likely to have hypertension compared with those without exposure (odds ratio = 1.11, 95% CI: 1.02, 1.20). No significant associations were found in boys. Conclusions Exposure to parental smoking was associated with increased blood pressure and higher prevalence of hypertension in girls, but not in boys. Urgent strategies are needed for the promotion of smoking-free environment, especially for children and adolescents. Electronic supplementary material The online version of this article (10.1186/s12887-019-1505-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zilong Zhang
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Haidian District, Beijing, 100191, China.,Public Health Ontario, Toronto, ON, Canada
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Haidian District, Beijing, 100191, China
| | - Zhenghe Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Haidian District, Beijing, 100191, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Haidian District, Beijing, 100191, China
| | - Zhaogeng Yang
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Haidian District, Beijing, 100191, China
| | - Bin Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Haidian District, Beijing, 100191, China.
| | - Yinghua Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University Health Science Center, Xueyuan Road 38, Haidian District, Beijing, 100191, China.
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Prevalence of high blood pressure and high normal blood pressure among 7- to 17-year-old children and adolescents in developed regions, China from 2014 to 2017: using new national blood pressure reference for Chinese children and adolescents. J Hum Hypertens 2019; 33:400-410. [PMID: 30804460 DOI: 10.1038/s41371-019-0183-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 02/04/2019] [Accepted: 02/05/2019] [Indexed: 12/14/2022]
Abstract
As the first blood pressure (BP) reference considering influence of height in China, national blood pressure reference for Chinese han children and adolescents aged 7 to 17 years (CCBP) was issued in 2017. The current study aimed to observe the short-term trends in BP and prevalence of high blood pressure (HBP) and high normal blood pressure (HNBP) using this CCBP reference in Suzhou, China. Data of children and adolescents aged 7 to 17 years were collected from 2014 to 2017. Total population of 2014 to 2017 were 617,383, 684,453, 695,302, and 774,605, respectively, and proportions of males were 54.1%, 54.0%, 53.9%, and 53.8%, respectively. P-trend tests were conducted to examine the trends of BP among different age, region, body mass index, and socioeconomic status groups for each gender. Multivariate logistic regression analyses found secular decreases in prevalence of HBP and HNBP, after adjustment for potential confounders. Compared with that in 2014, the odds ratios (95% confidence intervals) for total study population were 0.936 (0.928, 0.944) in 2015, 0.879 (0.872, 0.887) in 2016, and 0.934 (0.926, 0.941) in 2017. In conclusion, prevalence of HBP and HNBP decreased among children and adolescents in developed regions of China from 2014 to 2017, and a slight rise were found in 2017.
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Alper Z, Ercan İ, Uncu Y. A Meta-Analysis and an Evaluation of Trends in Obesity Prevalence among Children and Adolescents in Turkey: 1990 through 2015. J Clin Res Pediatr Endocrinol 2018; 10:59-67. [PMID: 28901943 PMCID: PMC5838374 DOI: 10.4274/jcrpe.5043] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 09/11/2017] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Obesity in childhood and adolescence is one of the most serious public health problems due to a remarkable increase in prevalence in recent years and its close relationship with non-communicable diseases, such as diabetes and hypertension, resulting in increased adult morbidity and mortality. This study aims to quantify the secular trend in different regions of Turkey from 1990 to 2015 by performing a meta-analysis of childhood and adolescent obesity prevalence studies conducted. METHODS Uludag University Library Database was searched for relevant articles published prior to March 2017. The heterogeneity of the studies in the meta-analysis was tested by the I2 statistic and Cochran's Q test. The obesity trend analyses were examined by chi-square trend analysis with respect to five year periods. The statistical significance level was taken as α=0.05. RESULTS A total of 76 papers were initially identified addressing childhood and adolescent obesity in Turkey. Fifty-eight papers were selected for analysis. The prevalence of obesity increased from 0.6% to 7.3% with an 11.6-fold increase between the periods 1990-1995 to 2011-2015. The prevalence of obesity increased in both genders. However, boys were more likely to be obese than girls. CONCLUSION Studies on obesity prevalence in the 5-19 age group in Turkey have gained importance, especially in the 2000s. While a remarkable number of prevalence studies, mostly regional, have been conducted between 2005-2011, a gradual decline was observed thereafter. Further national and population-based surveys on prevalence of obesity in children and adolescents are definitely needed in Turkey.
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Affiliation(s)
- Züleyha Alper
- Uludağ University Faculity of Medicine, Department of Family Practice, Bursa, Turkey
| | - İlker Ercan
- Uludağ University Faculity of Medicine, Department of Biostatistics, Bursa, Turkey
| | - Yeşim Uncu
- Uludağ University Faculity of Medicine, Department of Family Practice, Bursa, Turkey
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Roulet C, Bovet P, Brauchli T, Simeoni U, Xi B, Santschi V, Paradis G, Chiolero A. Secular trends in blood pressure in children: A systematic review. J Clin Hypertens (Greenwich) 2016; 19:488-497. [DOI: 10.1111/jch.12955] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/17/2016] [Accepted: 10/29/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Céline Roulet
- Institute of Social and Preventive Medicine (IUMSP); Lausanne University Hospital (CHUV); Lausanne Switzerland
| | - Pascal Bovet
- Institute of Social and Preventive Medicine (IUMSP); Lausanne University Hospital (CHUV); Lausanne Switzerland
| | - Thomas Brauchli
- Institute of Social and Preventive Medicine (IUMSP); Lausanne University Hospital (CHUV); Lausanne Switzerland
| | - Umberto Simeoni
- Department of Pediatrics; Lausanne University Hospital; Lausanne Switzerland
| | - Bo Xi
- Department of Epidemiology; School of Public Health; Shandong University; Jinan China
| | - Valérie Santschi
- La Source, School of Nursing Sciences; University of Applied Sciences Western Switzerland; Lausanne Switzerland
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics, and Occupational Health; McGill University; Montreal Canada
| | - Arnaud Chiolero
- Institute of Social and Preventive Medicine (IUMSP); Lausanne University Hospital (CHUV); Lausanne Switzerland
- Department of Epidemiology, Biostatistics, and Occupational Health; McGill University; Montreal Canada
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Agirbasli M, Agaoglu NB, Orak N, Caglioz H, Ocek T, Poci N, Salaj A, Maya S. Sex hormones and metabolic syndrome in children and adolescents. Metabolism 2009; 58:1256-62. [PMID: 19497594 DOI: 10.1016/j.metabol.2009.03.024] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2008] [Accepted: 03/30/2009] [Indexed: 10/20/2022]
Abstract
Cardiovascular risk starts early in life, yet the patterns of changes in metabolic syndrome (MS) during puberty and normal development have not been completely defined. Sex hormones are shown to play a pivotal role in the modulation of insulin resistance and MS. Our aim is to clarify the relation between sex hormones and MS in normal children and adolescents. This is a cross-sectional study of 365 (8-12 and 14-18 years old) school students. We analyzed the associations of sex hormones (testosterone, free androgen index, estradiol, free estradiol index [FEI], and sex hormone-binding globulin [SHBG]) with cardiovascular risk factors and MS. Prevalence of MS varied depending on the definition, and 33 (9%) students had MS based on at least 1 definition of MS. Frequency of MS doubled among 14- to 18-year-old adolescents compared with 8- to 12-year-old children (12.4% vs 5.6%, P = .02). Adolescent boys and girls with MS had significantly lower SHBG levels compared with controls. Adolescent boys with MS also had significantly higher FEI levels compared with controls. Logistic regression analysis was performed to find the predictors of MS. Among covariates of age, estradiol, testosterone, free androgen index, and FEI, SHBG was the only significant predictor of MS (B = -0.3, odds ratio = 0.8, 95% confidence interval for odds ratio are 0.64 and 0.92, P = .005, Nagelkarke R(2) = 0.48) in adolescent boys. In conclusion, sex hormone levels and androgen/estrogen balance may play an important role in determining MS and future cardiovascular risk among children and adolescents.
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Affiliation(s)
- Mehmet Agirbasli
- Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey.
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