Effect of body mass index trajectory on hypertension among children and adolescents aged 5-18 years: a retrospective cohort study

Challenges in blood pressure measurement in children with obesity: focus on the cuff

Childhood obesity is a well-known risk factor for primary hypertension (HTN), especially during puberty. Validated automated oscillometric devices based on universal protocols using proper cuffs according to arm sizes must be selected for blood pressure (BP) measurement in clinical practice. Recent recommendations have addressed the importance of accurate BP measurement in patients with obesity. The American Heart Association (AHA) suggests using a cone-shaped cuff, while the European Society of Hypertension (ESH) emphasizes the significance of cuff characteristics based on arm size. The applicability of cone-shaped cuffs over cylindrical cuffs has been studied in adults with obesity. Most studies focused on the upper arm's shape and provided evidence that the use of cylindrical cuffs may overestimate BP in individuals with obesity, while the conical cuff was proposed as a proper alternative. However, current validation studies for BP measurement devices have not included the arm's size as a recruiting criterion, which may compromise the accuracy of devices in individuals with obesity. This review discusses the role of arm characteristics in cuff selection and the potential role of conical cuffs as an alternative to commonly used cylindrical ones in BP measurement in pediatric patients with obesity.

Association Between Healthful Plant-Based Dietary Pattern and Obesity Trajectories and Future Cardiovascular Diseases in Middle-Aged and Elderly: A Prospective and Longitudinal Cohort Study

We aimed to explore the association between plant-based dietary (PBD) patterns and obesity trajectories in middle-aged and elderly, as well as obesity trajectories linked to cardiovascular disease (CVD) risk. A total of 7108 middle-aged and elderly UK Biobank participants with at least three physical measurements were included. Dietary information collected at enrolment was used to calculate the healthful plant-based diet index (hPDI). Group-based trajectory modeling identified two trajectories for each adiposity measure: BMI Low-Smooth and High-Growth-Decline; FMI Low-Smooth and High-Growth-Decline; WHR Low-Growth and High-Growth. Logistic regression showed that participants in the medium and high hPDI groups were less likely to follow the BMI High-Growth-Decline (OR = 0.72, 95% CI: 0.60-0.87; OR = 0.49, 95% CI: 0.39-0.61), FMI High-Growth-Decline (OR = 0.71, 95% CI: 0.60-0.84; OR = 0.55, 95% CI: 0.46-0.66), and WHR High-Growth (OR = 0.73, 95% CI: 0.61-0.87; OR = 0.52, 95% CI: 0.43-0.63) trajectories. After a median follow-up time of 3.88 years, Cox regression showed higher CVD risk for participants in these trajectories (HR = 1.70, 95% CI: 1.37-2.11; HR = 1.68, 95% CI: 1.37-2.06; HR = 1.30, 95% CI: 1.04-1.63). A healthy PBD pattern was associated with the maintenance of a healthy BMI classification. Furthermore, the long-term stabilization of a healthy BMI classification may be linked to a reduced risk of CVD.

Hypertension: A Continuing Public Healthcare Issue

Hypertension is a cardiovascular disease defined by an elevated systemic blood pressure. This devastating disease afflicts 30-40% of the adult population worldwide. The disease burden for hypertension is great, and it greatly increases the risk of cardiovascular morbidity and mortality. Unfortunately, there are a myriad of factors that result in an elevated blood pressure. These include genetic factors, a sedentary lifestyle, obesity, salt intake, aging, and stress. Although lifestyle modifications have had limited success, anti-hypertensive drugs have been moderately effective in lowering blood pressure. New approaches to control and treat hypertension include digital health tools and compounds that activate the angiotensin receptor type 2 (AT2), which can promote cardiovascular health. Nonetheless, research on hypertension and its management is vital for lessening the significant health and economic burden of this condition.

Nuts and seeds consumption impact on adolescent obesity: sex-specific associations from 2003 to 2018 National Health and Nutrition Examination Survey

The nutritional benefits and immunological advantages of consuming nuts and seeds are well-established. However, the link between nuts and seeds consumption and the susceptibility of being overweight or obese among adolescents is not clear. This study aims to explore this relationship in adolescents aged 12-19. Using a weighted multiple logistic regression model, we analysed data of the Food Patterns Equivalents Database and the U.S. National Health and Nutrition Examination Survey (NHANES) from 2003 to 2018. We found a significant association between nuts and seeds consumption and a reduced odds of being overweight or obese in females. Specifically, females who habitually consumed nuts and seeds had lower odds of being overweight or obese (OR = 0.55, 95% CI: 0.32-0.94). Additionally, we found an L-shaped relationship between nuts and seeds consumption and appropriate waist-to-height ratio in males. The findings suggest that nuts and seeds consumption may contribute to healthier physical development in adolescents.