Blood pressure and associated factors in a North African adolescent population. a national cross-sectional study in Tunisia

<p>Abstract</p> <p>Background</p> <p>In southern and eastern Mediterranean countries, changes in lifestyle and the increasing prevalence of excess weight in childhood are risk factors for high blood pressure (BP) during adolescence and adulthood. The aim of this study was to evaluate the BP status of Tunisian adolescents and to identify associated factors.</p> <p>Methods</p> <p>A cross-sectional study in 2005, based on a national, stratified, random cluster sample of 1294 boys and 1576 girls aged 15-19 surveyed in home visits. The socio-economic and behavioral characteristics of the adolescents were recorded. Overweight/obesity were assessed by Body Mass Index (BMI) from measured height and weight (WHO, 2007), abdominal obesity by waist circumference (WC). BP was measured twice during the same visit. Elevated BP was systolic (SBP) or diastolic blood pressure (DBP) ≥ 90th of the international reference or ≥ 120/80 mm Hg for 15-17 y., and SBP/DBP ≥ 120/80 mm Hg for 18-19 y.; hypertension was SBP/DBP ≥ 95th for 15-17 y. and ≥ 140/90 mm Hg for 18-19 y. Adjusted associations were assessed by logistic regression.</p> <p>Results</p> <p>The prevalence of elevated BP was 35.1%[32.9-37.4]: higher among boys (46.1% vs. 33.3%; <it>P </it>< 0.0001); 4.7%[3.8-5.9] of adolescents had hypertension. Associations adjusted for all covariates showed independent relationships with BMI and WC: - obesity vs. no excess weight increased elevated BP (boys OR = 2.1[1.0-4.2], girls OR = 2.3[1.3-3.9]) and hypertension (boys OR = 3.5[1.4-8.9], girls OR = 5.4[2.2-13.4]), - abdominal obesity (WC) was also associated with elevated BP in both genders (for boys: 2nd vs. 1st tertile OR = 1.7[1.3-2.3], 3rd vs.1st tertile OR = 2.8[1.9-4.2]; for girls: 2nd vs. 1st tertile OR = 1.6[1.2-2.1], 3rd vs.1st tertile OR = 2.1[1.5-3.0]) but only among boys for hypertension. Associations with other covariates were weaker: for boys, hypertension increased somewhat with sedentary lifestyle, while elevated BP was slightly more prevalent among urban girls and those not attending school.</p> <p>Conclusion</p> <p>Within the limits of BP measurement on one visit only, these results suggest that Tunisian adolescents of both genders are likely not spared from early elevated BP. Though further assessment is likely needed, the strong association with overweight/obesity observed suggests that interventions aimed at changing lifestyles to reduce this main risk factor may also be appropriate for the prevention of elevated BP.</p

Paediatric hypertension-associated erythromelalgia responds to corticosteroids and is not associated with SCN9A mutations

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CpG methylation in 11beta-hydroxysteroid dehydrogenase type 2 promoter is increased in adult essential hypertensives

CpG methylation in 11beta-hydroxysteroid dehydrogenase type 2 promoter is increased in adult essential hypertensive

11 Beta-Hydroxysteroid Dehydrogenase Type2 Promoter Polymorphisms Determines a Decreased HSD11B2 Expression in Vivo

Secondary hypertension is a main clinical issue and molecular underlying mechanism need deep investigation to unravel novel paths for interventional protocols. The equilibrium among steroid compounds is major pathway with high potential for novel prospectives. The present study highlights for the first time that 11 Beta-Hydroxysteroid Dehydrogenase Type 2 Promoter Polymorphisms Determines a Decreased HSD11B2 Expression in Viv

Acompanhamento da pressão arterial: estudo com crianças e adolescentes com história familiar de hipertensão Acompañamiento de la presión arterial: investigación con niños y adolescentes con historia familiar de hipertensión Blood pressure tracking: study with children and adolescents with familial history of hypertension

Objetivou-se analisar a evolução dos percentis de pressão arterial em crianças e adolescentes com história familiar de hipertensão arterial. Estudo longitudinal desenvolvido em uma comunidade de Fortaleza, Ceará. A pressão arterial foi avaliada em cinco encontros domiciliares, de janeiro de 2004 a dezembro de 2006. Grupo de 141 participantes, dos quais 92 crianças e 49 adolescentes. Das crianças, 67,4% permaneceram sem alterações dos percentis de pressão arterial em todas as avaliações; dos adolescentes, 65,3% permaneceram nesta condição. A maior parte dos indivíduos mantiveram seus valores e percentis de pressões arteriais sistólica e diastólica elevados, e muitos que não apresentavam inicialmente alterações passaram a mostrá-las no decorrer do acompanhamento. Confirma-se a necessidade de monitoração da pressão arterial rotineira de crianças e adolescentes tanto para a detecção precoce como para a prevenção de complicações.<br>El objetivo fue analizar la evolución de los percentiles de presión arterial en niños y adolescentes con historia familiar de hipertensión arterial. Estudio longitudinal en una comunidad de Fortaleza, Ceará, Brasil. La presión arterial fue evaluada en cinco encuentros en los sitios, de enero de 2004 a diciembre de 2006. El grupo fue de 141 participantes, de los cuales 92 niños y 49 adolescentes. De los niños, 67,4% permanecieron sin alteraciones de los percentiles de presión arterial en todas las evaluaciones; de los adolescentes, 65,3% permanecieron en ésta condición. La mayor parte de los individuos mantenieron sus valores y percentiles de presión arterial sistólica y presión arterial diástolica muy altos, y muchos que no presentaban inicialmente alteraciones, pasaron a señalalas en el decurrir del acompañamiento. Así, se comprueba la necesidad de monitoración de la presión arterial rutinera de niños y adolescentes tanto para la detección como para la prevención de complicaciones.<br>The purpose of this study is to analyze the evolution of the percentiles of blood pressure in children and adolescents with familial history of arterial hypertension. This is a longitudinal study developed in a community in Fortaleza, Ceará, Brazil. The blood pressure was evaluated in five home visits from January, 2004 to December, 2006. The group was composed of 141 participants, of which 92 were children and 49 adolescents. Of the children, 67,4% remained with no alterations of the percentiles of blood pressure in all the evaluations; of the adolescents, 65,3% remained in the same condition. Most individuals kept their values and percentiles of systolic blood pressure and diastolic blood pressure, and many that did not initially present alterations started to show some during the follow up. As a result, routine monitoring of blood pressure of children and adolescents proves necessary for the early detection and prevention of complications

Hemolytic-uremic syndrome in Chile: clinical features, evolution and prognostic factors

Background: Hemolytic-uremic syndrome (HUS) is characterized by acute renal failure, microangiopathic hemolytic anemia and thrombocytopenia. Aim: To describe the characteristics of patients with the diagnosis of HUS in Chile, and to identify the most reliable early predictors of morbidity and mortality. Material and methods: The clinical records of patients with HUS aged less than 15 years, attended between January 1990 and December 2003 in 15 hospitals, were reviewed. Demographic, clinical, biochemical, hematological parameters, morbidity and mortality were analyzed. Results: A cohort of 587 patients aged 2 to 8 years, 48% males, was analyzed. Ninety two percent had diarrhea. At the moment of diagnosis, anuria was observed in 39% of the patients, hypertension in 45% and seizures in 17%. Forty two percent required renal replacement therapy (RRT) and peritoneal dialysis was used in the majority of cases (78%). The most frequently isolated etiological agent was Escherichia coli. Mortality rate was 2.9% in the acute phase of the disease and there was a positive correlation between mortality and anuria, seizures, white blood cell count (WCC) >20.000/mm3 and requirements of renal replacement therapy (p <0.05). Twelve percent of patients evolved to chronic renal failure and the risk factors during the acute phase were the need for renal replacement therapy, anuria, WCC >20.000/mm3, seizures and hypertension. Conclusions: The present study emphasizes important clinical and epidemiological aspects of HUS in a Chilean pediatric population