Objective: This study is aimed at investigating the in¯uence of body size, body fat and sexual maturation on blood pressure (BP) in adolescents. Design: A cross-sectional study. Setting: A suburban student population of Southern Italy. Subjects: One hundred ninety students attending the ®rst and second year of a secondary school. Five were excluded because they were affected by major diseases. The remaining were 98 M and 87 F (mean age for either group 12.0 AE 0.8 y). Methods: Blood pressure was measured by a mercury sphygmomanometer, body weight by a platform beamscale, other measurements included height, biceps, triceps, subscapular and suprailiac skinfolds by a caliper; sexual maturation was evaluated according to Tanner. Results: Body size was greater than in Tanner's population: in particular body weight (but not height) in our sample markedly exceeded that of the children of the same age in Tanner's population. Boys had higher systolic blood pressure (SBP) than girls (BP 109a64 AE 12a10 vs 103a63 AE 11a8 mmHg, P`0.02 for SBP), while heart rate and waistahip ratio were lower.During puberty Ð evaluated on the basis of pubic hair growth Ð BP in girls was higher than in the prepubertal phase (107a66 AE 9a7 vs 99a61 AE 10a7, P`0.01). Pubertal boys showed a reduced percent of body fat (calculated from four skinfold measurements) in comparison to prepubertal ones (21.0% AE 4.5 vs 24.5% AE 7.1, P`0.01). In linear correlation analysis, height, BW, BMI and lean body mass were found to be signi®cantly associated with SBP in both sexes and to diastolic blood pressure (DBP) in girls. Percent body fat was correlated with SBP in boys, while sexual maturation was associated to SBP and DBP in girls only.Multiple regression analysis indicated a signi®cant contribution of body size to BP variability, particularly in the girls. Sexual maturation was excluded from the ®nal regression equations when height, BW or lean body mass were present. Conclusions: These data indicate that body weight in these adolescents is greater that in Tanner's population of the same age and sex. Body size appears to be a major determinant of BP, whereas sexual maturation seems to in¯uence BP levels mainly through body growth. The in¯uence of percent body fat on BP setting seems to be of limited importance.

These results, at variance with those of others, suggest that IOH affects the cardiovascular system even during the early phases of the disease and indicate the need for prospective clinical trials to evaluate the benefit from early treatment of IOH patients.

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Thirty patients with intermittent claudication (IC) and treated diabetes mellitus and 30 age- and gender-matched nondiabetic claudicants underwent a vascular examination by noninvasive ultrasound methods (continuous-wave Doppler, duplex scanner). The ankle/arm systolic pressure index did not differ in the two groups. Diabetic patients with IC had more (p less than .001) non-flow-reducing stenoses (lumen reduction less than 50%) and fewer (p less than .002) flow-reducing obstructions (lumen reduction greater than 50%) of the iliac arteries than nondiabetics had. These data are consistent with a preferentially distal (below the inguinal ligament) localization of arterial stenoses in diabetic patients, whereas iliac artery diseases are relatively more severe in nondiabetics.

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