Abnormal Circadian Blood Pressure Regulation in Children Born Preterm

Bayrakçı, Umut Selda; Schaefer, Franz; Düzova, Ali; Yiğit, Şule; Bakkaloğlu, Ayşı̇n

doi:10.1016/j.jpeds.2007.04.003

Cited by 54 publications

(52 citation statements)

References 35 publications

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“…23 The most commonly used marker of BP rhythmicity is nocturnal dipping that has been shown to be an important independent risk factor for cardiovascular disease. 11,24 Our results confirm that the nighttime dipping of BP is reduced in children born SGA, as already found in prepubertal, low birth weight children, 25,26 and in children with primary 27 or secondary hypertension attributed to chronic kidney disease. In addition to the conventional dipping analysis, Fourier analysis of ABPM profiles permits the description of the circadian (24-hour) and the ultradian (12-, 8-, and 6-hour) cardiovascular rhythmicity by the amplitudes and acrophases of the derived cosine curves.…”

Section: Discussionsupporting

confidence: 89%

Altered Cardiovascular Rhythmicity in Children Born Small for Gestational Age

et al. 2012

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Abstract-Low birth weight is frequently associated with a disproportionately high incidence of cardiovascular disease, diabetes mellitus, and kidney disease in adulthood. Epidemiological studies have identified an inverse association between low birth weight or being small for gestational age and hypertension in adulthood. We hypothesized that children born with low birth weight might have altered circadian and ultradian cardiovascular rhythmicity independent of the prevailing blood pressure level. Twenty-four-hour ambulatory blood pressure and heart rate rhythmicity was prospectively evaluated by Fourier analysis in a cohort of healthy children born with low birth weight and compared with normative pediatric data. Seventy-five children born small for gestational age (mean age, 8.1Ϯ2.2 years) and 139 controls matched for age and sex were investigated. In addition to increased 24-hour, daytime, and especially nighttime blood pressure levels (PϽ0.05), children born small for gestational age exhibited blunted circadian (24-hour) and ultradian (12-, 8-, and 6-hour) blood pressure rhythmicity (PϽ0.05). In a multivariate analysis including children born with low birth weight and controls, being born with low birth weight independently influenced ultradian blood pressure rhythmicity, whereas in a multivariate analysis including children born with low birth weight only, circadian and ultradian rhythms were independently influenced by catch-up growth, gestational age, and blood pressure level. This study demonstrates blunted circadian and ultradian cardiovascular rhythmicity in prepubertal children born small for gestational age, independent from the presence of arterial hypertension. Circadian and ultradian rhythms may be sensitive indicators for detecting subtle early abnormalities of cardiovascular regulation. (Hypertension. 2012;60:865-870.)Key Words: small for gestational age Ⅲ low birth weight Ⅲ child Ⅲ blood pressure Ⅲ circadian and ultradian cardiovascular rhythmicity

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Section: Discussionsupporting

confidence: 89%

Altered Cardiovascular Rhythmicity in Children Born Small for Gestational Age

et al. 2012

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“…Furthermore, a higher combined prevalence of office and ambulatory hypertension could be confirmed in children born LBW, a finding in line with previous observations. 6,7,31 Assessing renal mass by ultrasound is not compromised by differences in sex in renal biometry, 25 which allowed us to use all of the data without considering sex. As expected from earlier observations in children with LBW, [12][13][14] we again observed an impaired kidney size by measuring the mean kidney length and volume.…”

Section: Discussionmentioning

confidence: 99%

Salt Sensitivity of Children With Low Birth Weight

et al. 2008

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Abstract-Compromised intrauterine fetal growth leading to low birth weight (Ͻ2500 g) is associated with adulthood renal and cardiovascular disease. The aim of this study was to assess the effect of salt intake on blood pressure (salt sensitivity) in children with low birth weight. White children (nϭ50; mean age: 11.3Ϯ2.1 years) born with low (nϭ35) or normal (nϭ15) birth weight and being either small or appropriate for gestational age (nϭ25 in each group) were investigated. The glomerular filtration rate was calculated using the Schwartz formula, and renal size was measured by ultrasound. Salt sensitivity was assigned if mean 24-hour blood pressure increased by Ն3 mm Hg on a high-salt diet as compared with a controlled-salt diet. Baseline office blood pressure was higher and glomerular filtration rate lower in children born with low birth weight as compared with children born at term with appropriate weight (PϽ0.05). Salt sensitivity was present in 37% and 47% of all of the low birth weight and small for gestational age children, respectively, higher even than healthy young adults from the same region. Kidney length and volume (both PϽ0.0001) were reduced in low birth weight children. Salt sensitivity inversely correlated with kidney length (r 2 ϭ0.31; Pϭ0.005) but not with glomerular filtration rate. We conclude that a reduced renal mass in growth-restricted children poses a risk for a lower renal function and for increased salt sensitivity. Whether the changes in renal growth are causative or are the consequence of the same abnormal "fetal programming" awaits clarification. Key Words: arterial hypertension Ⅲ Barker's hypothesis Ⅲ Brenner's hypothesis Ⅲ low birth weight Ⅲ salt sensitivity Ⅲ small for gestational age

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“…Dois estudos, Bayrakci et al 9 e Rondó et al 30 , utilizaram somente análise univariada. Dentre os fatores de confundimento analisados, os mais citados foram altura atual (4 artigos), seguidos do IMC (3 artigos), e sexo e idade, ambos citados por 2 artigos.…”

Section: Resultsunclassified

“…Nas últimas duas décadas, alguns estudos evidenciaram associação entre prematuridade, condição de crianças nascidas com idade gestacional inferior a 37 semanas 7 , e o desenvolvimento de alguns agravos, incluindo hipertensão arterial, intolerância à glicose e dislipidemias, tanto em crianças 8,9,10 como em adultos 11,12,13 .…”

Section: Introductionunclassified

Prematuridade como fator de risco para pressão arterial elevada em crianças: uma revisão sistemática

et al. 2011

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Estudos epidemiológicos têm sugerido que a hipertensão arterial é uma doença que tem início na infância e a prematuridade, crianças nascidas com menos de 37 semanas, um possível fator associado ao desenvolvimento deste agravo. Este estudo tem por objetivo identificar a associação entre prematuridade e elevação da pressão arterial em crianças por meio de revisão sistemática da literatura. Foram selecionados artigos das bases de dados MEDLINE, LILACS e SciELO publicados no período de 1998 a 2009. Excluiu-se os que não apresentavam resumo, redigidos em idioma diferente do inglês, português e espanhol e os que não objetivavam analisar a relação entre prematuridade e hipertensão. Foram analisados 9 artigos: 5 estudos de caso-controle, 2 transversais e 2 de coorte. Prematuridade não esteve associada à elevação da pressão arterial na infância na maioria dos artigos analisados, porém, sua influência não deve ser descartada, tendo em vista a pequena produção sobre o assunto, bem como as grandes diferenças metodológicas observadas nos estudos publicados no período analisado.

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Abnormal Circadian Blood Pressure Regulation in Children Born Preterm

Cited by 54 publications

References 35 publications

Altered Cardiovascular Rhythmicity in Children Born Small for Gestational Age

Altered Cardiovascular Rhythmicity in Children Born Small for Gestational Age

Salt Sensitivity of Children With Low Birth Weight

Prematuridade como fator de risco para pressão arterial elevada em crianças: uma revisão sistemática

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