Blood pressure centiles for Great Britain

Jackson, Lisa V; Thalange, Nandu; Cole, Tim J.

doi:10.1136/adc.2005.081216

Cited by 173 publications

(153 citation statements)

References 43 publications

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“…Logistic regression analysis was conducted to calculate odds ratios of elevated MAP from categorical fitness and fatness variables. MAP centiles were generated from ageand sex-specific Z-scores and participants were classified as having high or low MAP using the 91st centile cut-off as recommended (8) . Predictors in the regression analysis were weight status (BMI category) and fitness (fit, unfit).…”

Section: Discussionmentioning

confidence: 99%

“…Standardized scores were derived for MAP (Z-score) using the BP reference charts for the UK (8) , which adjust for age, sex and skewness.…”

Section: Blood Pressure Measurementmentioning

confidence: 99%

“…Reported secular declines in childhood fitness (6) and increases in adiposity are both alarming and well documented in many developed countries including the UK (7) . As body weight is positively associated with blood pressure (BP) (8) , it is unsurprising that a secular increase in children's BP has also been reported (9) . In schoolchildren, that cardiorespiratory fitness is cardioprotective may be well established (10)(11)(12) , but details of how it interacts with body composition to mediate BP remain inconsistent.…”

mentioning

confidence: 99%

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Prevalence of elevated mean arterial pressure and how fitness moderates its association with BMI in youth

Ogunleye

Sandercock

Voss

et al. 2012

Public Health Nutr.

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Objective: Cardiorespiratory fitness is known to be cardioprotective and its association with the components of the metabolic syndrome in children is becoming clearer. The aim of the present study was to examine the extent to which cardiorespiratory fitness may offset the weight-related association with mean arterial pressure (MAP) in schoolchildren. Design: Cross-sectional study. Settings: Schoolchildren from the East of England, UK. Subjects: A total of 5983 (48 % females) schoolchildren, 10 to 16 years of age, had height, weight and blood pressure measured by standard procedures and cardiorespiratory fitness assessed by the 20 m shuttle-run test. Participants were classified as fit or unfit using internationally accepted fitness cut-off points; and as normal weight, overweight or obese based on BMI, again using international cut-off points. Age-adjusted ANCOVA was used to determine the main effects and interaction of fitness and BMI on MAP Z-score. Logistic regression models were used to estimate odds ratios of elevated MAP. Results: Prevalence of elevated MAP in schoolchildren was 14?8 % overall and 35?7 % in those who were obese-unfit. Approximately 21 % of participants were overweight and 5 % obese, while 23 % were classified as unfit. MAP generally increased across BMI categories and was higher in the aerobically unfit participants. Obese-fit males had lower MAP compared with obese-unfit males (P , 0?001); this trend was similar in females (P 5 0?05). Conclusions: Increasing fitness level may have a positive impact on the weightrelated elevations of MAP seen in obese and overweight schoolchildren.

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Section: Discussionmentioning

confidence: 99%

“…Standardized scores were derived for MAP (Z-score) using the BP reference charts for the UK (8) , which adjust for age, sex and skewness.…”

Section: Blood Pressure Measurementmentioning

confidence: 99%

mentioning

confidence: 99%

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Prevalence of elevated mean arterial pressure and how fitness moderates its association with BMI in youth

Ogunleye

Sandercock

Voss

et al. 2012

Public Health Nutr.

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“…For blood pressure, standard deviation scores (SDS) were derived according to the British reference charts [14] and hypertension was defined as systolic (SBP) and/or diastolic blood pressure (DBP) >2 SDS for age and sex. In selected cases, medical therapy aimed to reduce cortisol concentrations and antihypertensives were used.…”

Section: Clinical Evaluationmentioning

confidence: 99%

Management of Cushing syndrome in children and adolescents: experience of a single tertiary centre

et al. 2016

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What is Known:-Cushing syndrome is an extremely rare entity in the paediatric and adolescent age groups, so not many cohort studies have been published in this population.-Several tests can be employed to firstly diagnose hypercortisolaemia and secondly, identify the source of origin of it. The efficacy and safety of these tests in children is still uncertain. What is New:-This study includes cases due to the different aetiologies of endogenous hypercortisolaemia (pituitary, adrenal and ectopic hypercortisolaemia) allowing us to compare the differences in presentation, diagnosis, management and long-term outcome between the groups.-There is a difference in the prevalence of Cushing syndrome symptoms and in the performance of the tests in our cohort compared to previously published studies in the literature. ABSTRACT:The diagnosis and management of paediatric Cushing syndrome (CS) is highly challenging. This study aims to characterise its presentation, diagnosis, management and outcome by a retrospective case review of 30 patients (14 females) followed at a single tertiary paediatric endocrinology centre over a 30-year period.At presentation, median age was 8.9 years (0.2-15.5) and the commonest manifestations were weight gain (23/30), hirsutism (17/30), acne (15/30) and hypertension (15/30). Growth retardation was present in 11/30. Median BMI was +2.1SDS (-6.5 -+4.6). Urinary Free Cortisol (UFC) was abnormal in 17/18 (94%), midnight cortisol in 27/27 (100%) and Low Dose Dexamethasone Suppression (LDDS) test in 20/20 (100%). High Dose Dexamethasone Suppression (HDDS) test was abnormal in: 6/6 (100%) of adrenal tumours, 1/10 (10%) of Cushing Disease (CD) and 1/2 (50%) of ectopic tumours. Bilateral Inferior Petrosal Sinus Sampling (IPSS) identified 5 CD cases and 1 ectopic tumour.All patients underwent surgery and subsequently required cortisol replacement. Final diagnoses were 16 CD, 11 adrenal disease, 2 ectopic ACTH-secreting lesions and 1 case of unidentified aetiology. One year post-diagnosis, median BMI was 0.5SDS (-2.5 -+3.7), hypertension was present in 4/14 (28%) and 43% (12/30) of individuals were off hydrocortisone. Conclusion:The prevalence of the clinical manifestations differs from that reported in other series.Screening tests were highly sensitive, with UFC, midnight cortisol and LDDS performing well. One year post-treatment, BMI and BP normalized in the majority of patients, and almost half of them were able to discontinue replacement hydrocortisone.

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“…Blood pressure in childhood rises progressively with age and more rapidly in puberty, with girls reaching puberty earlier than boys. 48 Hence, the gender effect observed here may in part be attributable to variation in the age of onset of puberty. Pubertal stage was…”

Section: Discussionmentioning

confidence: 79%

The relationship between gestational age, systolic blood pressure and pulse pressure in children

2008

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This cross-sectional study investigates the relationship between gestational age and systolic blood pressure and pulse pressure in childhood. Blood pressure was measured in 483 schoolchildren, free from cardiovascular disease, aged between 6 and 16 years. Pulse pressure was estimated as the difference between the 24-h mean systolic and diastolic blood pressure values. Linear regression showed an inverse relationship between gestational age and mean 24-h systolic blood pressure (adjusted regression coefficient mm Hg per week gestation À0.631, 95% confidence interval (CI) À1.21 to À0.04, P ¼ 0.036). Further, linear regression showed a significant negative association between gestational age and log-transformed pulse pressure (adjusted antilog regression coefficient mm Hg per week of gestation À1.39, 95% CI À2.96 to À0.3, P ¼ 0.013), which after gender-specific analyses was found to be restricted to the girls in the study. The results of the present study suggest that low gestational age is associated with elevated systolic blood pressure and pulse pressure in childhood, the latter particularly in girls. This observation provides some support for the developmental origins of adult disease hypothesis-that adverse events in early life may have long-term consequences for cardiovascular health. However, as gestational age itself is unlikely to be the causal event in determining blood pressure control, further investigation is required, particularly with regard to the nutritional, physiological and molecular mechanisms that explain such epidemiological observations.

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Blood pressure centiles for Great Britain

Cited by 173 publications

References 43 publications

Prevalence of elevated mean arterial pressure and how fitness moderates its association with BMI in youth

Prevalence of elevated mean arterial pressure and how fitness moderates its association with BMI in youth

Management of Cushing syndrome in children and adolescents: experience of a single tertiary centre

The relationship between gestational age, systolic blood pressure and pulse pressure in children

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