Hypertension in adolescents: diagnosis, treatment, and implications

Khoury, Michael; Urbina, Elaine M.

doi:10.1016/s2352-4642(20)30344-8

Cited by 36 publications

(24 citation statements)

References 81 publications

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“…Previous studies had found that the mendelian inheritance can be confirmed in approximately 20% of families [2] and 60% of twin studies [3] in familial hypertension cases. Hypertension has caused a serious disease burden in China, and is associated with adverse cardiac changes, adipose tissue factor changes, and vascular damage [4]. The increase in BP is affected by multiple factors, such as excessive intake of salt, reduced physical activity, and excessive psychological stress, which could further account for the development of hypertension [5].…”

Section: Introductionmentioning

confidence: 99%

Association between Body Fat and Elevated Blood Pressure among Children and Adolescents Aged 7–17 Years: Using Dual-Energy X-ray Absorptiometry (DEXA) and Bioelectrical Impedance Analysis (BIA) from a Cross-Sectional Study in China

Chen

Liu

et al. 2021

IJERPH

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To investigate the associations between body fat percentage (BF%) with childhood blood pressure (BP) levels and elevated BP (EBP) risks, and further examine the validity of bioelectrical impedance analysis (BIA), we conducted a cross-sectional study of 1426 children and adolescents aged 7–17 years in Beijing, 2020. EBP, including elevated systolic BP (ESBP) and elevated diastolic BP (EDBP), was defined based on the age- and sex-specific 90th BP reference values of children and adolescents in China. BF% was measured by dual-energy X-ray absorptiometry (DEXA) and BIA devices, and was divided into four quartiles. Log-binomial models were applied to calculate odds ratios (ORs) and 95% confidence intervals (95%CI). Girls tended to have higher BF% levels than boys (p < 0.05). There was 41.0% of girls who developed EBP. High BF% was associated with increased BP levels with ORs of 0.364 (95%CI = 0.283–0.444) for SBP, 0.112 (95%CI = 0.059–0.165) for DBP, and 1.043 (95%CI = 1.027–1.059) for EBP, while the effects were more pronounced in girls and older-aged children. BIA devices agreed well with BF% assessment obtained by DEXA. High BF% might have negative effects on childhood BP. Convenient measurements of body fat might help to assess childhood obesity and potential risks of hypertension.

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Section: Introductionmentioning

confidence: 99%

Association between Body Fat and Elevated Blood Pressure among Children and Adolescents Aged 7–17 Years: Using Dual-Energy X-ray Absorptiometry (DEXA) and Bioelectrical Impedance Analysis (BIA) from a Cross-Sectional Study in China

Chen

Liu

et al. 2021

IJERPH

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“…In 2019, the results of a study on mice which assessed the effect of dietary zinc levels on blood pressure showed that mice fed a zinc-deficient diet had increased blood pressure [ 25 ]. Hypertension is known to be a risk factor for CVD [ 26 , 27 ]. Zinc deficiency may be an indirect risk factor for cardiovascular disease but current findings are inconsistent, so the exact clinical benefits and dosage range of dietary zinc intake to prevent CVD have not been determined.…”

Section: Discussionmentioning

confidence: 99%

Associations of Dietary Zinc–Vitamin B6 Ratio with All-Cause Mortality and Cardiovascular Disease Mortality Based on National Health and Nutrition Examination Survey 1999–2016

Zhang

et al. 2023

Nutrients

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Previous studies have suggested a possible association among dietary zinc and vitamin B6 intake and CVD mortality and all-cause mortality. However, evidence on the association of dietary zinc and vitamin B6 intake and their interactions with CVD mortality and all-cause mortality remains unclear. This prospective study utilized data from the US National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016. After a median follow-up of 10.4 years, 4757 deaths were recorded among 36,081 participants. Higher dietary zinc intake levels (≥9.87 mg/day) were associated with lower CVD mortality (hazard ratio (HR) = 0.85, 95% confidence interval (CI): 0.83–0.87). Vitamin B6 intake levels (≥1.73 mg/day) were associated with lower CVD mortality (HR = 0.91, 95% CI: 0.86–0.96) and all-cause mortality (HR = 0.91, 95% CI: 0.90–0.93). Higher dietary zinc intake and higher vitamin B6 intake were associated with a lower risk of CVD mortality, with an interaction between dietary zinc intake levels and vitamin B intake levels (LZLV group (HR, CI): 1.21,1.12–1.29; LZHV group (HR, CI): 1.42, 1.34–1.50; LZHV group (HR, CI): 1.28, 1.14–1.45; HZHV group (HR, CI): ref). There was also a J-type association (p for nonlinear < 0.001) between the dietary zinc–vitamin B6 ratio and CVD mortality, with a high dietary zinc–vitamin B6 ratio increasing the risk of CVD mortality (HR = 1.27, 95% CI: 1.19–1.35), whereas a moderate dietary zinc–vitamin B6 ratio appeared to be beneficial for CVD mortality. These results suggest that increasing the appropriate proportion of dietary zinc and vitamin B6 intake is associated with a lower risk of CVD mortality. Furthermore, precise and representative studies are needed to verify our findings.

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“…При выявлении у ребенка или подростка стабильной (по результатам суточного мониторирования АД (СМАД)) АГ 1-й степени, множественных (3 и более) факторов риска сердечно-сосудистых заболеваний (ожирения, гиподинамии, дислипидемии, курения, нарушений углеводного обмена), признаков поражения органов-мишеней (гипертрофии миокарда левого желудочка (ЛЖ)), сопутствующих заболеваний/состояний (хронической болезни почек (ХБП), СД, МС) или при выявлении у пациента АГ 2-й степени медикаментозное лечение назначается одновременно с немедикаментозной терапией [10]. Зарубежные специалисты обозначают также симптомную, вторичную и семейную АГ как показания к медикаментозной антигипертензивной терапии [11][12][13].…”

Section: обзор литературыunclassified

Current Approaches to Arterial Hypertension Management in Children and Adolescents: Clinical Guidelines Review

Балыкова

Леонтьева

Краснопольская

et al. 2021

Vopr. sovr. pediatr.

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The prevalence of arterial hypertension (AH) in children and adolescents is increasing, thus it is crucial and topical to make pediatricians familiar with modern approaches in drug and drug-free therapy for AH. The aim of this review was to provide the overview of international and Russian guidelines for the AH treatment. We have searched the following keywords in PubMed: guidelines, arterial hypertension treatment, guidelines of management, pediatric hypertension. Reviews, clinical guidelines, and original articles published from 2010 to 2020 were analyzed. Detailed description of AH management in children and adolescents is presented. Approaches to drug-free correction of increased blood pressure (BP) are discussed in detail, indications for antihypertensive therapy are described, characteristics of the main classes of antihypertensive drugs are given (indications, contraindications, and possible side effects). Principles of refractory AH management and antihypertensive drugs combinations are also described.

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Hypertension in adolescents: diagnosis, treatment, and implications

Cited by 36 publications

References 81 publications

Association between Body Fat and Elevated Blood Pressure among Children and Adolescents Aged 7–17 Years: Using Dual-Energy X-ray Absorptiometry (DEXA) and Bioelectrical Impedance Analysis (BIA) from a Cross-Sectional Study in China

Association between Body Fat and Elevated Blood Pressure among Children and Adolescents Aged 7–17 Years: Using Dual-Energy X-ray Absorptiometry (DEXA) and Bioelectrical Impedance Analysis (BIA) from a Cross-Sectional Study in China

Associations of Dietary Zinc–Vitamin B6 Ratio with All-Cause Mortality and Cardiovascular Disease Mortality Based on National Health and Nutrition Examination Survey 1999–2016

Current Approaches to Arterial Hypertension Management in Children and Adolescents: Clinical Guidelines Review

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