Association between lifestyle modifications and improvement of early cardiac damage in children and adolescents with excess weight and/or high blood pressure.

Autor: Genovesi S; School of Medicine and Surgery, Milano-Bicocca University, 20100, Milan, Italy. simonetta.genovesi@unimib.it.; Cardiology Unit, Istituto Auxologico Italiano, IRCCS, 20100, Milan, Italy. simonetta.genovesi@unimib.it., Tassistro E; Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 Center), School of Medicine and Surgery, Milano-Bicocca University, 20100, Milan, Italy., Giussani M; Cardiology Unit, Istituto Auxologico Italiano, IRCCS, 20100, Milan, Italy., Antolini L; Bicocca Center of Bioinformatics, Biostatistics and Bioimaging (B4 Center), School of Medicine and Surgery, Milano-Bicocca University, 20100, Milan, Italy., Lieti G; School of Medicine and Surgery, Milano-Bicocca University, 20100, Milan, Italy., Orlando A; Cardiology Unit, Istituto Auxologico Italiano, IRCCS, 20100, Milan, Italy., Montemerlo M; Cardiology Unit, Istituto Auxologico Italiano, IRCCS, 20100, Milan, Italy., Patti I; School of Medicine and Surgery, Milano-Bicocca University, 20100, Milan, Italy., Parati G; School of Medicine and Surgery, Milano-Bicocca University, 20100, Milan, Italy.; Cardiology Unit, Istituto Auxologico Italiano, IRCCS, 20100, Milan, Italy.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2023 Dec; Vol. 38 (12), pp. 4069-4082. Date of Electronic Publication: 2023 Jun 22.
DOI: 10.1007/s00467-023-06034-5
Abstrakt: Background: It is not known whether, in children and adolescents with alterations in weight and/or blood pressure (BP), lifestyle modifications are associated with an improvement of early cardiac damage.
Methods: In a pediatric population referred for excess weight, high BP, or both (n = 278, 10.6 (2.3) years), echocardiography was performed at enrollment and after 15 months of follow-up, during which participants received nonpharmacological treatment, based on correcting unhealthy lifestyles and improving dietary habits. Left ventricular mass was indexed for height (g/m 2.7 , LVMI), and an LVMI value higher than or equal to age- and gender-specific 95 th percentile was the criterion for defining left ventricular hypertrophy (LVH). Multiple linear and logistic regression analyses were carried out to determine associations between changes in BMI and BP z-scores and changes of LVMI values and LVH prevalence, from baseline to follow-up.
Results: At baseline, 33.1% of study participants were hypertensive, 52.9% obese, and 36.3% had LVH. At follow-up, the prevalence of hypertension, obesity, and LVH was 18.7%, 30.2%, and 22.3%, respectively (p < 0.001 for all). A decrease in LVMI from 37.1 to 35.2 g/m 2.7 (p < 0.001) was observed. Only delta BMI z-score positively related to an improvement of LVMI. Reductions of BMI (OR = 0.22, 95% CI 0.07-0.64) and diastolic BP (OR = 0.64, 95% CI 0.42-0.93) z-scores from baseline to follow-up and family history of hypertension (OR = 0.36, 95% CI 0.16-0.78) were associated with a lower prevalence of LVH.
Conclusions: In a pediatric population at cardiovascular risk, changing incorrect lifestyle and dietary habits is associated with both reduction of BMI and BP values and regression of early cardiac damage. A higher resolution version of the Graphical abstract is available as Supplementary information.
(© 2023. The Author(s).)
Databáze: MEDLINE
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