Increases in Peripheral Systolic Pressure Levels and Z-score Associate Gradual Aortic Pressure Increase and Functional Arterial Impairment in Children and Adolescents
| Autor: | Edmundo I. Cabrera-Fischer, Pedro Chiesa, Mariana Marin, Daniel Bia, Santiago Curcio, Yanina Zócalo, Gustavo Giachetto, Victoria García-Espinosa |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty CIENCIAS MÉDICAS Y DE LA SALUD Adolescent Brachial Artery 0206 medical engineering Hemodynamics CHILDREN 02 engineering and technology 030204 cardiovascular system & hematology Standard score Asymptomatic ARTERIAL WALL Young Adult 03 medical and health sciences Sex Factors Vascular Stiffness 0302 clinical medicine Heart Rate Risk Factors Internal medicine Heart rate Internal Medicine Humans Medicine Arterial Pressure Child Pulse wave velocity Aorta business.industry Age Factors 020601 biomedical engineering ARTERIAL HYPERTENSION Otras Ciencias Médicas Blood pressure Case-Control Studies Child Preschool Asymptomatic Diseases Hypertension Aortic pressure Cardiology CENTRAL AORTIC BLOOD PRESSURE Female Analysis of variance BLOOD PRESSURE medicine.symptom business |
| Zdroj: | Current Hypertension Reviews. 14:170-182 |
| ISSN: | 1573-4021 |
| DOI: | 10.2174/1573402114666180413141509 |
| Popis: | Background: Arterial changes associated with children and adolescents high blood pressure (HBP) states would vary depending on the arterial type, arterial indexes considered and/or on blood pressure (BP) levels. Aims: To determine in children and adolescents: 1) if there is gradual structural-functional arterial impairment associated with gradual peripheral (brachial) systolic BP (pSBP) level or z-score increases, and 2) whether subjects with HBP levels and those with normal BP differ in the profiles of arterial changes associated with pSBP deviations. Methods: 1005 asymptomatic children and adolescents were included. Clinical, anthropometric and arterial non-invasive evaluations were performed. Heart rate, brachial BP, aortic BP and wavederived parameters (i.e. augmentation index), carotid and femoral diameters, blood velocities and elastic modulus, carotid intima-media thickness and aortic pulse wave velocity, were obtained. Two groups were assembled: Reference (without cardiovascular risk factors (CVRFs); n=379) and HBP (n=175). Additionally, subjects were ascribed to groups according to their pSBP z-scores (z-score ≤ 0, 0< z-score < 1 or z-score ≥ 1). Age and sex-related mean and standard deviation equations were obtained for each variable (Reference group). Using those equations, data (entire population) were converted into z-scores. Groups were compared (absolute and z-scored variables) before and after adjusting for cofactors (ANOVA/ANCOVA). Linear regression analyses were done considering: pSBP and z-pSBP (independent) and absolute levels and z-scores for hemodynamic and arterial indexes (dependent variables). Differences in hemodynamic and arterial levels and z-scores variations (dependent) associated with variations in pSBP and z-pSBP (independent variable) were assessed. The slopes of the models for Reference and HBP groups were compared. Conclusion: HBP states associate hemodynamic and arterial changes not explained by exposure to other CVRFs, anthropometric or demographic factors. The higher the pSBP deviations from ageand sex-expected mean value in the Reference group, the higher the hemodynamic and arterial indexes deviation. The pSBP-related variations in hemodynamic and arterial indexes would not differ depending on whether HBP states are present or not. Fil: Zócalo, Yanina. Universidad de la Republica Facultad de Medicina; Uruguay Fil: Marin, Mariana. Universidad de la Republica Facultad de Medicina; Uruguay Fil: Curcio, Santiago. Universidad de la Republica Facultad de Medicina; Uruguay Fil: García-Espinosa, Victoria. Universidad de la Republica Facultad de Medicina; Uruguay Fil: Chiesa, Pedro. Centro Hospitalario Pereira Rossell; Uruguay Fil: Giachetto, Gustavo. Universidad de la República; Uruguay Fil: Cabrera Fischer, Edmundo Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Medicina Traslacional, Trasplante y Bioingeniería. Fundación Favaloro. Instituto de Medicina Traslacional, Trasplante y Bioingeniería; Argentina Fil: Bia, Daniel. Universidad de la República; Uruguay |
| Databáze: | OpenAIRE |
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