High cotinine levels are persistent during the first days of life in newborn second hand smokers.

a b s t r a c t Background: Despite the adverse effects of maternal smoking during pregnancy on the newborn's health are well-known, in the pediatric population, a high prevalence exists that is very much affected by second hand smoke (SHS). This study aims to investigate the impact of maternal smoking habits during preg- nancy on cotinine levels in newborns during the first days of life. The high association between cotinine concentration in maternal and umbilical cord blood (UCB) has been previously reported, but the levels of blood cotinine that remain in infants born to smokers is unknown. Methods: Cotinine concentration was measured in UCB, in maternal and newborn peripheral blood. Dat…

Influence of Concurrent Obesity and Low Birth Weight on Blood Pressure Phenotype in Youth

The aim of this study was to assess the impact of obesity and low birth weight on both office and ambulatory blood pressure (BP) values, as well as on aortic-derived parameters in youths. A total of 422 white youths, from 10 to 18 years of age, were included. Subjects were divided into 4 groups according to the presence (234; 55%) or the absence (188; 45%) of obesity and according to low (114; 27%) or normal (308; 73%, birth weight. Spacelabs 90207 was used to measure ambulatory BP during a 24-hour period. SphygmoCor radial/aortic transform software was used to estimate aortic pressure waveform. Office, 24-hour, daytime, and nighttime systolic BP values were significantly higher in those s…

Isolated Systolic Hypertension in the Young

Elevated systolic blood pressure with normal diastolic blood pressure is the most prevalent type of hypertension in young people. The prevalence of isolated systolic hypertension reported among youth ranges widely as a result of the differences in population characteristics such as age, ethnicity, and obesity. Even though it is not an unusual condition, there is still debate in the literature about the clinical significance of an isolated increase in systolic blood pressure detected in the first decades of life. The reported phenotypic characteristics of subjects with isolated systolic hypertension are rather scarce and many relevant pieces of information are still elusive. Further studies …

Body weight variation and control of cardiovascular risk factors in essential hypertension.

The objective was to assess the impact of weight changes on blood pressure (BP), lipids and glucose goals in a cohort of hypertensive subjects.Prospective follow-up.Hypertension clinic.326 hypertensive non-diabetic subjects, 46% with metabolic syndrome (MS).Usual care treatment, which included diet, physical exercise and drugs prescribed when indicated. All patients were observed for up to 1 year.BP and low-density lipoprotein-cholesterol (LDL-C) goal were those in ESH/ESC and ATP III recommendations, respectively. The glucose goal was to delay progression to type 2 diabetes mellitus, or to achieve blood glucose100 mg/dl for non-diabetics. According to body weight changes, patients were cat…

Prevalencia del trastorno por atracón en una muestra clínica de obesos

Resumen: Introducción: El trastorno por atracón se caracteriza por presencia de episodios de sobreingesta recurrentes en un periodo corto, acompañados de pérdida de control. Este trastorno es el más frecuente de entre todos los trastornos de la conducta alimentaria en población obesa, tanto en adultos como en niños. Objetivo: El objetivo de este estudio fue obtener datos prevalencia del trastorno por atracón en una muestra de niños y adolescentes obesos, usuarios de una unidad de pediatría especializada en el tratamiento de la obesidad infantil. Material y métodos: Se contó con una muestra 70 niños y adolescentes con edades comprendidas entre los 9 y los 16 años, con una edad media de 12 añ…

Differences in intermittent postural control between normal-weight and obese children.

Abstract Aim The main objective of this study was to determine differences in postural control between obese and non-obese children. Methods The study design was cross-sectional, prospective, between-subjects. Postural control variables were obtained from a group of obese children and a normal-weight control group under two different postural conditions: bipedal standing position with eyes open and bipedal standing with eyes closed. Variables were obtained for each balance condition using time domain and sway-density plot analysis of the center of pressure signals acquired by means of a force plate. Results Pairwise comparisons revealed significant differences between obese and normal-weigh…

European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring

Given the increasing use of ambulatory blood pressure monitoring (ABPM) in both clinical practice and hypertension research, a group of scientists, participating in the European Society of Hypertension Working Group on blood pressure monitoring and cardiovascular variability, in year 2013 published a comprehensive position paper dealing with all aspects of the technique, based on the available scientific evidence for ABPM. The present work represents an updated schematic summary of the most important aspects related to the use of ABPM in daily practice, and is aimed at providing recommendations for proper use of this technique in a clinical setting by both specialists and practicing physici…

Network for blood pressure research in children and adolescents: A Cost Action

COST Action will contribute pioneering research going beyond the state of the art and facing the most critical challenges affecting high BP in children and adolescents. HyperChildNET will go beyond the Working Group during its 4-year duration

From pioneering to implementing automated blood pressure measurement in clinical practice: Thomas Pickeringʼs legacy

Thomas G. Pickering spent most of his scientific career in carrying out research on clinical hypertension and blood pressure (BP) measurement. In our review of Pickering's seminal work, we first focused on white-coat hypertension and masked hypertension, two terms that he had introduced. Next, we highlighted the early publications of Pickering on diurnal BP variability and on the clinical application of self-measured BP. Pickering's work inspired many investigators worldwide and constituted a solid basis for further research. Pickering's original ideas led to algorithms for risk stratification involving white-coat hypertension and masked hypertension, diurnal BP variability, and self-measur…

El espacio de los editores: anuario de Anales de Pediatría

cientificas (13%), 20 articulos editoriales (3%), 125 cartas al editor (19%), 14 articulos especiales (2%), 29 articulos AEP (4%), 101 imagenes en pediatria (15%) y 62 articulos originales breves (9%). Este ultimo tipo de manuscrito se ha extinguido con la introduccion de las nuevas normas editoriales dando paso a la seccion de cartas cientificas. En el primer cuatrimestre de 2015 el numero de manuscri

Predictors of Progression in Hypertensive Renal Disease in Children

In hypertensive renal disease in children, several risk factors influence the development and the rate of progression of renal damage, including blood pressure levels, proteinuria, lipid disorders, and genetic differences. The impact of blood pressure on renal structures, the most important of the factors, depends not only on blood pressure levels, but also on the persistence of the blood pressure levels over time, mainly during the hours when the patient is resting or sleeping. Abnormal circadian variability is frequently observed in patients with renal damage, and nocturnal blood pressure reduction should be a major therapeutic objective to protect against a decline in renal function. Pro…

Blood cell transcript levels in 5-year-old children as potential markers of breastfeeding effects in those small for gestational age at birth

BackgroundNutrition of the newborn during the early postnatal period seems to be of capital importance and there is clinical evidence showing the protective effect of breastfeeding compared with formula feeding on childhood obesity and its comorbidities. Infants born small for gestation age may be more sensitive to the type of feeding during lactation. Here, we aimed to analyze the impact of birth weight and the type of infant feeding on the expression levels in peripheral blood cells of selected candidate genes involved in energy homeostasis in 5-year-old children, to find out potential early biomarkers of metabolic programming effects during this period of metabolic plasticity.MethodsFort…

Immigration and hypertension in youths learning from one country's experience

Developmental and Early Life Origins of Cardiometabolic Risk Factors

The intent of this review is to critically consider the data that support the concept of programming and its implications. Birth weight and growth trajectories during childhood are associated with cardiometabolic disease in adult life. Both extremes, low and high birth weight coupled with postnatal growth increase the early presence of cardiometabolic risk factors and vascular imprinting, crucial elements of this framework. Data coming from epigenetics, proteomics, metabolomics, and microbiota added relevant information and contribute to better understanding of mechanisms as well as development of biomarkers helping to move forward to take actions. Research has reached a stage in which suff…

Response to Cardiovascular Autonomic Dysfunction as a Link Between Insulin Resistance and Nocturnal Blood Pressure Elevation

We welcome the interest that Perciaccante1 has shown in our research on the impact of obesity and insulin resistance in nocturnal blood pressure elevation in children and adolescents.2 We agree with his hypothesis that abnormal cardiovascular autonomic function is a potential link between insulin resistance …

Associations of Birth Weight and Postnatal Weight Gain With Cardiometabolic Risk Parameters at 5 Years of Age

The present prospective study assessed the impact of birth weight (BW) and postnatal weight gain on blood pressure and metabolic profile during the first 5 years of life. One hundred thirty-nine newborns (63 women) born at term after uncomplicated pregnancies and in the absence of perinatal illness were included. Subjects were divided according to size at birth in small, appropriate, and large for gestational age. After the initial evaluation on the second day of life, infants were followed up at 6 months and 2 and 5 years. Anthropometric parameters and blood pressure were measured at each visit and metabolic assessment was performed at 5 years of age. Among the BW groups, mothers did not d…

Knowledge gaps and future directions in cognitive functions in children and adolescents with primary arterial hypertension: A systematic review

Arterial hypertension (AH) among adults is known to be associated with worse cognitive outcomes. Similarly, children and adolescents with AH could be expected to underperform during neuropsychological evaluations when compared with healthy peers. Our aims were to review the existing literature on cognitive functioning among children and adolescents with primary AH and to identify what additional evidence may be needed to substantiate the impact of hypertension on poor cognitive outcomes in this population. We conducted a systematic review of articles in PubMed and Web of Science published before 17 January 2022, reporting on cognitive testing among children and adolescents with primary AH. …

Reproducibility and validity of ambulatory blood pressure monitoring in children.

During the past several years ambulatory blood pressure monitoring (ABPM) has been introduced into the study of hypertension and has become a useful tool in making clinical decisions. The ABPM improves the reproducibility of the estimates of a subject's casual blood pressure (BP) both in normotensive and in hypertensive subjects, independent of age. The advantages of ambulatory BP (ABP) over its office counterpart have been studied in children to observe the relationship between BP measurement and early markers of organ damage. In different groups of subjects that have included normotensives, essential hypertensives, renal transplant recipients, or patients with repair of an aortic coarctat…

Blood pressure measurement in children and adolescents : key element in the evaluation of arterial hypertension

Arterial hypertension is the main modifiable risk factor for cardiovascular disease, occupying the first place among the causes of loss of life years adjusted for disability. In recent years, arterial hypertension in children and adolescents has gained ground in cardiovascular medicine thanks to progress made in several areas, fundamentally in pathophysiological and clinical research. Despite the advances that have been made in recent years, the prevention, diagnosis and treatment of high blood pressure in children and adolescents still have room for improvement. In this sense, the correct measurement of blood pressure is especially important, since it includes a series of essential element…

Increase in Nocturnal Blood Pressure and Progression to Microalbuminuria in Type 1 Diabetes

Patients with type 1 diabetes mellitus and microalbuminuria often have elevated blood pressure while they are asleep, but it is not known whether the elevation develops concomitantly with microalbuminuria or precedes it.We monitored 75 adolescents and young adults who had had type 1 diabetes with normal urinary albumin excretion and blood pressure for more than five years. Ambulatory blood-pressure monitoring was used to assess blood pressure at the initial evaluation and about two years later, at which time all subjects had normal urinary albumin excretion. Subsequently, subjects were monitored for the development of microalbuminuria.Microalbuminuria developed in 14 subjects, whereas the o…

The Role of Ambulatory Blood Pressure Monitoring in Diagnosis of Hypertension and Evaluation of Target Organ Damage

The goal of blood pressure (BP) measurement in children and adolescents is to provide strategies for promoting cardiovascular health which should be integrated into a comprehensive pediatric health-care program. Blood pressure, however, is a parameter that changes on a beat-to-beat basis in response to a variety of physiological and environmental stimuli. Nevertheless, casual BP measurement has provided the basis for present knowledge of the potential risk associated with hypertension (1) and has guided patient management for many years (2). A few BP measurements obtained in the office, on the contrary, may not necessarily reflect the true BP of an individual. Subsequently, a better charact…

MOESM12 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 12: Figure S4. Boxplots showing the DNA methylation beta values of the 36 common 0→5→10 dmCpGs described in Table 2.

Overview of ambulatory blood pressure monitoring in childhood and pregnancy.

Despite the fact that the study and applicability of ambulatory blood pressure in children and pregnant women share characteristics which limit the potential development of knowledge for their use, advances produced in the last few years provided the present knowledge regarding the significance and the potential use of ambulatory blood pressure in children and in the pregnant women. In children ambulatory blood pressure monitoring is useful for the diagnosis of mild hypertensives, assessment of refractory hypertension, therapeutic trials with antihypertensive drugs, and clinical investigation when BP is one of the parameters to be taken into account and/or when subtle BP abnormalities are t…

Comparison of validation protocols for blood pressure measuring devices in children and adolescents

Accuracy of blood pressure (BP) measurement is important for the evaluation of hypertension in children and adolescents, and it is critically dependent upon the accuracy of the BP measuring device. A device that could pass validated protocols with reliable accuracy would be desirable in clinical and research settings. Several scientific organizations have published recommendations on the validation of different BP measuring devices. Most of them focus on adults but separate recommendations and validation criteria for BP devices intended for use in children and adolescents are included in some validation protocols. In this review, we compare the validation criteria for BP measuring devices a…

The impact of birth weight on pulse pressure during adolescence

Background The objective was to study the influence of birth weight on office and ambulatory pulse pressure. Methods and results Three hundred healthy children (176 girls), aged 10–18 years, born at term after a normotensive pregnancy were included. The subjects were divided according to birth weight: 2.000–2.500 kg, 2.501–3.000 kg, 3.001–3.500 kg and >3.500 kg. For each subject, office and 24-h ambulatory blood pressure monitoring were performed according to the protocol designed. There were significant differences among groups in 24-h ambulatory systolic blood pressure, and pulse pressure (PP). No differences were observed in terms of sex, current age, weight and height. Using a multiple …

Obesity and cardiovascular risk

: Obesity is a key factor for cardiovascular diseases and complications. Obesity is associated with hypertension, dyslipidemia and type II diabetes, which are the major predictors of cardiovascular disease in the future. It predisposes for atrial fibrillation, heart failure, sudden cardiac death, renal disease and ischemic stroke that are the main causes of cardiovascular hospitalization and mortality. As obesity and the cardiovascular effects on the vessels and the heart start early in life, even from childhood, it is important for health policies to prevent obesity very early before the disease manifestation emerge. Key roles in the prevention are strategies to increase physical exercise,…

Las múltiples facetas de la hipertrofia ventricular izquierda en la obesidad e hipertensión arterial

Obesity and cardiovascular risk: a call for action from the European Society of Hypertension Working Group of Obesity, Diabetes and the High-risk Patient and European Association for the Study of Obesity part B obesity-induced cardiovascular disease, early prevention strategies and future research directions

: Obesity predisposes for atrial fibrillation, heart failure, sudden cardiac death, renal disease and ischemic stroke, which are the main causes of cardiovascular hospitalization and mortality. As obesity and the cardiovascular effects on the vessels and the heart start early in life, even from childhood, it is important for health policies to prevent obesity very early before the disease manifestation emerge. Key roles in the prevention are strategies to increase physical exercise, reduce body weight and to prevent or treat hypertension, lipids disorders and diabetes earlier and efficiently to prevent cardiovascular complications.

Home-exercise Childhood Obesity Intervention: A Randomized Clinical Trial Comparing Print Versus Web-based (Move It) Platforms.

Abstract Purpose To compare the impact of adhering to a Mediterranean diet plus mixed physical exercise program (Move-It) implemented by means of printed instructions or via a web-platform (with or without e-mail support) on body composition, physical fitness, and blood pressure. Design and Methods Randomized clinical trial. Fifty-two overweight or obese Spanish children and adolescents were randomly assigned to the print-based (n = 18), Move-It (n = 18), or Move-It plus support (n = 16) intervention groups. Two-way mixed ANOVA tests were used to compare any changes between the groups in terms of percentage body fat, physical fitness (VO2peak), handgrip strength, and systolic and diastolic …

Beneficios de la medida de la masa ventricular en adolescentes con hipertensión arterial

Influencia de los antecedentes familiares sobre la edad de aparición de la hipertensión. Implicación de la impronta genética

Obesity, Body Fat Distribution, and Ambulatory Blood Pressure in Children and Adolescents

Obesity is a common disease with an ever-increasing prevalence and usually with late-onset consequences. If acquired during childhood, it tracks into adult life to some extent, and since the relationship between obesity and hypertension is well established in adults, obese children appear to be at particularly high risk of becoming hypertensive adults. In the authors' study, obese children seemed to have significantly higher casual and ambulatory blood pressure than nonobese children, except for nighttime diastolic blood pressure. The health effects of obesity may depend on the anatomic distribution of body fat, which in turn may be a better indicator of endocrinologic imbalance, environmen…

Sympathetic neural activity, metabolic parameters and cardiorespiratory fitness in obese youths.

OBJECTIVE: The main objective of this cross-sectional study is to assess the cardiac autonomic neural activity in the presence of abnormally increased body weight in youths and its relationship to metabolic risk factors and cardiorespiratory fitness (CRF). METHODS: Sixty-four overweight and obese patients, aged 9-17 years, of both sexes, stratified according to the international BMI cut-off, were enrolled. Continuous ECG was recorded during 15 min in resting conditions, and the heart rate variability (HRV) was measured in the time domain, frequency domain and for nonlinear dynamics. In addition, cardiometabolic risk factors and CRF in effort conditions were assessed. RESULTS: Among the over…

Relationship between body composition and postural control in prepubertal overweight/obese children: A cross-sectional study

Abstract Background Excess body weight during childhood causes reduced motor functionality and problems in postural control, a negative influence which has been reported in the literature. Nevertheless, no information regarding the effect of body composition on the postural control of overweight and obese children is available. The objective of this study was therefore to establish these relationships. Methods A cross-sectional design was used to establish relationships between body composition and postural control variables obtained in bipedal eyes-open and eyes-closed conditions in twenty-two children. Centre of pressure signals were analysed in the temporal and frequency domains. Pearson…

Out-of-office blood pressure measurement in children and adolescents

Obesity modifies the relationship between ambulatory blood pressure and natriuresis in children

The objective in the present study was to evaluate if obesity beginning in the first two decades of life influences the relationship between ambulatory blood pressure and urinary sodium excretion.Eighty-five obese and 88 non-obese children aged 3-19 years were included in the study. For each subject, a 24h ambulatory blood pressure monitoring and a complete urine collection were simultaneously performed according to the protocols designed. The averages of ambulatory blood pressure and of the urinary excretion rates for sodium, potassium and creatinine were calculated separately for 24-h, awake and sleep periods as defined by a mini-diary.Weight and sodium excretion are directly associated w…

Ambulatory blood pressure monitoring in normotensive children

OBJECTIVE To assess reference values of ambulatory blood pressure in normotensive children. SUBJECTS AND DESIGN Twenty-four-hour non-invasive ambulatory blood pressure monitoring (ABPM) was carried out in 241 healthy normotensive children aged from 6 to 16 years (126 boys, mean +/- SD age 11.2 +/- 2.7 years; 115 girls, mean +/- SD age 10.9 +/- 2.9 years). The subjects were subdivided into three age-sex groups: 6-9, 10-12 and 13-16 years. SETTING Primary care. MAIN OUTCOME MEASURES ABPM was performed using an oscillometric device (SpaceLabs model 90207) and appropriate cuff size during a regular school day. Blood pressure was measured every 20 min from 0600 to 2400 h, and thereafter every 30…

Clinical and research aspects of ambulatory blood pressure monitoring in children.

The Role of ABPM in Evaluation of Hypertensive Target-Organ Damage

Casual blood pressure measurement has provided the basis for the present knowledge of the potential risk associated with hypertension and has guided patient management for many years. The possibility of carrying out repeated ambulatory blood pressure measurements using automatic or semiautomatic devices allows for the gathering of more representative values of blood pressure and for observing the behavior of blood pressure during both moments of activity as well as rest. Ambulatory blood pressure measurement is now increasingly recognized as being indispensable to the diagnosis and management of hypertension, and it has contributed significantly to our understanding of hypertension. Likewis…

Innovations in Infant Feeding: Future Challenges and Opportunities in Obesity and Cardiometabolic Disease

The field of nutrition in early life, as an effective tool to prevent and treat chronic diseases, has attracted a large amount of interest over recent years. The vital roles of food products and nutrients on the body’s molecular mechanisms have been demonstrated. The knowledge of the mechanisms and the possibility of controlling them via what we eat has opened up the field of precision nutrition, which aims to set dietary strategies in order to improve health with the greatest effectiveness. However, this objective is achieved only if the genetic profile of individuals and their living conditions are also considered. The relevance of this topic is strengthened considering the importance of …

Birth weight modifies pulse pressure in children and adolescents

High blood pressure in children: clinical and health policy implications.

J Clin Hypertens (Greenwich). Hypertension is a global problem, affecting both developed and developing nations. In addition to being a major cause of morbidity and mortality, hypertension places a heavy burden on health care systems, families, and society as a whole. Despite evidence of an increasing prevalence of hypertension among youth, the consequences of early onset are poorly established and often overlooked. Childhood hypertension is often asymptomatic and easily missed, even by health professionals. Target organ damage is detectable in children and adolescents, however, and hypertension continues into adulthood. Additional strategies to improve cardiovascular health among children …

Increase in Nocturnal Blood Pressure and Progression to Microalbuminuria in Diabetes

Obesity and Eating Disorders in Children and Adolescents: The Bidirectional Link

Obesity, eating disorders and unhealthy dieting practices among children and adolescents are alarming health concerns due to their high prevalence and adverse effects on physical and psychosocial health. We present the evidence that eating disorders and obesity can be managed or prevented using the same interventions in the pediatric age. In the presence of obesity in the pediatric age, disordered eating behaviors are highly prevalent, increasing the risk of developing eating disorders. The most frequently observed in subjects with obesity are bulimia nervosa and binge-eating disorders, both of which are characterized by abnormal eating or weight-control behaviors. Various are the mechanism…

Network for blood pressure research in children and adolescents (COST Action CA 19115)

High blood pressure is a clearly established modifiable risk factor for cardiovascular and renal disease. Although most of its adverse effects develop in adulthood, it has become clear that high BP is a lifelong problem that can manifest early in life. While few would dispute the importance of taking effective steps to identify and manage this condition in middle-aged and elderly individuals, relatively little attention has been paid to the problem of high BP in children and adolescents.Therefore, the development of actions focused on early childhood, childhood and adolescence and the investigation of the underlying causes of this epidemic are of utmost importance. There is a pressing need …

Prevention, diagnosis, and treatment of obesity. 2016 position statement of the Spanish Society for the Study of Obesity.

Added impact of obesity and insulin resistance in nocturnal blood pressure elevation in children and adolescents.

The aim of the present study was to analyze the relationship between insulin resistance and the ambulatory blood pressure components in obese children and adolescents. Eighty-seven overweight and obese white children and adolescents of both sexes, of European origin from 6 to 18 years of age (mean age: 10.9±2.7 years), were selected. Obesity was defined on the basis of a threshold body mass index z score >2 (Cole’s least mean square method) and overweight with a body mass index from the 85th to 97th percentile. A validated oscillometric method was used to measure ambulatory BP (Spacelabs 90207) during 24 hours. Fasting glucose and insulin were measured, and the homeostasis model assessm…

Orígenes de la hipertensión arterial: el peso al nacer, un nuevo elemento

Determinants of Cardiometabolic Risk Factors in the First Decade of Life

The present prospective study assessed the association of birth weight (BW) and growth pattern on cardiometabolic risk factors in a cohort followed from birth to 10 years of age. One hundred and forty-five subjects (73 girls) who fulfilled the inclusion criteria and had all their data recorded at birth and at 5 years were enrolled. Of these, 100 (52 girls) also recorded data at 10 years. Anthropometric measurements, office and 24-hour blood pressure, and metabolic parameters were obtained. At 5 years, both BW and current weight were determinants of blood pressure and metabolic parameters; however, as the subjects got older, the impact of body size increased. Higher BW and maternal obesity i…

Hypertension in Children and Adolescents

During the last few decades, hypertension in children and adolescents has gained ground in cardiovascular medicine, thanks to the progress made in several areas of pathophysiological and clinical research. The prevalence in school-aged children appears to be increasing, perhaps as a result of the increased prevalence of obesity in the last years. Despite evidence of an increasing prevalence of hypertension in the young, the consequences of early onset hypertension are poorly established and often overlooked. In children hypertension can be caused by multiple conditions, and therefore it is warranted to consider a wide range of differential diagnoses and to search for definable causes of hyp…

Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

[Background] Early life is a period of drastic epigenetic remodeling in which the epigenome is especially sensitive to extrinsic and intrinsic influence. However, the epigenome-wide dynamics of the DNA methylation changes that occur during this period have not been sufficiently characterized in longitudinal studies.

Exercise intervention in childhood obesity : a randomized controlled trial comparing hospital-versus home-based groups

The aim of this study was to compare the effect of a hospital clinic group- versus home-based combined exercise-diet program for the treatment of childhood obesity.One hundred ten overweight/obese Spanish children and adolescents (6-16 years) in 2 intervention groups (hospital clinic group-based [n = 45] and home-based [n = 41]) and a sex-age-matched control group (n = 24) were randomly assigned to participate in a 6-month combined exercise (aerobic and resistance training) and Mediterranean diet program. Anthropometric values (including body weight, height, body mass index, BMI-Z score, and waist circumference) were measured pre- and postintervention for all the participants. Percentage bo…

Assessment of blood pressure early morning rise

MOESM11 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 11: Figure S3. Treemap plots indicating the results of REViGO sematic analyses of significantly enriched (FDR < 0.05) gene ontology biological process terms for genes containing (a) hyper- and (b) hypomethylated 0→5 dmCpGs. The dmCpGs are grouped by annotated genomic location (see Table S1, column “annotation”, for the annotations; “promoter” is formed by collapsing “Distal promoter” and “Promoter (<= 1kb)”, “gene body” is formed by collapsing “3’ UTR”, “5’ UTR”, “Intron”, “Exon” and “Downstream”). See Table S6 for full results, including Molecular Function and Cellular Component terms.

Current and birth weights exert independent influences on nocturnal pressure-natriuresis relationships in normotensive children.

The objective was to study the impact of birth weight on the relationship between ambulatory blood pressure and urinary sodium excretion in children and adolescents. The study included 134 healthy children (61 boys), all Caucasians, who were born at term after a normotensive pregnancy. For each subject, a 24-hour ambulatory blood pressure monitoring and a complete urine collection were simultaneously performed according to the protocols designed. Average ambulatory blood pressure (BP) and the urinary excretion rates for sodium, potassium, and creatinine were calculated separately for 24-hour, awake, and sleep periods defined by a mini-diary. The excretion rate of sodium during sleep time w…

The Impact of Obesity and Body Fat Distribution on Ambulatory Blood Pressure in Children and Adolescents

To assess the relationship between obesity, body fat distribution, and blood pressure in children and adolescents, various measures of obesity and the waist-to-hip circumference ratio were related to casual and ambulatory blood pressure as measured using a SpaceLabs 90207 monitor during a regular school day. Seventy obese and 70 nonobese children aged 6 to 16 years were included in the study. Regardless of the time period analyzed (24 h, daytime, or nighttime), ambulatory blood pressure and casual blood pressure were significantly higher among the obese children. The differences in systolic blood pressure observed between the groups were attributable to the presence of obesity as estimated …

Longitudinal study of DNA methylation during the first 5 years of life

[Background]: Early life epigenetic programming influences adult health outcomes. Moreover, DNA methylation levels have been found to change more rapidly during the first years of life. Our aim was the identification and characterization of the CpG sites that are modified with time during the first years of life. We hypothesize that these DNA methylation changes would lead to the detection of genes that might be epigenetically modulated by environmental factors during early childhood and which, if disturbed, might contribute to susceptibility to diseases later in life. [Methods]: The study of the DNA methylation pattern of 485577 CpG sites was performed on 30 blood samples from 15 subjects,…

Nutraceuticals and blood pressure control: A European Society of Hypertension position document

: High-normal blood pressure (BP) is associated with an increased risk of cardiovascular disease, however the cost-benefit ratio of the use of antihypertensive treatment in these patients is not yet clear. Some dietary components and natural products seems to be able to significantly lower BP without significant side effects. The aim of this position document is to highlight which of these products have the most clinically significant antihypertensive action and wheter they could be suggested to patients with high-normal BP. Among foods, beetroot juice has the most covincing evidence of antihypertensive effect. Antioxidant-rich beverages (teas, coffee) could be considered. Among nutrients, …

Impact of ESH and AAP hypertension guidelines for children and adolescents on office and ambulatory blood pressure-based classifications.

The objective was to assess the differences between the 2016 European Society of Hypertension (ESH) and the 2017 American Academy of Pediatrics (AAP) hypertension (HTN) guidelines in the distribution of office blood pressure (BP) categories as well as in the office and ambulatory BP mismatches.The study included 4940 clinical evaluations performed in 2957 youth (5-18 years) of both sexes. BP and anthropometric parameters were measured following standard conditions. The classification of the BP measurements was normotension, high-normal, stages 1 and 2 HTN, following the criteria of both guidelines. In a subgroup of 2467 participants, 3941 office BP assessment was completed with 24-h ambulat…

Ambulatory blood pressure monitoring is ready to replace clinic blood pressure in the diagnosis of hypertension: con side of the argument.

The San Francisco experience with Perloff and Sokolow was the starting point for the clinical application of ambulatory blood pressure (ABP) measurement. Using a semiautomatic device, the superiority of ABP to office measurement was demonstrated in the relationship with hypertension-induced organ damage1 and in the risk for cardiovascular events.2 This seminal study impelled an issue with the largest production and impact in the field of hypertension in recent decades, boosting research and having an enormous influence on daily clinical practice. Initially restricted to specialized clinics, ABP monitoring (ABPM) has largely expanded to primary care in many countries. Similarly, scientific p…

Monitorización ambulatoria de la presión arterial durante 24, 48, 72 horas… ¿Cuál es el límite razonable?

Uric acid is linked to cardiometabolic risk factors in overweight and obese youths.

OBJECTIVE Observational studies have indicated that high levels of serum uric acid are associated with the risk of cardiovascular disease. The aim of the present study is to investigate the association of uric acid with individual cardiometabolic risk factors, as well as their degree of clustering, in overweight and moderate obese youth. METHODS Three hundred and thirty-three Caucasians of both sexes (149 women), from 5-18 years of age from those who underwent an assessment of overweight/obesity. Anthropometric parameters, office and 24-h blood pressure measurements and metabolic profile, including HDL-cholesterol, triglycerides, insulin, HOMA index and uric acid were assessed. RESULTS Uric…

The impact of the degree of obesity on the discrepancies between office and ambulatory blood pressure values in youth.

Objectives Obesity is an increasingly frequent problem among children and adolescents, and may lead to blood pressure (BP) increase. The aim of the present study was to assess the prevalence of hypertension, white-coat and masked hypertension in obese adolescents making systematic use of both office BP and 24-h ambulatory BP measurement. The impact of different degrees of obesity on BP and heart rate variability was also investigated. Methods Office and ambulatory BP were obtained in 285 overweight and obese Caucasian adolescents (11–18 years old) and in 180 age- and sex-matched controls. The extent of obesity was quantified using body mass index z score. Results A significant positive rela…

Assessment of ten trace elements in umbilical cord blood and maternal blood: association with birth weight

Background Trace elements are an essential nutritional component for humans and inadequate tissue-concentrations may have a significant effect on fetal size. Objective To measure ten trace elements in blood samples from mothers and their newborns, and assess their association with anthropometric characteristics at birth. The effects of other factors on fetal growth, such as biologic characteristics of the infant and mother, were analysed. Methods A cross-sectional study was conducted in the Hospital general, University of Valencia, Spain. Healthy pregnant women, and their full-term infants were selected (n = 54 paired samples). Infants were grouped according to birth weight: small for gesta…

Uncertainty in the assessment of trends in childhood blood pressure.

Metabolomic profiling in blood from umbilical cords of low birth weight newborns

AbstractBackgroundLow birth weight has been linked to an increased risk to develop obesity, type 2 diabetes, and hypertension in adult life, although the mechanisms underlying the association are not well understood. The objective was to determine whether the metabolomic profile of plasma from umbilical cord differs between low and normal birth weight newborns.MethodsFifty healthy pregnant women and their infants were selected. The eligibility criteria were being born at term and having a normal pregnancy. Pairs were grouped according to their birth weight: low birth weight (LBW, birth weight < 10thpercentile, n = 20) and control (control, birth weight between the 75th-90thpercentiles, n…

Reduction in aortic compliance in adolescents with suboptimal intrauterine growth

First-year blood pressure increase steepest in low birthweight newborns.

The present research has been undertaken prospectively to study the impact of birthweight and growth pattern on blood pressure changes from birth through the first year of life.Parents of newborns born at term (gestational age37 weeks) after uncomplicated pregnancies and in the absence of perinatal illness were randomly invited to allow their children to participate in the study. One hundred and forty-nine (84 male and 65 female) newborns were included in the present analysis. The newborns were divided into four groups according to birthweight:2500 g (n = 23); 2500-2999 g (n = 39); 3000-3500 g (n = 48); and3500 g (n = 39).At birth systolic and diastolic blood pressure were significantly low…

DNA methylation patterns in newborns exposed to tobacco in utero

[Background] Maternal smoking during pregnancy is a major risk factor for adverse health outcomes. The main objective of the study was to assess the impact of in utero tobacco exposure on DNA methylation in children born at term with appropriate weight at birth.

Reproducibility of ambulatory blood pressure monitoring in children

Competitive active video games: Physiological and psychological responses in children and adolescents

Recent strategies to reduce sedentary behaviour in children include replacing sedentary screen time for active video games. Active video game studies have focused principally on the metabolic consumption of a single player, with physiological and psychological responses of opponent-based multiplayer games to be further evaluated.To determine whether adding a competitive component to playing active video games impacts physiological and psychological responses in players.Sixty-two healthy Caucasian children and adolescents, nine to 14 years years of age, completed three conditions (8 min each) in random order: treadmill walking, and single and opponent-based Kinect active video games. Affect,…

Advance in Vascular Phenotype Assessment in Children and Adolescents

Cardiovascular damage occurring in adults finds its roots in risk factors operating early in life. Among the factors influencing cardiovascular risk, blood pressure values represent an important measurable marker of the level of potential cardiovascular risk in children and adolescents. Indeed, there is growing evidence that mild blood pressure elevations are much more common than was thought in the past in a pediatric population. Furthermore, hypertension in childhood has gained ground in cardiovascular medicine thanks to the progress made in several areas of pathophysiological and clinical research.1 It is not uncommon for high blood pressure in the young to be accompanied by evidence of …

Hypertension in children and adolescents

Identifying poor cardiorespiratory fitness in overweight and obese children and adolescents by using heart rate variability analysis under resting conditions.

Background: Childhood obesity, including overweight, continues increasing worldwide affecting health expectancy, quality of life and healthcare expenditure. These subjects have higher probability of suffering or developing cardio metabolic risk factors. Recent studies have revealed cardiorespiratory fitness (CRF) as a valuable clinical parameter to identify these subjects and have even suggested cut-off values. However, evaluating CRF in overweight and obese youth can be difficult to implement, unfriendly and expensive. Objective: Develop a screening tool to identify high-risk subjects in a representative population of those attending overweight/obesity assessment programmes without prior i…

Emotional eating scale for children and adolescents: psychometric characteristics in a Spanish sample

The aims of this study were to validate the Emotional Eating Scale version for children (EES-C) in a Spanish population and study the differences in emotional eating among children with binge eating (BE), overeating (OE), and no episodes of disordered eating (NED). The questionnaire was completed by 199 children aged 9 to 16 years. Confirmatory factor analysis revealed five scales: eating in response to anger, anxiety, restlessness, helplessness, and depression. The EES-C showed good internal consistency and test-retest reliability, and it showed moderate relationships with measures of disordered-eating [Children's Eating Attitudes Test-26 (ChEAT-26), Questionnaire of Eating and Weight Patt…

Primordial Prevention of High Blood Pressure in Childhood

Hypertension is a condition with increased risk for subsequent adverse events, and treatment of hypertension is prescribed for primary prevention of adverse events. Primordial prevention is a concept that precedes primary prevention and focuses on risk factor prevention. Primordial prevention of hypertension consists of strategies to maintain blood pressure in a normal range and prevent development of elevated blood pressure or hypertension. Childhood is a period in which primordial prevention could be effective and if sustained throughout childhood could contribute to a healthier young adulthood. Targets for primordial prevention in childhood include preventing and reducing childhood obesi…

Birth weight impacts on wave reflections in children and adolescents.

The objective of the present study was to assess central aortic pressure and wave reflection in children and adolescents at different birth weights. Two hundred nineteen healthy children (126 girls), from 7 to 18 years of age (mean, 11.3 years) and born at term after a normotensive pregnancy, were included. The subjects were divided according to birth weight: <2.5 kg, from 2.5 to 2.999 kg, from 3.0 to 3.5 kg, and >3.5 kg. Pressure waveforms were recorded from the radial artery of the wrist, and the waveform data were then processed by the SphygmoCor radial/aortic transform software module to produce the estimated aortic pressure waveform. Augmentation index, an estimate of the pulse …

Birth Weight Influences Blood Pressure Values and Variability in Children and Adolescents

The objective of the present study was to assess the relationships between birth weight and the values and variability of ambulatory blood pressure. Six hundred thirty healthy children (369 girls) age 4 to 18 years (mean, 9.9 years) born at term after a normotensive pregnancy were included. The subjects were divided into 5 groups according to birth weight. For each subject, a 24-hour ambulatory blood pressure monitoring was performed according to the protocol designed. Average and variability (estimated as the standard deviation) of ambulatory blood pressure and heart rate were calculated separately for 24-hour, daytime, and nighttime periods. When values were adjusted for gender, current …

Gender-related differences in serum uric acid in treated hypertensive patients from central and east European countries: findings from the Blood Pressure control rate and CArdiovascular Risk profilE study.

OBJECTIVE: Hyperuricemia has been associated with high blood pressure (BP) values, diabetes mellitus, metabolic syndrome and chronic kidney disease (CKD). In the present study, we assessed the gender-related relationships between serum uric acid (SUA) and cardionephrometabolic variables in central and east European hypertensive patients. METHODS: A total of 3206 treated hypertensive patients with available SUA levels from the BP-CARE study was analyzed. Correlations among SUA, BP values, BP control, diabetes mellitus, metabolic syndrome and CKD were performed according to gender. RESULTS: Twenty-five percent of the whole population showed hyperuricemia (28% in women and 23% in men). These p…

Obesity and Cardiometabolic Risk Factors : from Childhood to Adulthood

Obesity has become a major epidemic in the 21st century. It increases the risk of dyslipidemia, hypertension, and type 2 diabetes, which are known cardiometabolic risk factors and components of the metabolic syndrome. Although overt cardiovascular (CV) diseases such as stroke or myocardial infarction are the domain of adulthood, it is evident that the CV continuum begins very early in life. Recognition of risk factors and early stages of CV damage, at a time when these processes are still reversible, and the development of prevention strategies are major pillars in reducing CV morbidity and mortality in the general population. In this review, we will discuss the role of well-known but also …

Relationship between birth weight and awake blood pressure in children and adolescents in absence of intrauterine growth retardation.

This study was designed to examine the relationship between birth weight (BW) and ambulatory blood pressure in children and adolescents, born at term in absence of intrauterine growth retardation. Twenty-four hour ambulatory blood pressure monitoring (ABPM) was performed on 332 children (150 boys), aged from 6 to 16 years. Subjects were stratified by BW tertiles and age. ABPM was performed using SpaceLabs 90207 monitor during a regular school day. Blood pressure (BP) was measured every 20 min from 06:00 to 24:00, and thereafter every 30 min. Means of systolic BP (SBP) and diastolic BP (DBP) during 24 h, daytime (08:00 to 22:00), and nighttime (24:00 to 06:00) were calculated. Systolic and d…

Insights and implications of new blood pressure guidelines in children and adolescents.

Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension.

Hypertension in children and adolescents has been gaining ground in cardiovascular medicine, mainly due to the advances made in several areas of pathophysiological and clinical research. These guidelines arose from the consensus reached by specialists in the detection and control of hypertension in children and adolescents. Furthermore, these guidelines are a compendium of scientific data and the extensive clinical experience it contains represents the most complete information that doctors, nurses and families should take into account when making decisions. These guidelines, which stress the importance of hypertension in children and adolescents, and its contribution to the current epidemi…

The spectrum of circadian blood pressure changes in type I diabetic patients.

Background The objective of the present study was to characterize the spectrum of circadian blood pressure changes in type I diabetes at different stages of nephropathy by using two monitorings in each patient in order to avoid intra-individual variability. Patients and methods A total of 80 type I diabetic subjects and the same number of age, sex and awake mean blood pressure (BP)-matched controls were included. According to urinary albumin excretion, there were 57 normoalbuminurics, 15 persistent microalbuminurics and eight proteinurics. Two 24 h ambulatory blood pressure monitorings were performed at the same urinary albumin excretion stage in absence of antihypertensive treatment for ea…

Manejo de la hipertensión arterial en niños y adolescentes: recomendaciones de la Sociedad Europea de Hipertensión

Resumen: La hipertensión en niños y adolescentes ha ido ganando terreno en la medicina cardiovascular, gracias a los avances producidos en distintas áreas de la investigación fisiopatológica y clínica. Estas guías nacen del consenso al que han llegado los especialistas en la detección y control de la hipertensión en niños y adolescentes. Por otra parte, dichas guías son un compendio de los datos científicos y la extensa experiencia clínica con la que se cuenta, y constituyen la información clínica más completa que los médicos, enfermeras y familiares deberían tener en cuenta a la hora de tomar decisiones. Estas guías, que hacen hincapié en la importancia de la hipertensión en niños y adoles…

MOESM10 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 10: Figure S2. a) Treemap plots indicating the results of REViGO sematic analyses of significantly enriched (FDR < 0.05) gene ontology biological process terms for genes that simultaneously contained 0→5 hyper- and hypomethylated dmCpGs. In total, 460 significant terms were found (see Table S6 for full results, including Molecular Function and Cellular Component terms, and also 5→10 dmCpG enrichments). b) Equivalent plots for genes containing, respectively, hyper- or hypomethylated dmCpGs, irrespective of those same genes also containing dmCpGs that changed in the opposite direction.

Additional file 1. of Assessment of ten trace elements in umbilical cord blood and maternal blood: association with birth weight

In the supplemental material section the results of the correlation coefficients between birth weight, birth length, head circumference and trace elements as well as the correlation coefficients between the maternal and cord serum levels of ten trace elements are presented.

2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement.

High blood pressure (BP) is the leading modifiable risk factor for morbidity and mortality worldwide. The basis for diagnosing and managing hypertension is the measurement of BP, which is routinely used to initiate or rule out costly investigations and long-term therapeutic interventions. Inadequate measurement methodology or use of inaccurate BP measuring devices can lead to overdiagnosis and unnecessary treatment, or underdiagnosis and exposure to preventable cardiovascular disease (CVD). [...]

Efficacy of a cognitive and behavioral treatment for childhood obesity supported by the ETIOBE web platform

Recently, the prevalence of childhood obesity has increased alar- mingly. Interventions combining eating habits, physical activity (PA), behavioral components, and family support have been shown to be effective, although variables such as self-efficacy beliefs and motivation seem to be important in achieving stable changes. Information and communication technologies (ICTs) can provide additional resources to traditional treatments. The objective is to analyze the efficacy of two treatments: a cognitive and behavioral treatment (CBT) focused on the promotion of healthy eating and PA habits, and this CBT intervention supported by a web platform (ETIOBE). Forty-seven obese children were random…

Sexual Dimorphism in the Transition From Masked to Sustained Hypertension in Healthy Youths

The risk and factors related to the development of hypertension among healthy youths with elevated ambulatory and normal conventional blood pressure, masked hypertension, have not been established. We performed a long-term follow-up study assessing how hypertension develops over time in healthy, masked hypertensive youths. The potential sex dimorphism in the incidence and timing of the development of hypertension has been analyzed. In a long-term follow-up study (median follow-up, 36 months), we enrolled 272 healthy conventional normotensive youths (aged 6–18 years; 55.8% girls) of whom 39 had masked hypertension at baseline. Development of sustained hypertension (hypertension in both conv…

Red europea para la investigación de la presión arterial en niños y adolescentes (COST Action CA19115)

Resumen La hipertension arterial es un factor de riesgo cardiovascular y renal modificable. Aunque la mayoria de los resultados adversos ocurren en la edad adulta, la hipertension arterial puede estar presente en etapas tempranas de la vida. Mientras pocos cuestionan la importancia de implementar medidas para identificar y manejar esta afeccion en personas adultas, se ha prestado relativamente poca atencion al problema de la hipertension arterial en ninos y adolescentes. Conocer los origenes de la hipertension arterial es un tema que cada vez esta mas presente en los foros de debate. En este sentido, es absoluta la necesidad de una accion paneuropea con el fin de profundizar en los conocimi…

Prevención, diagnóstico y tratamiento de la obesidad. Posicionamiento de la Sociedad Española para el Estudio de la Obesidad de 2016

Steep blood pressure increase in low birth weight newborns

European society of hypertension position paper on ambulatory blood pressure monitoring

Ambulatory blood pressure monitoring (ABPM) is being used increasingly in both clinical practice and hypertension research. Although there are many guidelines that emphasize the indications for ABPM, there is no comprehensive guideline dealing with all aspects of the technique. It was agreed at a consensus meeting on ABPM in Milan in 2011 that the 34 attendees should prepare a comprehensive position paper on the scientific evidence for ABPM.This position paper considers the historical background, the advantages and limitations of ABPM, the threshold levels for practice, and the cost-effectiveness of the technique. It examines the need for selecting an appropriate device, the accuracy of dev…

Factors related to quality of ambulatory blood pressure monitoring in a pediatric population.

To assess the factors related to the quality of ambulatory blood pressure monitoring in a pediatric population, we performed 24-h ambulatory blood pressure monitorings on 333 unselected children aged 3 to 18 years using a Spacelabs 90207 monitor. For each individual, the percentages of valid measurements (ratio between valid and total number of measurements, 76.4% +/-15.6%) and of successful measurements (percentage of valid preset measurements, 89.8% +/- 11.5%) were calculated. Two hundred eighty-one (84.1%) monitorings had a successful measurement rate of >80%. Two hundred thirteen (64%) were of excellent quality, as defined by the percentage of successful measurements being higher than o…

MOESM5 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 5: Figure S1. Boxplots indicating the distribution of absolute beta values of the DNA methylation changes for 0→5 and 5→10 hyper- and hypomethylated dmCpGs. Effect size is measured as median difference and Cliff’s delta.

Procedure to consistently obtain endothelial and smooth muscle cell cultures from umbilical cord vessels

The prenatal history of an individual can be responsible to some extent for the occurrence of several diseases later in life. Thus, low birth weight has been related to an increased risk of developing hypertension or type 2 diabetes. The molecular and cellular basis of this increased risk could be found in body fluids and cell types that can be obtained just after birth. To get this unique information, a methodology was developed to consistently obtain cultures of 4 cell types, endothelial and smooth muscle cells from both the vein and the arteries present in the umbilical cord of an individual. From 21 umbilical cords processed, 82 of the 84 possible cell cultures were obtained. The cell c…

2016 European Society of Hypertension guidelines for the management of high blood pressure in children and adolescents.

Increasing prevalence of hypertension (HTN) in children and adolescents has become a significant public health issue driving a considerable amount of research. Aspects discussed in this document include advances in the definition of HTN in 16 year or older, clinical significance of isolated systolic HTN in youth, the importance of out of office and central blood pressure measurement, new risk factors for HTN, methods to assess vascular phenotypes, clustering of cardiovascular risk factors and treatment strategies among others. The recommendations of the present document synthesize a considerable amount of scientific data and clinical experience and represent the best clinical wisdom upon wh…

European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the second international consensus conference on home blood pressure monitoring

This document summarizes the available evidence and provides recommendations on the use of home blood pressure monitoring in clinical practice and in research. It updates the previous recommendations on the same topic issued in year 2000. The main topics addressed include the methodology of home blood pressure monitoring, its diagnostic and therapeutic thresholds, its clinical applications in hypertension, with specific reference to special populations, and its applications in research. The final section deals with the problems related to the implementation of these recommendations in clinical practice. ispartof: Journal of Hypertension vol:26 issue:8 pages:1505-1530 ispartof: location:Neth…

Medicamentos utilizados en pediatría extrahospitalaria: ¿disponemos de información suficiente?

Objetivo: Analizar los medicamentos que reciben los pacientes pediátricos en el ámbito extrahospitalario y la información disponible sobre los mismos. Pacientes y métodos: Estudio transversal, observacional y descriptivo realizado en una muestra de pacientes menores de 14 años atendidos en urgencias del Servicio de Pediatría del Consorcio Hospital General Universitario de Valencia entre junio 2005 y agosto 2006. Se cuantifican y clasifican los medicamentos utilizados antes de acudir a urgencias y se analiza la información sobre su uso que contiene el Vademécum Internacional Medicom y la ficha técnica. Resultados: Se recogió información sobre 462 niños con media de edad de 5,2 años (interval…

Diurnal blood pressure curve in children and adolescents

Objective To investigate the diurnal blood pressure curve in healthy normotensive children. Thirty-one children were re-examined after a median interval of 123 days in order to study the reproducibility of the diurnal profile. Subjects Twenty-four-hour ambulatory blood pressure monitoring and conventional blood pressure readings were obtained in 228 normotensive children, whose ages ranged from 6 to 16 years and of whom 116 were boys and 112 girls. Results The conventional blood pressure averaged 99+/-11/57+/-9 mmHg in boys and 98+/-12/56+/-9 mmHg in girls (means+/-SD); the corresponding 24 h pressures were 111+/-7/66+/-5 mmHg and 109+/-7/65+/-5 mmHg, respectively. Of the children, 83% had …

Blood pressure and obesity exert independent influences on pulse wave velocity in youth.

The objective was to analyze pulse wave velocity (PWV) in normotensive, high-normal, and hypertensive youths by using aortic-derived parameters from peripheral recordings. The impact of obesity on vascular phenotypes was also analyzed. A total of 501 whites from 8 to 18 years of age were included. The subjects were divided according to BP criteria: 424 (85%) were normotensive, 56 (11%) high-normal, and 21 (4%) hypertensive. Obesity was present in 284 (56%) and overweight in 138 (28%). Pulse wave analysis using a SphygmoCor device was performed to determine central blood pressure (BP), augmentation index, and measurement of PWV. Among the BP groups, differences appeared in age, sex, and hei…

MOESM13 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 13: Table S7. DNA methylation values obtained by bisulfite sequencing for 3 CpGs across the original 33 subjects (technical validation) and two independent longitudinal cohorts (biological validation).

MOESM4 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 4: Table S6. Gene ontology enrichment analysis of 0→5 and 5→10 dmCpGs. Enrichments were calculated from the difference between the dmCpGs obtained in each of the analyses and the GO ontology database by the R/Bioconductor package missMethyl. Ontologies for genes with 1) both hyper- and hypomethylated probes 2) exclusively either hyper- or hypomethyated and 3) from mapped hyper- or hypomethylated dmCpGs which did not take into account CpGs differentially methylated in the opposite direction in the same genes are included. Also included are the ontologies found when analyzing 0→5 dmCpGs grouped by gene region (promoter, exon, intron and gene body). All of the analyses include …

MOESM7 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 7: Table S3. Histone mark enrichment analysis of 0→5 and 5→10 dmCpGs. Enrichments were calculated based on differences between the dmCpGs obtained in each of the analyses and the full collection of Roadmap epigenomics hg19 regions integrated in the LOLA extended software. Corresponding array backgrounds were used for the different comparisons.

MOESM9 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 9: Table S5. Enhancer element enrichment analysis of 0→5 and 5→10 dmCpGs. Enrichments were calculated from the difference between the dmCpGs obtained in each of the analyses and the enhancer elements obtained from the EnhancerAtlas database. A customized LOLA database which included information related to the enhancers in the different tissues/cell lines and corresponding array backgrounds were used for the appropriate enrichment calculation.

MOESM6 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 6: Table S2. Blood cell-type compositions as predicted by the Houseman algorithm for the 33 samples.

MOESM3 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 3: Table S1. Lists of annotated 0→5 and 5→10 dmCpGs.

MOESM2 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 2: Table S8. Primer sequences for bisulfite sequencing of the validated CpGs.

MOESM8 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 8: Table S4. Chromatin state enrichment analysis of 0→5 and 5→10 dmCpGs. Enrichments were calculated based on differences between the dmCpGs obtained in each of the analyses and the hg19 chromatin segmentation regions (ChromHMM, 18 states) obtained from Roadmap and ENCODE consortia. A custom LOLA database including information related to the chromatin states in the different tissues/cell lines and corresponding array backgrounds were used for the correct enrichment calculation.

MOESM1 of Longitudinal genome-wide DNA methylation analysis uncovers persistent early-life DNA methylation changes

Additional file 1: Table S9. Clinical characteristics of the 18 subjects from the independent cohorts.