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[Changes in the ambulatory arterial pressure of normotensive obese children]
I Pela1, P A Modesti, C Cocchi
1Clinica Pediatrica Ia, Università degli Studi Firenze, Italia.
Insights
Obese children show elevated systolic blood pressure (BP) during both day and night, detectable by ambulatory monitoring. These early hemodynamic changes in pediatric obesity may precede hypertension development.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Disease Research
- Hypertension Studies
Background:
- Obesity is a significant risk factor for cardiovascular disease.
- Childhood obesity is linked to the future development of essential hypertension.
- Early detection of hemodynamic alterations is crucial for preventing future cardiovascular complications.
Purpose of the Study:
- To evaluate early hemodynamic alterations in obese, normotensive children.
- To compare 24-hour ambulatory blood pressure monitoring (ABPM) in obese children versus controls.
- To identify subtle blood pressure changes in pediatric obesity.
Main Methods:
- Ambulatory monitoring using ICR 5200 (Spacelabs, USA) was performed.
- 18 obese children (mean age 9.6 +/- 2.9 years) and 33 controls were studied.
- Blood pressure daily curves were compared using MANOVA.
Main Results:
- Basal blood pressure did not differ between obese children and controls.
- Ambulatory monitoring revealed significantly higher systolic blood pressure in obese children (112 +/- 7 mmHg) compared to controls (107 +/- 7 mmHg).
- Elevated systolic BP was observed during both daytime and nighttime in obese children, while diastolic pressure and heart rate showed no significant differences.
Conclusions:
- Ambulatory 24-hour monitoring detects blood pressure alterations in obese children that are missed by routine checks.
- Early systolic hypertension may be present in obese children before clinical diagnosis.
- ABPM is a valuable tool for identifying subclinical cardiovascular risks in pediatric obesity.
Abstract:
Obesity represents an important risk factor for cardiovascular disease and in children it is often associated to the future development of essential hypertension. To evaluate the early hemodynamic alterations in obese normotensive children, ambulatory monitoring was performed in 18 obese children aged 9.6 +/- 2.9 and in 33 controls of equivalent age by ICR 5200 (Spacelabs, USA). Blood pressure daily curves in the two groups were compared by MANOVA. Basal blood pressure did not differ in the two groups (115 +/- 17 mmHg and 79 +/- 7 mmHg respectively systolic and diastolic in controls and 115 +/- 12 mmHg and 79 +/- 6 mmHg in obese children). On the contrary ambulatory monitoring showed higher systolic values in obese children when compared to controls (112 +/- 7 versus 107 +/- 7, p less than 0.04) (MANOVA test, p less than 0.03). The difference was observed both during the day time (115 +/- 6 vs 111 +/- 7, p less than 0.03) and during the night (107 +/- 9 vs 102 +/- 8, p less than 0.5). No differences in diastolic pressure and in heart rate were observed. Those findings indicate that in obese children blood pressure alterations unrecognized at usual blood pressure checks are detectable by ambulatory 24 hour monitoring.