The association between metabolic complications and arterial hypertension in obese adolescents

There is increasing evidence for the contribution of obesity and its metabolic sequels in the development of arterial hypertension (AH).

The casual blood pressure (CBP), 24hABPM, ambulatory arterial stiffness index (AASI) and symmetric (sAASI) ambulatory arterial stiffness index (both derived from a 24 h ABPM) and selected laboratory tests were performed in 130 obese (mean BMI SDS 4.2) adolescents at the mean age of 13.7 years.

AH was diagnosed in 36.2%, and in 33.8% patients on the basis of CBP and 24hABPM respectively. There were significant correlations between: CBPSBP insulin level (fasting r=0.19, p=0.03 and post glucose load r=0.18, p=0.04), HOMA-IR (r=0.18, p=0.04), and uric acid (UA) level (r=0.35, p<0.001); CBPDBP and UA level (r=0.23, p=0.01). There were significant correlations between 24hABPM parameters and cortisol secretion: dSBP and urinary free cortisol (r=0.3, p=0.03), nDBP and nMAP and cortisol rhythm (r=0.21, p=0.03). There a correlation between sAASI and creatinine level (r=0.29, p=0.002) and negative correlation between AASI and eGFR (r=-0.23, p=0.009).

The increase of the CBP parameters is associated with insulin resistance and hyperuricemia, while the increase of ABPM results is proportional to the cortisol secretion in obese adolescents.