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J Pediatr. 2002 Jun;140(6):660-6.

Isolated systolic hypertension, obesity, and hyperkinetic hemodynamic states in children.

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1
Department of Pediatrics, University of Texas-Houston Medical School, Houston, Texas 77030, USA.

Abstract

OBJECTIVE:

To determine the factors that contribute to the pathogenesis of isolated systolic hypertension in children.

METHODS:

School-based measurement was performed of blood pressure (BP), heart rate, weight, and height in 2460 students (49% Hispanic, 31% black, 13% white) 12 to 16 years of age in 8 urban public schools. An independent group of 71 untreated children underwent 24-hour ambulatory BP monitoring (ABPM) to confirm clinic hypertension and assess circadian BP patterns.

RESULTS:

Hypertension and obesity were found in 17% and 23% of students, respectively. Among hypertensive students, 88% (363/413) had isolated systolic hypertension. Hypertension was more prevalent in obese than nonobese students (33% vs 11%, P <.0001). Obese hypertensive students had higher resting heart rate than nonobese normotensive patients (85.9 vs 79.6 beats/min, P <.001). Among patients who underwent ABPM, isolated systolic hypertension was found in 51% (36/71) by clinic BP and in 62% (18/29) with confirmed hypertension by ABPM. Blood pressure variability during daytime and sleep periods was higher in obese than nonobese patients for systolic BP (P <.01) and diastolic BP (P <.05).

CONCLUSIONS:

The findings of increased heart rate and BP variability in obese children with isolated systolic hypertension suggest that sympathetic nervous system hyperactivity may contribute to its pathogenesis.

PMID:
12072867
DOI:
10.1067/mpd.2002.125228
[Indexed for MEDLINE]

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