Overweight and decreased baroreflex sensitivity as independent risk factors for hypertension in children, adolescents, and young adults.
We studied the relationship between blood pressure (BP), body mass index (BMI, kg/m(2)) and baroreflex sensitivity (BRS, ms/mmHg) in adolescents. We examined 34 subjects aged 16.2+/-2.4 years who had repeatedly high causal BP (H) and 52 controls (C) aged 16.4+/-2.2 years. Forty-four C and 22 H were of normal weight (BMI between 19-23.9), and 8 C and 12 H were overweight (BMI between 24-30). Systolic BP was recorded beat-to-beat for 5 min (Finapres, controlled breathing 0.33 Hz). BRS was determined by the cross-spectral method. The predicting power of BMI and BRS for hypertension was evaluated by sensitivity, specificity, and receiver operating curve (ROC - plot of sensitivity versus specificity). H compared with C had lower BRS (p<0.01) and higher BMI (p<0.05). Multiple logistic regression analysis (p<0.001) revealed that a decreased BRS (p<0.05) and an increased BMI (p<0.01) were independently associated with an increased risk of hypertension. No correlation between BMI and BRS was found either in H or in C. Following optimal critical values by ROC, the sensitivity, specificity and area under ROC were determined for: BMI - 22.2 kg/m(2), 61.8 %, 69.2 %, 66.0 %; BRS - 7.1 ms/mmHg, 67.7 %, 69.2 %, 70.0 %; BMI and BRS - 0.439 a.u., 73.5 %, 82.7 %, and 77.3 %. Decreased BRS and overweight were found to be independent risk factors for hypertension.
Krontorádová
K
K
Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Honzíková
N
N
Fiser
B
B
Nováková
Z
Z
Závodná
E
E
Hrstková
H
H
Honzík
P
P
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017704:Baroreflex; D001794:Blood Pressure; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D050177:Overweight / Q000150:complications* / Q000503:physiopathology; D011237:Predictive Value of Tests; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013599:Systole