title: Longitudinal assessment of high blood pressure in children with nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  Nonalcoholic fatty liver disease (NAFLD) affects 9.6% of children and may put these children at elevated risk of high blood pressure and subsequent cardiovascular morbidity and mortality. Therefore, we sought to determine the prevalence of and risk factors for high blood pressure in children with NAFLD.
  
  
  METHODS
  Cohort study performed by the NIDDK NASH Clinical Research Network. There were 484 children with NAFLD ages 2 to 17 at enrollment; 382 children were assessed both at enrollment and 48 weeks afterwards. The main outcomes were high blood pressure at baseline and persistent high blood pressure at both baseline and 48 weeks.
  
  
  RESULTS
  Prevalence of high blood pressure at baseline was 35.8% and prevalence of persistent high blood pressure was 21.4%. Children with high blood pressure were significantly more likely to have worse steatosis than children without high blood pressure (mild 19.8% vs. 34.2%, moderate 35.0% vs. 30.7%, severe 45.2% vs. 35.1%; P = 0.003). Higher body mass index, low-density lipoprotein, and uric acid were independent risk factors for high blood pressure (Odds Ratios: 1.10 per kg/m2, 1.09 per 10 mg/dL, 1.25 per mg/dL, respectively). Compared to boys, girls with NAFLD were significantly more likely to have persistent high blood pressure (28.4% vs.18.9%; P = 0.05).
  
  
  CONCLUSIONS
  In conclusion, NAFLD is a common clinical problem that places children at substantial risk for high blood pressure, which may often go undiagnosed. Thus blood pressure evaluation, control, and monitoring should be an integral component of the clinical management of children with NAFLD.
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego, School of Medicine, San Diego, California, United States of America; Department of Gastroenterology, Rady Children's Hospital San Diego, San Diego, California, United States of America; Liver Imaging Group, Department of Radiology, University of California San Diego, School of Medicine, San Diego, California, United States of America.
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Schwimmer
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego, School of Medicine, San Diego, California, United States of America; University of California San Diego, Master of Advanced Studies in Clinical Research, San Diego, California, United States of America.
authors.forename: Anne
authors.initials: A
authors.lastname: Zepeda
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Diego, School of Medicine, San Diego, California, United States of America; Department of Gastroenterology, Rady Children's Hospital San Diego, San Diego, California, United States of America.
authors.forename: Kimberly P
authors.initials: KP
authors.lastname: Newton
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States of America.
authors.forename: Stavra A
authors.initials: SA
authors.lastname: Xanthakos
authors.affiliation: Department of Pathology, Sharp Medical Center, San Diego, California, United States of America.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Behling
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Erin K
authors.initials: EK
authors.lastname: Hallinan
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Michele
authors.initials: M
authors.lastname: Donithan
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: James
authors.initials: J
authors.lastname: Tonascia
mesh_terms: D000293:Adolescent; D001795:Blood Pressure Determination / Q000379:methods*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D005234:Fatty Liver / Q000150:complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D007328:Insulin / Q000097:blood; D016015:Logistic Models; D008297:Male; D009316:National Institutes of Health (U.S.); D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014527:Uric Acid / Q000097:blood
chemical_list: D008078:Cholesterol, LDL; D007328:Insulin; D014527:Uric Acid