title: Impaired cardiac autonomic nervous system function is associated with pediatric hypertension independent of adiposity.
abstract: BACKGROUND
  We examined whether sympathetic nervous system activity influences hypertension status and systolic blood pressure (SBP) independent of adiposity in youth ranging from normal-weight to severe obesity.
  
  
  METHODS
  We examined the association of heart rate variability (HRV) with hypertension status and SBP among youth (6-18 y old; n = 188; 103 female). Seated SBP was measured using an automated cuff. Prehypertension (SBP percentile ≥ 90th to <95th) and hypertension (SBP percentile ≥ 95th) were defined by age-, sex-, and height-norms. Autonomic nervous system activity was measured using HRV via SphygmoCor MM3 system and analyzed for time- and frequency-domains. Total body fat was measured via dual-energy X-ray absorptiometry.
  
  
  RESULTS
  Logistic regression models demonstrated lower values in each time-domain HRV measure and larger low-frequency (LF):high-frequency (HF) ratio to be significantly associated with higher odds of being prehypertensive/hypertensive (11-47% higher odds) independent of total body fat (P < 0.05). In linear regression analysis, lower time-domain, but not frequency-domain, HRV measures were significantly associated with higher SBP independent of total body fat (P < 0.05).
  
  
  CONCLUSIONS
  These data suggest that impaired cardiac autonomic nervous system function, at rest, is associated with higher odds of being prehypertensive/hypertensive and higher SBP which may be independent of adiposity in youth.
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota.|Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota.
authors.forename: Justin R
authors.identifier: http://orcid.org/0000-0002-7506-9497
authors.initials: JR
authors.lastname: Ryder
authors.affiliation: Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, Minnesota.
authors.forename: Michael
authors.initials: M
authors.lastname: O'Connell
authors.affiliation: Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota.
authors.forename: Tyler A
authors.identifier: http://orcid.org/0000-0002-1207-0626
authors.initials: TA
authors.lastname: Bosch
authors.affiliation: Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota.
authors.forename: Lisa
authors.initials: L
authors.lastname: Chow
authors.affiliation: Division of Biostatistics, University of Minnesota School of Public Health, Minneapolis, Minnesota.
authors.forename: Kyle D
authors.initials: KD
authors.lastname: Rudser
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota.|School of Kinesiology, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Dengel
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota.
authors.forename: Claudia K
authors.initials: CK
authors.lastname: Fox
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota.
authors.forename: Julia
authors.initials: J
authors.lastname: Steinberger
authors.affiliation: Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota.|Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota.
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Kelly
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000886:Anthropometry; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology*; D001794:Blood Pressure; D001823:Body Composition; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000503:physiopathology; D058246:Prehypertension / Q000503:physiopathology; D011627:Puberty