In adults, initial stages of hypertension are associated with elevated sympathetic drive and significant alterations in indirect autonomic markers. There is growing evidence that children in the highest-pressure percentiles will be more likely to develop hypertension in adulthood, although mechanisms are not understood. We assessed whether computer analysis of RR interval and arterial blood pressure variability could detect early autonomic alterations in childhood hypertension, as assessed by noninvasive time and frequency domain measures of baroreflex regulation. We studied 75 children, subdivided in 3 subgroups of similar age (9.7+/-0.2 years): control subjects, prehypertensive children (ie, children with arterial pressure values >90th and <95th percentile for age, gender, and height), and children in the hypertensive range (ie, >95th percentile; systolic arterial pressure: 97+/-3/57+/-2, 121+/-5/70+/-1, and 128+/-2/80+/-2 mm Hg, respectively). We observed that hypertensive children demonstrate a significant impairment of the baroreflex as compared with control subjects (index alpha: 20+/-2 and 40+/-4 ms/mm Hg; spontaneous baroreflex slope: 20+/-2 and 37+/-5; ms/mm Hg; P<0.05 in both cases) and reduced RR variance. A similar baroreflex impairment is also observed in children whose arterial pressure falls short of this limit, ie, in the prehypertensive range. In conclusion, hypertensive children display a marked baroreflex impairment. A similar baroreflex impairment is also observed in the prehypertensive state. Baroreflex assessment could furnish additional information in the clinical assessment of pediatric hypertension.
Analysis of heart period and arterial pressure variability in childhood hypertension : key role of baroreflex impairment / S. Genovesi, F. Pieruzzi, M. Giussani, V. Tono, A. Stella, A. Porta, M. Pagani, D. Lucini. - In: HYPERTENSION. - ISSN 0194-911X. - 51:5(2008), pp. 1289-1294.
|Titolo:||Analysis of heart period and arterial pressure variability in childhood hypertension : key role of baroreflex impairment|
PAGANI, MASSIMO (Penultimo)
LUCINI, DANIELA (Ultimo)
|Parole Chiave:||Autonomic nervous system; Baroreceptors; Hypertension; Lifestyle; Pediatrics|
|Settore Scientifico Disciplinare:||Settore MED/09 - Medicina Interna|
Settore ING-INF/06 - Bioingegneria Elettronica e Informatica
Settore M-EDF/01 - Metodi e Didattiche delle Attivita' Motorie
|Data di pubblicazione:||2008|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1161/HYPERTENSIONAHA.107.109389|
|Appare nelle tipologie:||01 - Articolo su periodico|