RESUMO
OBJECTIVE: The objective of this study was to determine the predictors of future ambulatory blood pressure in normotensive youths with family histories of essential hypertension. STUDY DESIGN: Eighty-eight healthy youths (mean age 10.9 +/- 2.5 years; 52 blacks, 36 whites; 45 boys) were studied. During an initial visit anthropometric variables and hemodynamics were measured at rest and before, during, and after three laboratory stressors: postural change, forehead cold, and video game challenge. The subjects' ambulatory blood pressure was monitored for 24 hours as part of a follow-up evaluation an average of 2.5 years later. RESULTS: Anthropometric and demographic variables and measures of reactivity to laboratory stressors were related to future daytime and nighttime ambulatory blood pressure. CONCLUSION: These findings provide important information on the predictors of ambulatory blood pressure and underscore the importance of resting blood pressure and adiposity. These results support the guidelines of the Second Task Force, which recommend the measurement of blood pressure and adiposity in the context of ongoing health care.
Assuntos
Pressão Sanguínea , Hipertensão/epidemiologia , Determinação da Pressão Arterial , Monitorização Ambulatorial da Pressão Arterial , Constituição Corporal , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Valor Preditivo dos Testes , Estudos Prospectivos , Fatores de Risco , Fatores de TempoAssuntos
Bilirrubina/sangue , Diatrizoato de Meglumina/farmacologia , Diatrizoato/análogos & derivados , Diatrizoato/farmacologia , Recém-Nascido , Albumina Sérica/metabolismo , Cateterismo Cardíaco , Diatrizoato/efeitos adversos , Diatrizoato/sangue , Combinação de Medicamentos/farmacologia , Humanos , Lactente , Icterícia Neonatal/complicações , Ligação Proteica , RiscoRESUMO
To determine normal values for the exercise variables heart rate, blood pressure, maximal workload, physical working capacity index, J point displacement, and ST segment slope, we stress tested 405 healthy children. We analyzed the data for four body surface area-determined groups, to discover whether there were any racial differences between healthy white children and black children. There were numerous racial differences in blood pressure, maximal workload, and physical working capacity index; there were no differences in the heart rate values. The incidence of false-positive J point displacement was less than or equal to 3% when the PR isoelectric line method was used. The ST segment slope in healthy children was always greater than zero at maximal exercise. Thus, norms for exercise variables must be expressed in relation to both sex and race. The nomograms presented in this report provide an easy-to-use set of normative data for cycle ergometer stress testing in children.
Assuntos
Negro ou Afro-Americano , Teste de Esforço , População Branca , Adolescente , Pressão Sanguínea , Superfície Corporal , Criança , Feminino , Frequência Cardíaca , Humanos , Masculino , Resistência Física , Valores de Referência , Avaliação da Capacidade de TrabalhoRESUMO
In order to determine normal values for systolic blood pressure response to cycle ergometer stress testing in children, we performed 405 studies in subjects from 6 to 15 years of age, of whom 184 were black and 221 were white. We analyzed the data in relation to sex, color, age, and body surface area. Resting systolic blood pressure showed no differences between groups of black and white children, analyzed either by age or surface area. Peak exercise blood pressures were higher in the black females, in comparison to their white counterparts, only when separated into groups by body surface area. The black males had higher exercise blood pressure values than the whites, both by age and surface area evaluation. Our data suggest a difference in the blood pressure response to dynamic exercise within the black population. Further studies are needed to define the mechanism of this difference and whether this difference may provide a clue to the identification of children at increased risk for developing hypertension later in life.