THIRTY-TWO-YEAR DYNAMICS AND PROGNOSTIC SIGNIFICANCE OF BASELINE LEVELS OF SYSTEMIC PRESSURE IN TEENAGE BOYS

Aim. To evaluate the 32-year dynamics and prognostic significance of the baseline levels of arterial pressure (BP) in teenage boys.

Material and methods. Thirty-two-year prospective cohort follow-up of males, beginning from the age 11-12 y.o. In 32 years, among 1005 participants, 303 (30,1%) assessed, and the cohort consisted of 290. The investigation included: standard questionnaires; three-time BP measurement; pulse rate; anthropometry; triceps, scapula and abdominal skin folds measurement, waist and hip circumference; total cholesterol measurement, as high density lipoproteides and triglycerides.

Results. The prevalence of arterial hypertension slightly declines in 12 to 15 years, and then increases at 17-22 years with high increase at 33 years, with further stabilization. All tracking coefficients (Pearson correlation) for systolic BP (sBP) were statistically significant, but decreased from the age 33 to 43 (from 0,35 to 0,17). For the diastolic BP-5 (dBP5) statistic significance was found only by 22 years, dBP4 — by 33 years. There was significant correlation of sBP and dBP with body mass index and anthropometry. In 30 years, the stabilized increase (fifth quintile) remains by sBP and dBP for every fifth. From the first to the fifth, every tenth switched by sBP and every fifth by dBP.

Conclusion. Measurement of BP in childhood and teenage is worthful, as there is significant relation of sBP and dBP in teenage with its adult level. Every fifth teenager with increased BP at childhood remain it in 30 years. Also, every tenth with low BP shows its increase in 30 years. The special attention should be paid for primary prevention of arterial hypertension in obese children and those with raised BP. It is important to search for new markers of prognosis.

1. Коllias A, Pansiotou K, Rarpetals, et al. Tracking of blood pressure from childhood to adolescens in a greek cohort. J Hypertension 2010; 28: e223-4.

2. Boytsov SA, Balanova YA, Shalnova SA, et al. From the participants of ECCD-RF. Arterial hypertension among individuals of 25–64 years old: prevalence, awareness, treatment and control. By the data from ECCD. Cardiovascular Therapy and Prevention 2014; 13 (4): 4-14. (In Russ.) DOI: 10.15829/1728-8800-2014-4-4-14 Russian (Бойцов С.А., Баланова Ю.А., Шальнова С.А. и др. от имени участников исследования ЭССЕ-РФ. Артериальная гипертония среди лиц 25–64 лет: распространенность, осведомленность, лечение и контроль. По материалам исследования ЭССЕ. Кардиоваскулярная терапия и профилактика 2014; 13 (4): 4-14). DOI: 10.15829/1728-8800-2014-4-4-14

3. Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood. A systematic review and meta-regression analysis. Circulation 2008; 117 (25): 3171-80.

4. Toschke AM, Kohl L, Mansmann U, von Kries R. Meta-analysis of blood pressure tracking from childhood to adulthood and implications for the design of intervention trials. Actapaediatr 2010; 99 (1): 24-9.

5. Moyer VA. Screening for primary hypertension in children and adolescents: U. S. preventive services task force recommendation statement. Pediatrics 2013; 132: 907-14.

6. Hayman LL, Meininger JC, Daniels SR, et al. Primary prevention of cardiovascular disease in nursing practice: Focus on Children and Youth a scientific statement from the American heart association committee on atherosclerosis, hypertension, and obesity in youth of the council on cardiovascular disease in the young, council on cardiovascular nursing, council on epidemiology and prevention, and council on nutrition, physical activity, and metabolism. Circulation 2007; 116: 344-57.

7. Diagnostics and treatment and prevention of arterial hypertension in children and adolescents. National clinical guidelines. Cardiovascular Therapy and Prevention 2009; 8 (4), (Suppl. 1): 1-32. Russian (Диагностика, лечение и профилактика артериальной гипертензии у детей и подростков. Национальные рекомендации. Кардиоваскулярная терапия и профилактика 2009; 8 (4), (Приложение 1): 1-32). 8. Diagnostics and treatment of arterial hypertension. National clinical guidelines. Systematic hypertensions 2010; 3: 5-26. Russian (Диагностика и лечение артериальной гипертензии. Системные гипертензии 2010; 3: 5-26).

8. Cole TJ, Bellizzi MC, FlegalKM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240-3.

9. Flynn JT. Hypertension in adolescents. Adolesc Med Clin 2005; 16: 11-29.

10. Plotnikova IV, Kovalev IA, Trushkina IV, Fillipov GP. Arterial hypertension in children and adolescents. Tomsk: Pechatnaya manufaktura 2008; 134 р. Russian (Плотникова И.В., Ковалев И.А., Трушкина И.В., Филиппов Г.П. Артериальная гипертензия у детей и подростков. Учебное пособие. Томск: издательство “Печатная мануфактура” 2008; 134 с).

11. Rozanov VB. Prognostic value of blood pressure study in adolescence (22-year follow-up). The Russian Newsletter of Perinatal Medicine and Pediatrics 2006; 5: 27-41. Russian (Розанов В.Б. Прогностическое значение артериального давления в подростком возрасте (22-летнее проспективное наблюдение). Российский вестник перинатологии и педиатрии 2006; 5: 27-41).

12. Denisova D, Zavjalova L, Nikitin Yu. Overweight, hypertension and nutrition among adolescents in changing Russia (1989-2003). European Journal of Public Health 2008; 17 (Suppl. 2): 213-4.

13. Leontjeva IV, Alexandrov AA, Rozanov VB. Arterial hypertension among children and adolescents. M. Vikas Print, 2010; p. 250. Russian (Леонтьева И.В., Александров А.А., Розанов В.Б. Артериальная гипертензия у детей и подрост¬ ков. М.: Викас принт, 2010; 250 с).

14. Bao W, Threefoot SA, Srinivasan SR, Berenson GS. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa Heart Study. Am J Hypertension 1995; 8: 657-65.

15. Klumbiene J, Milasauskiene Z, Sachkute A. The dynamics of blood pressure and predicting of arterial hypertension: 20-year prospective study. Kardiologiia 2004; 44 (2): 30-4. Russian (Клумбене Ю., Мелашаускане Ж., Шачкуте А. Динамика артериального давления и прогнозирование артериальной гипертензии: данные 20-летнего наблюдения детской когорты. Кардиология 2004; 44 (2): 30-4).