Evaluating the determinants and the effects of elevated blood pressure in a population of children and adolescents at-risk for hypertension
Notice bibliographique
Résumé
Background:Elevated casual hypertension in children can be predicted by a number of factors, including excessive BMI and poor lifestyle habits. If maintained into adolescence, hypertension can lead to increased left ventricular mass index (LVMI) and carotid intima media thickness (cIMT), and eventually cardiovascular events. However, the association of 24-hours ambulatory blood pressure (BP) on these outcomes has not been thoroughly investigated. Moreover, it is unclear if the risk factors for hypertension change throughout childhood.Objectives:1. Determine which characteristics are associated with elevated blood pressure (BP) inchildhood, and whether the same characteristics similarly impact BP throughout childhood.2. Evaluate the extent to which elevated BP is associated with LVMI and cIMT.Methods:Two observational cohort studies:1. Prospective longitudinal cohort at two Quebec hospitals: visit 1: n=631, visit 2: n=564. Participants underwent a study visit, consisting of measurements of anthropometry, body composition, accelerometer data, fitness test, oral glucose tolerance test, and blood samples, as well as comprehensive lifestyle questionnaires for both patient and parents. Associations between variables and casual BP were measured to determine predictors of elevated BP.2. Prospective cross-sectional cohort at a Montreal hospital: 134 patients were recruited in this ongoing study. 24-hour ambulatory blood pressure monitoring (ABPM) and echocardiograms were performed to ascertain BP, LVMI, and cIMT. Associations between ABPM-derived BP and LVMI and cIMT were measured.Results:Longitudinal cohort: n=631, age=9.6 years at visit 1; n=564, age=11.7 years at visit 2; 40% of participants were overweight or obese at each visit. Adiposity and hereditary factors were associated with systolic and diastolic BP. BMIz was a significant predictor of future BP levels. Cross-sectional cohort: n=134, age=17.2 years; 36% were overweight or obese at the study visit. BMIz and lean body mass were associated with LVMI, while only BP was associated with cIMT. Other factors were independently associated with both measures, but were not significant when the models were adjusted for additional variables.Conclusions:Hypertension is associated with several measurable variables, although children and adolescents that present with these risk factors often go unscreened and untreated. The risk factors themselves and the associated ambulatory hypertension can lead to significant end-organ damage in adolescents. Research should focus on developing and testing better measurement indices, while policy and protocol changes should make BP screening and tracking a more widely implemented practice.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».