Evaluating the determinants and the effects of elevated blood pressure in a population of children and adolescents at-risk for hypertension
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".