Updated and revised normal values of aortic pulse wave velocity in children and adolescents aged 3-18 years.

Measurement of aortic pulse wave velocity (PWVao) is recommended for stratifying individual cardiovascular (CV) risk in adults. Diseases in children and adolescents might influence aortic stiffness. It is necessary to exclude overweight (OW), obese (O) subjects, and individuals with increased systolic (SBP) and/or diastolic blood pressure (DBP) from the population, when creating normal values of PWVao in children and adolescents. Body mass index (BMI), SBP/DBP cut-off values have remarkably changed in this population during the last decade. Aims of our study were to expand our previously published PWVao database and to revise it by using the recently determined normal values. PWVao was measured by an occlusive-oscillometric device (Arteriograph, TensioMed Ltd, Budapest, Hungary) in a healthy population aged 3-18 years. 7940 (4374 boys) participants were recruited, 1912 OW/O subjects and 1368 individuals with high SBP/DBP were excluded. Finally, n = 4690 (2599 boys) participants were enrolled. Mean PWVao values increased from 5.4 ± 0.6 to 6.4 ± 0.5 m/s (p < 0.05) in boys and from 5.5 ± 0.6 to 6.4 ± 0.5 m/s (p < 0.05) in girls. Mean PWVao values were significantly lower in our new study, in boys in age groups of 9-16, in girls in age groups of 11-17. This is the largest and widest age-ranged database of PWVao published to date. Due to the change of BMI and SBP/DBP reference values during the last decade, the "old" database of PWVao needed to be revised. As a result of this, normal values of PWVao decreased significantly in both sexes.

Childhood Obesity: Does it Have Any Effect on Young Arteries?

Prevalence of overweight (OW) and obesity (O) in children and adolescents has been increased in the past three decades. Increased arterial stiffness measuring by aortic pulse wave velocity (PWVao) might be detected in OW/O children and adolescents. The aim of our study was to compare the arterial function parameters (AFPs), such as PWVao; aortic augmentation index (Aixao); aortic systolic blood pressure (SBPao) and brachial systolic blood pressure (SBPbrach) measured simultaneously in O/OW patients and healthy subjects. In our study 6,816 subjects (3,668 boys) aged 3-18 years were recruited and categorized by their body mass index (BMI) into normal weight (N), OW and O groups regarding their age and sex. AFPs were measured by a non-invasive, occlusive-oscillometric device. 19.9% (n = 1,356) of the population were OW/O, 911 (516 boys) were OW and 445 (272 boys) were O. After accounting for the effect of covariates, PWVao did not differ significantly between N (5.9 ± 0.8 m/s) and OW patients (5.9 ± 0.8 m/s); and N (6.0 ± 0.7 m/s) and O patients (6.0 ± 0.8 m/s). Aixao was significantly lower in OW (9.3 ± 7.4% vs. 7.6 ± 7.0%, p < 0.00001) and in O patients (9.7 ± 8.1% vs. 6.6 ± 7.2%, p < 0.00001) compared to controls. No significant difference was found regarding SBPao values between controls and OW and O groups (N = 110.7 ± 12.4 mmHg vs. OW = 110.3 ± 11.9 mmHg; N = 115.6 ± 14.0 mmHg vs. O = 114.3 ± 12.8 mmHg). According to our results we may conclude that the unchanged PWVao in O/OW subjects might be due to the compensatory decrease in Aixao, referring to enhanced vasodilatory status in the studied population.

[Prevalence of hypertension in overweight and obese Hungarian children and adolescents]. / A magasvérnyomás-betegség prevalenciája túlsúlyos és elhízott magyar gyermek- és serdülokorú populációban.

Introduction: The prevalence of overweight and obesity is increasing worldwide, which affects not only adults, but children and adolescents as well. Moreover, this condition may lead to several comorbidities, such as elevated or even high blood pressure. Aim: Aim of this study was to assess the prevalence of overweight- and obesity-related elevated and high blood pressure in a population aged 3-18 years in Hungary. Method: Between 2005 and 2018, altogether 8624 (boys = 4719) individuals were enrolled to this study. Normal weight, overweight and obese groups were created on the basis of body mass index. The diagnosis of elevated (systolic and/or diastolic blood pressure is between 90th and 95th percentile) and high blood pressure (systolic and/or diastolic blood pressure is over 95th percentile) was based on detailed examination (laboratory tests, abdominal ultrasonography, paediatric cardiology and 24-hours ambulatory blood pressure monitoring). Results: In this study, the prevalence of overweight and obesity was 23.5% overall, 26.4% in boys and 20% in girls. The prevalence of elevated blood pressure was 9.8% in overweight patients, while it was 4.6% in the obese group. The prevalence of high blood pressure was 8.3% (odds ratio: 1.1%, 95% CI) among overweight subjects, while it was 26.7% (odds ratio: 3.6, 95% CI) in the obese group. Conclusion: To the best of our knowledge, this is the first Hungarian population-based study on the prevalence of overweight- and obesity-related elevated and high blood pressure assessed in a large contemporary cohort of children and adolescents. The cardiovascular risk is increased in this patient group. Hence, it is essential to set up a proper primary prevention strategy. Orv Hetil. 2020; 161(4): 151-160.

Prevalence of Overweight and Obesity in Hungarian Children and Adolescents.

BACKGROUND/AIMS: The prevalence of overweight and obesity in children and adolescents is increasing worldwide, and this condition is a risk factor for cardiovascular mortality. The aim of this study was to assess the prevalence of overweight and obesity among the 3-18-year-old population in Szolnok City and the surrounding areas. METHODS: Anthropometric data from healthy, white individuals recruited from nursery, elementary, and secondary schools were used to assess the prevalence of obesity and overweight in Szolnok City and the surrounding area, Jász-Nagykun-Szolnok county, Hungary. Healthy subjects numbering 6,824 (54% boys) were included; overweight and obesity were defined according to the relevant guidelines. RESULTS: Overweight individuals constituted 13.4% of the population and 6.6% were obese. The total prevalence was higher in boys (21.6%) than in girls (18.1%). The peak of the prevalence was observed at age 10 in both sexes (boys 33%, girls 27%) followed by a gradual decrease, which was more significant in the case of girls. CONCLUSIONS: On the basis of the recent Hungarian data, we have not detected any changes in overweight and obesity in the age group 3-9 years and we have found a significant decrease in the age group 7-14 years. Prevention of overweight and obesity in early childhood is essential.