Saner Christoph, Simonetti Giacomo D, Wühl Elke, Mullis Primus E, Janner Marco
University Children's Hospital UKBB, Spitalstrasse 33, CH-4056, Basel, Switzerland.
Division of Pediatric Nephrology, Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 15, CH-3010, Bern, Switzerland.
Eur J Pediatr. 2016 Aug;175(8):1031-8. doi: 10.1007/s00431-016-2736-4. Epub 2016 May 30.
Altered circadian and ultradian blood pressure (BP) and heart rate (HR) rhythmicity have been described in diseases with increased cardiovascular risk. We analyzed cardiovascular rhythmicity in obese children. BP and HR rhythmicity was assessed with Fourier analysis from 24-h ambulatory BP measurements in 75 obese children and compared with an age- and gender-matched, lean healthy reference group of 150 subjects. Multivariate regression analysis was applied to identify significant independent factors explaining variability of rhythmicity. Prevalence of 24- and 6-h BP rhythmicity in the obese group was lower (p = 0.03 and p = 0.02), whereas the prevalence of HR rhythmicity was comparable in both groups. Excluding hypertensive participants, the results remained similar. Twenty-four-hour BP and HR acrophase were delayed in obese children (p = 0.004, p < 0.0001), 24-h BP amplitude did not differ (p = 0.07), and 24-h HR amplitude was blunted (p = < 0.0001). BP Mesor in the obese group was higher (p = 0.02); HR Mesor did not differ (p = 0.1). Multivariate regression analysis failed to identify a single anthropometric or blood pressure parameter explaining the variability of BP and HR rhythmicity.
Prevalence and parameters of circadian and ultradian BP and HR rhythmicity in obese children are altered compared to a healthy reference group, independent of preexisting hypertension.
• Altered cardiovascular rhythmicity has been described in children with different diseases such as primary hypertension or chronic renal failure. What is New: • This study reveals altered cardiovascular rhythmicity in obese children compared to an age and gender-matched healthy reference group independent from preexisting hypertension.
在心血管风险增加的疾病中,已观察到昼夜和超日血压(BP)及心率(HR)节律的改变。我们分析了肥胖儿童的心血管节律。通过傅里叶分析,对75名肥胖儿童的24小时动态血压测量结果进行了BP和HR节律评估,并与150名年龄和性别匹配的瘦健康参考组进行了比较。应用多变量回归分析来确定解释节律变异性的显著独立因素。肥胖组24小时和6小时BP节律的患病率较低(p = 0.03和p = 0.02),而两组HR节律的患病率相当。排除高血压参与者后,结果仍然相似。肥胖儿童的24小时BP和HR峰相位延迟(p = 0.004,p < 0.0001),24小时BP振幅无差异(p = 0.07),24小时HR振幅减弱(p = < 0.0001)。肥胖组的BP中值较高(p = 0.02);HR中值无差异(p = 0.1)。多变量回归分析未能确定一个单一的人体测量或血压参数来解释BP和HR节律的变异性。
与健康参考组相比,肥胖儿童的昼夜和超日BP及HR节律的患病率和参数发生了改变,且与既往高血压无关。
• 在患有不同疾病(如原发性高血压或慢性肾衰竭)的儿童中,已描述了心血管节律的改变。新发现:• 本研究揭示,与年龄和性别匹配的健康参考组相比,肥胖儿童的心血管节律发生了改变,且与既往高血压无关。