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Sympathoadrenergic and metabolic factors are involved in ambulatory blood pressure rise in childhood obesity

Journal of Human Hypertension volume 22, pages 75–82 (2008)Cite this article

Abstract

We investigated in a young Italian obese population, the relationship between ambulatory BP (ABP) and several pathophysiological factors linking obesity to hypertension. A total of 89 obese children and adolescents underwent a 24-h ambulatory BP monitoring (ABPM) and an oral glucose tolerance test. The circulating levels of insulin, lipids, uric acid, C-reactive protein, interleukin-6, renin and aldosterone and the 24-h urinary levels of epinephrine, norepinephrine and albumin excretion rate were measured. Nine percent of subjects had daytime sustained hypertension (SH), 26 % night-time hypertension and 11 % a non-dipping pattern. SH subjects compared to those with sustained normotension (SN) were more obese (P<0.05), with a more frequent family history of hypertension (P<0.05), higher urinary catecholamine (P<0.05) and heart rate values (P<0.05) after adjustment for standard deviation score (SDS) of body mass index (BMI) and sex. Subjects with night-time hypertension compared to those with night-time normotension were more obese (P<0.0001), with a higher prevalence of impaired glucose tolerance (P<0.05) and metabolic syndrome (P<0.05) and higher 2-h glucose (P<0.05), uric acid (P<0.05) and triglycerides (P<0.05). In multivariate regression analysis, daytime systolic BP (SBP) remained independently correlated with urinary norepinephrine and SDS-BMI (P<0.05 for both), daytime diastolic BP (DBP) with waist circumference (P<0.05) and night-time SBP and DBP with SDS-BMI (P<0.01 for both). The risk of having systolic and diastolic hypertension increased with the increase in SDS-BMI and waist circumference, respectively. In conclusion, in our cohort of obese children and adolescents, daytime and night-time hypertension were associated with activation of the sympathoadrenal system and worst metabolic conditions, respectively.

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Authors and Affiliations

  1. Unit of Metabolic Diseases and Diabetes, Istituto Auxologico Italiano, Milan, Italy

    L Gilardini, B Pontiggia & C Invitti

  2. Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milan, Italy

    G Parati

  3. Department Cardiology, S Luca Hospital, Istituto Auxologico Italiano, Milan, Italy

    G Parati

  4. Department of Auxology, Istituto Auxologico Italiano, Piancavallo, Italy

    A Sartorio & G Mazzilli

Authors
  1. L Gilardini
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  2. G Parati
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  3. A Sartorio
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  4. G Mazzilli
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  5. B Pontiggia
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  6. C Invitti
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Correspondence to C Invitti.

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Gilardini, L., Parati, G., Sartorio, A. et al. Sympathoadrenergic and metabolic factors are involved in ambulatory blood pressure rise in childhood obesity. J Hum Hypertens 22, 75–82 (2008). https://doi.org/10.1038/sj.jhh.1002288

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  • DOI: https://doi.org/10.1038/sj.jhh.1002288

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