Original ArticleAdiposity Has Unique Influence on the Renin-Aldosterone Axis and Blood Pressure in Black Children
Section snippets
Methods
The study design and data collection process were previously described.11, 12 Briefly, subjects were healthy black and white young people recruited from 33 participating schools in Indianapolis. The schools were selected to provide a range in socioeconomic status. Those with a history of cardiac and kidney disease, hypertension, diabetes mellitus, and those taking medications that can affect BP were excluded. Although subjects were followed prospectively with measurements of BP, height, and
Results
Five hundred ninety-three subjects contributed a total of 728 visits where blood samples were collected. Of these, 134 subjects contributed multiple blood samples during the course of follow-up. Demographic and clinical characteristics of the study subjects are presented in Table I. For continuous variable we reported mean values and 95% CI estimates. On average, blacks were slightly younger than whites (14.21 vs 15.10 years; P < .001), and had greater BMI (24.41 vs 22, P < .001), greater
Discussion
Obesity, which has taken on an alarmingly high prevalence and more so in blacks than in whites,16, 17 is a major contributor to the risk for hypertension.18, 19 Previous studies in adolescents as well as in adults have shown that levels of adiposity can be accompanied by increases in aldosterone production.6, 7, 20, 21 In the present study, we also found that PAC increased with BMI, but only in white subjects (Figure 1, A). In black subjects, on the other hand, there was little evidence that
References (28)
- et al.
The role of aldosteronism in causing obesity-related cardiovascular risk
Cardiol Clin
(2010) - et al.
Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents
Am J Clin Nutr
(2002) - et al.
Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents
J Pediatrics
(2004) - et al.
Clinical and genetic correlates of serum aldosterone in the community: the Framingham Heart Study
Am J Hypertens
(2005) - et al.
High blood pressure trends in children and adolescents in national surveys, 1963 to 2002
Circulation
(2007) Hypertension in children and adolescents: epidemiology and natural history
Pediatr Nephrol
(2010)- et al.
Obesity hypertension in adolescents: epidemiology, evaluation, and management
J Clin Hypertens (Greenwich)
(2011) - et al.
The effect of weight loss on the sensitivity of blood pressure to sodium in obese adolescents
New Engl J Med
(1989) - et al.
Aldosterone in obesity
Endocr Res
(1998) - et al.
Body mass index predicts aldosterone production in normotensive adults on a high-salt diet
J Clin Endocr Metab
(2007)
Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988-1994 and 1999-2004
Hypertension
Racial differences in aldosterone excretion and plasma aldosterone concentrations in children
New Engl J Med
Plasma levels of prorenin and renin in blacks and whites: their relative abundance and associations with plasma aldosterone concentration
Am J Hypertens
Synchronization of adolescent blood pressure and pubertal somatic growth
J Clin Endocrinol Metab
Cited by (11)
Obesity is Associated with Higher Blood Pressure and Higher Levels of Angiotensin II but Lower Angiotensin-(1-7) in Adolescents Born Preterm
2019, Journal of PediatricsCitation Excerpt :Distributional characteristics of the outcomes were improved with natural logarithmic transformation in the models. We employed directed acyclic graphs to determine potentially confounding factors based on the literature a priori and identified race and antenatal corticosteroid exposure in our minimally sufficient set of confounders for inclusion in the models.10,11,19 We used Enterprise Guide software, v 7.11 of the SAS System for Windows (SAS Institute Inc, Cary, North Carolina) for all analyses.
Salt Sensitivity in Childhood Hypertension
2023, Pediatric Hypertension: Fifth EditionSalt sensitivity of blood pressure in childhood and adolescence
2022, Pediatric NephrologyDiagnosis and management of endocrine hypertension in children and adolescents
2020, Current Pharmaceutical DesignModel selection in multivariate semiparametric regression
2018, Statistical Methods in Medical ResearchDietary sodium intake and its relationship to adiposity in young black and white adults: The African-PREDICT study
2018, Journal of Clinical Hypertension
Funded by the National Institutes of Health (RO1 HL095086) and a Veterans Administration Merit Review Award. The authors declare no conflicts of interest.