Sol Londe

Blood Pressure in Children: As Determined Under Office Conditions

From painstaking measurements of the supine blood pressure in 735 healthy boys and 738 healthy girls, this study done in St. Louis, Mo., establishes needed refer ence standards for both 80 and 90 per cent ranges of both systolic and diastolic blood pressure readings.

Blood pressure in a high school population

This is a report on the initial findings from an ongoing study of blood pressure in ninth to twelfth grade students in the St. Louis metropolitan area. The purpose was to establish standards, to determine the. incidence of hypertension, and to examine the relationship of blood pressure to age, weight, height, sex, and race. Subjects with persistent hypertension were to be investigated and checked annually as long as long as they were in high school. Students in the ninth grade at the beginning of the project were to be screened each year for four years.

Blood Pressure Standards for Normal Children As Determined Under Office Conditions

Standards for auscultatory blood pressure determinations under office conditions in 120 three-year olds are given here, to supple ment standards published previously for children aged four through 15. Discussed also are suggested thresholds for diagnosing hypertension; improved methods of obtaining reliable pressure readings in three-year olds; and some relationships of blood pressure to weight and height.

High blood pressure in children: Problems and guidelines for evaluation and treatment☆

Evidence is presented from studies of the authors and of other investigators that primary hypertension is more common in children than was previously thought. Ninety-five percent of 131 asymptomatic children with incidental hypertension were considered to have primary hypertension after investigation for possible causes. The definition of hypertension was based on normal ranges of blood pressure for each age and sex. However, the definition of juvenile hypertension is still unsettled as is the question of treatment. Investigation of the effect of prolonged antihypertensive therapy on growth and development is needed. Primary hypertension in the young makes possible the study of the disease at its inception.

Blood pressure and puberty

The purpose of this investigation was to study the relation of blood pressure to sexual maturation in 229 boys and 189 girls, 10 to 14 years of age. The results showed that there was no significant correlation between the systolic and diastolic pressure with the level of serum follicule-stimulating hormone and luteinizing hormone in either sex. Nor was there a significant correlation with the stage of pubic hair development in the boys nor with the stage of breast development, menarche, and duration since menarche in the girls. Therefore the presence of hypertension during 10 to 14 years of age should not be regarded as a physiologic response to pubertal development, but rather as a suspicious finding which deserves careful follow-up examinations.

Blood pressure in a high school population: II. Clinical profile of the juvenile hypertensive

One-hundred-fourteen hypertensive high school students were evaluated to determine whether a distinctive clinical profile could be identified; 71 normotensive students served as controls. Selected blood chemistry determinations, urinalysis, and chest roentgenograms were done to help rule out secondary causes of hypertension. Left ventricular function was assessed by echocardiography and systolic time intervals. The hemodynamic response to exercise was also evaluated. A significant number of the subjects 14 to 18 years of age with persistent systolic and/or diastolic pressure 1.65 SD above the mean for age and sex showed the following: obesity; elevated serum triglyceride concentration; basilar hypertrophy by electrocardiogram/vectorcardiogram; electromechanical systole and pre-ejection period shorter, and the ratio of the pre-ejection period over the left ventricular ejection time lower, than mean for age and sex as determined by systolic time intervals; volume indices depressed and cardiac contractile functions elevated as determined by echocardiography; higher blood pressure at start of exercise stress test and higher peak systolic and diastolic pressures during test, and a slower return of heart rate to base line level after the test. The above findings should be useful in following the course of a young individual with essential hypertension and may provide a means of evaluating therapeutic intervention.

HEMODYNAMIC |[lpar]|HD|[rpar]| FEATURES OF HYPERTENSION AMONG HIGH SCHOOL STUDENTS

HD of 111 hypertensive (H) high school students and their response to exercise were determined by non-invasive techniques and compared with 67 normotensive (N). Left ventricular ejection time (LVET) and pre-ejection period (PEP) were determined from simultaneously recorded electrocardiogram (ECG), phonocardiogram and external carotid pulse tracings, cardiac index (CI), ejection fraction (EF), mean velocity of circumferential fiber shortening (Vcf) and percent shortening of internal diameter (SID) of the left ventricle were measured by echocardiography. Exercise was performed on a bicycle ergometer against 3 work loads ending with a 10 minute rest period. Heart rate (HR) and blood pressure (BP) were monitored during and after the exercise. ECG-VCG showed mild left ventricular hypertrophy in 40% of male H and 19% of female H. PEP was significantly shortened, PEP/LVET decreased in H when compared with N. CI was lower and EF, Vcf and SID higher in the H. The peak HR and BP during exercise in H were significantly higher and their return to baseline levels slower than N. The HD response to exercise was not significantly different between H and N. This study suggested that young H have an identifiable hemodynamic profile.