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|Pathology of the circulatory system, blood vessels. Cardiovascular complaints (606)|
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MĂTRĂGUNĂ, Nelea; COJOCARI, Svetlana; BICHIR-THOREAC, Liliana. Factorii de risc asociați hipertensiunii arteriale la copii. In: Buletin de Perinatologie. 2019, nr. 3(84), pp. 57-74. ISSN 1810-5289.
|Buletin de Perinatologie|
|Numărul 3(84) / 2019 / ISSN 1810-5289|
Background. Essential hypertension (HT) is a multifactorial pathology, which may have its roots in childhood. Some of the risk factors are present from the intrauterine period, others appear in childhood and evolve, and therefore they persist throughout the life. Purpose of the study: Estimation of risk factors that cause the appearance of hypertension in children. Research material and methods: The study included 115 hypertensive children, aged 10-18 years, which were divided into 3 research groups: group I – 35 normal weight hypertensive children (HT, NW), group II – 36 overweight hypertensive children (HT, OW) and group III – 44 obese hypertensive children (HT, OB). Risk factors were estimated according to a specially developed questionnaire. Homocysteine (HC) was assessed by ion-exchange liquid chromatography method, and 25 OH vit D was determined by the immunochemical method with chemiluminescence detection (CLIA). Results: Most children with HT in the research, in the category of OW and OB have a sedentary lifestyle and an unbalanced diet. Among prenatal risk factors, feeding errors were noted during pregnancy (p <0.01), which were more frequent in the mothers of children, who were associated with HT and OB (group III of the research). The highest serum values of HC, relative to the control group, were found in children, which were associated with 2 risk factors – HT and OB (13.24 ± 0.8888 vs. 6.1 ± 0.23 mol / L; p <0.001). The lowest values of 25-OH vit D, relative to the control group, had children, which were associated with HT and OB (18.21 ± 0.835 vs. 32.22 ± 0.48 ng / mL; p <0.001), or were associated with HT and OW (20.5 ± 0.96 vs. 32.22 ± 0.48 ng / mL; p <0.001). 25-OH vit. D was negatively correlated with lipid profile parameters, proinflammatory markers and serum and urinary catecholamines. Conclusions: • Family planning, improving the health of parents in order to prevent premature pregnancies, giving birth to children with low birth weight, encouraging long-term natural nutrition could reduce the number of children suffering from HT and OB. • The modifiable risk factors must be influenced (removed or at least diminished) through a responsible attitude, which must be directed towards the pediatric population exposed to the increasing risk. • Although some evidence has been presented, which demonstrates the role of hypovitaminosis D and hyperhomocysteinemia in achieving HT and OB, further studies are needed to demonstrate the causal link.
risk factors, children, high blood pressure, obesity,
факторы риска, дети, артериальная гипертензия, ожирение