Hidden hypertension and early cardiac alterations: insights from ambulatory blood pressure monitoring in children and adolescents

Diagnostic Value of Ambulatory Blood Pressure Monitoring for Hypertension in Private Cardiology Practice in Senegal

Hypertension is a major contributor to cardiovascular morbidity and mortality. Ambulatory blood pressure monitoring (ABPM) complements office blood pressure measurement by detecting white-coat hypertension, masked hypertension, and nocturnal blood pressure abnormalities, and this study aimed to assess its diagnostic value in the management of hypertension in private cardiology practice in Senegal. A prospective, descriptive, and analytical study was conducted from July to September 2024 at Clinique Urgence Cardio in Dakar, including patients aged 18 years or older with a valid 24-hour ABPM recording. Clinical, anthropometric, and treatment data, together with cardiovascular risk factors, were collected; office and ambulatory blood pressure measurements were compared; and logistic regression was used to identify factors associated with discordance between the two methods. Of the 104 patients assessed, 97 had valid ABPM recordings. The mean age was 53.2 ± 14.1 years, and women predominated. Cardiovascular risk factors included abdominal obesity (77.3%), known hypertension (54.6%), physical inactivity (43.3%), dyslipidemia (37.1%), and diabetes (16.5%). Mean office blood pressure was 145.7/91.4 mmHg, compared with 130.5/80.2 mmHg over 24 hours, 134.4/82.4 mmHg during daytime, and 125/75 mmHg during nighttime. ABPM identified sustained hypertension in 53.61% of patients, white-coat hypertension in 18.56%, masked hypertension in 9.28%, and normotension in 18.56%, with overall agreement between office and ambulatory measurements of 72.2%. Among patients with elevated office blood pressure, 25.7% had white-coat hypertension, while 33.3% of those with normal office blood pressure had masked hypertension. Non-dipping and reverse-dipping patterns were observed in 45.4% and 19.6% of patients, respectively, and discordance was independently associated with alcohol consumption (OR = 5.08; p = 0.007). ABPM improves the diagnostic classification of hypertension and reveals a high prevalence of discordant phenotypes and nocturnal blood pressure abnormalities, and wider use of ABPM may help optimize patient management in this setting.

The role of preventive cardiology in children.

PURPOSE OF REVIEW This review examines prevalence, diagnosis, and management strategies for cardiovascular risk factors including dyslipidemia, hypertension, and obesity in children and adolescents. As these risk factors begin in childhood and track into adulthood, early intervention is important in preventing cardiovascular disease, the leading cause of mortality in the United States. RECENT FINDINGS The American Heart Association's Life's Essential 8 characterizes components of cardiovascular health including health behaviors (diet, exercise, sleep, tobacco use) and health factors (blood lipids, blood pressure, blood glucose, and weight). Optimizing these health metrics is associated with favorable overall and cardiovascular health (CVH) outcomes. In the United States, prevalence of hypertension, obesity, and cardiovascular disease is projected to rise over the next decade, while hypercholesterolemia is declining. While lifestyle modifications remain a cornerstone in care, new pharmacotherapeutic options have emerged for children over the past several years to treat dyslipidemia and obesity. SUMMARY Pediatric clinicians have an important role in counseling and supporting CVH in children. This review examines aspects of CVH that are commonly managed in preventive cardiology programs, focusing on diagnostic evaluation and treatment strategies, highlighting new and emerging therapies for children and adolescents, including pharmacotherapy and latest research on effective lifestyle modifications.

Early Screening of Diabetes Mellitus Through Blood Glucose Level Examination

Although the sample size was limited, the proportion of abnormal findings underscores the relevance of community-based screening as a preventive strategy, and community health screening is a feasible and practical approach for early risk detection of non-communicable diseases.

Bio Hypertension in young university students: analysis of risk factors in medical students

Prevalence of Metabolic Syndrome in Children with Obesity

Background: Childhood obesity has risen sharply over the past decades, leading to increased cardiometabolic ‘ risks. Metabolic syndrome (MS), characterized by central obesity, dyslipidemia, hypertension, and impaired glucose metabolism, poses significant long-term health threats in children. Aim: To assess the prevalence of metabolic syndrome in South Asian children with obesity and examine associated anthropometric and biochemical parameters. Methodology: A hospital-based cross-sectional study was conducted in 80 children aged 3–16 years attending the Department of Pediatrics, Shree Narayan Medical Institute & Hospital, Saharsa, Bihar, India. Anthropometric measurements, blood pressure, and fasting biochemical profiles were recorded. MS was defined using modified IDF criteria. Results: Among 80 participants, 18 children (22.5%) met criteria for MS. Central obesity was most prevalent (62.5%), followed by elevated triglycerides (35%), low HDL-C (27.5%), hypertension (22.5%), and impaired fasting glucose (15%). Children with MS had significantly higher BMI, waist circumference, triglycerides, blood pressure, and fasting glucose, and lower HDL-C than those without MS (p<0.05). Girls demonstrated greater susceptibility to central obesity and dyslipidemia. Conclusion: Metabolic syndrome affects a substantial proportion of South Asian children with obesity. Early screening and targeted lifestyle interventions are essential to mitigate long-term cardiovascular and metabolic risks.

Adolescent hypertension: a growing public health concern in western Maharashtra

Background: As change in lifestyle and food habits in recent years, increased prevalence of high blood pressure among adolescents is observed. Multiple studies have demonstrated that elevated blood pressure in childhood often persist into adulthood. Therefore, early screening is essential to identify adolescents at increased risk of developing hypertension later in life. The study was conducted with objective to estimate proportion of high blood pressure and to identify factors influencing blood pressure. Methods: A cross-sectional analytical study was conducted among 254 adolescents from 5th to 10th grade at secondary schools at Malakapur, Karad, using systematic sampling technique. Data collection was done using a structured questionnaire, a digital sphygmomanometer, an inelastic tape to measure height, an elastic tape to measure waist circumference and weighing machine. Data entry was performed by using Microsoft Excel for Microsoft 365 for windows. Descriptive statistics (percentage/proportion) and Analytical statistics (chi square test) were applied using SPSS Version 27.0. Results: Among 254 adolescents aged 10-17 years, 13% had elevated blood pressure, 7.1% had stage 1 hypertension (HTN), and 5.9% had stage 2 hypertension. Hypertension was significantly more common among male adolescents (17.9% elevated BP and 16.9% HTN) compared with females (9.2% elevated BP and 9.8% HTN) (p=0.017). Overweight and obese adolescents had a significantly higher proportion of HTN compared with those with normal BMI (p<0.001). Conclusions: School based evaluation offers a practical platform to detect influencing lifestyle and behavioral factors. Early identification enables targeted health education and preventive interventions.