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Open Access 22-06-2023 | Hypertension | Original Article

Association between lifestyle modifications and improvement of early cardiac damage in children and adolescents with excess weight and/or high blood pressure

Authors: Simonetta Genovesi, Elena Tassistro, Marco Giussani, Laura Antolini, Giulia Lieti, Antonina Orlando, Massimo Montemerlo, Ilenia Patti, Gianfranco Parati

Published in: Pediatric Nephrology | Issue 12/2023

Abstract

Background

It is not known whether, in children and adolescents with alterations in weight and/or blood pressure (BP), lifestyle modifications are associated with an improvement of early cardiac damage.

Methods

In a pediatric population referred for excess weight, high BP, or both (n = 278, 10.6 (2.3) years), echocardiography was performed at enrollment and after 15 months of follow-up, during which participants received nonpharmacological treatment, based on correcting unhealthy lifestyles and improving dietary habits. Left ventricular mass was indexed for height (g/m^2.7, LVMI), and an LVMI value higher than or equal to age- and gender-specific 95^th percentile was the criterion for defining left ventricular hypertrophy (LVH). Multiple linear and logistic regression analyses were carried out to determine associations between changes in BMI and BP z-scores and changes of LVMI values and LVH prevalence, from baseline to follow-up.

Results

At baseline, 33.1% of study participants were hypertensive, 52.9% obese, and 36.3% had LVH. At follow-up, the prevalence of hypertension, obesity, and LVH was 18.7%, 30.2%, and 22.3%, respectively (p < 0.001 for all). A decrease in LVMI from 37.1 to 35.2 g/m^2.7 (p < 0.001) was observed. Only delta BMI z-score positively related to an improvement of LVMI. Reductions of BMI (OR = 0.22, 95% CI 0.07–0.64) and diastolic BP (OR = 0.64, 95% CI 0.42–0.93) z-scores from baseline to follow-up and family history of hypertension (OR = 0.36, 95% CI 0.16–0.78) were associated with a lower prevalence of LVH.

Conclusions

In a pediatric population at cardiovascular risk, changing incorrect lifestyle and dietary habits is associated with both reduction of BMI and BP values and regression of early cardiac damage.

Graphical abstract

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Title: Association between lifestyle modifications and improvement of early cardiac damage in children and adolescents with excess weight and/or high blood pressure
Authors: Simonetta Genovesi
Elena Tassistro
Marco Giussani
Laura Antolini
Giulia Lieti
Antonina Orlando
Massimo Montemerlo
Ilenia Patti
Gianfranco Parati
Publication date: 22-06-2023
Publisher: Springer Berlin Heidelberg
Keywords: Hypertension
Obesity
Obesity
Hypertension
Lifestyle Modifications
Published in: Pediatric Nephrology / Issue 12/2023
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-023-06034-5

At a glance: The STEP trials

Springer Medicine

Association between lifestyle modifications and improvement of early cardiac damage in children and adolescents with excess weight and/or high blood pressure

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

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