A sex-related mediating effect of uric acid in the association between body composition and blood pressure in children and adolescents.

The increase in blood pressure (BP) during somatic growth might have direct determinants but also mediating factors. We investigated whether uric acid (UA) and other metabolic factors would mediate the association between body composition components and BP. A cross-sectional study was conducted in 928 children and adolescents (aged 6-18 years), in which body composition and blood biochemistry were evaluated. Structural equation modeling was performed to test the direct and indirect pathways between systolic blood pressure (SBP) and body composition parameters. Muscle mass (MM) showed a strong direct effect on BP, regardless of sex. In girls, a mediating pathway through UA was not significant, but the association between fat mass (FM) and MM with SBP was mediated by the cluster of metabolic factors. In boys, both MM and FM were associated with SBP through a mediating pathway via UA, but not via the cluster of metabolic factors. The association between body composition and BP in children and adolescents has a complex design and also has a sex-specific mediating component. The increase in the UA levels may affect BP levels early in boys. Also, metabolic changes elicited by FM contribute to the increase in BP at an early age in girls. Novelty: MM showed a strong direct effect on BP, regardless of sex. In girls, the association between FM and MM with SBP was mediated by the cluster of metabolic factors. In boys, both MM and FM were associated with SBP through a mediating pathway via UA.

Muscle mass is the main somatic growth indicator associated with increasing blood pressure with age in children and adolescents.

Studies have shown that lean mass must be an important determinant of blood pressure value in children and adolescents. The absence of adjustment for the collinearity between lean and fat mass (FM), restricted age span, and lack of separate analysis by sex leave a gap in the literature. This study determined direct and indirect effects of the somatic growth indicators linked to the association between age and systolic blood pressure (SBP) in boys and girls. This is a cross-sectional study comprising 1,510 participants (6-18 years). Path analysis was used to test a model in which the association between age and SBP would have a direct and independent component, but also indirect mediating paths through muscle mass (MM), FM, and height. There was no significant association between age and SBP (unstandardized ß ± SE) for both girls (0.072 ± 0.236, P = .761) and boys (0.238 ± 0.264, P = .368). Height was not a mediator for the association between age and SBP in both girls (-0.291 ± 0.156, P = .062) and boys (-0.015 ± 0.187, P = .935). Mediating effect of MM was significant for both girls (0.909 ± 0.137, P < .001) and boys (1.341 ± 0.161, P < .001), whereas mediating path through FM was significant only for boys (0.069 ± 0.023, P = .003). In conclusion, muscle mass was the strongest somatic growth indicator associated with the blood pressure value in children and adolescents. Further increase in body fat mass may affect systolic blood pressure more in boys than in girls.

Long-term intense resistance training in men is associated with preserved cardiac structure/function, decreased aortic stiffness, and lower central augmentation pressure.

OBJECTIVE: There have been contradictory reports regarding resistance exercise and central arterial compliance. The American Heart Association has recommended its use in preventing/treating cardiovascular diseases. We examined the effects of long-term endurance running and intense resistance training on central hemodynamics, compared with healthy control (CON). METHODS: Sixty-nine male participants, 25-50 years [19 intense resistance trained (IRT) group, 21 endurance runners, and 29 CON] were investigated by radial tonometry-pulse wave analysis, pulse wave velocity (PWV), and echocardiogram. Data were expressed as mean ± SE (median). Differences were tested by analysis of variance and analysis of covariance was used to adjust for confounding variables. RESULTS: There were no differences among groups regarding age, height (Ht), brachial and central blood pressure. Resting heart rate (HR) was lower and high-density lipoprotein cholesterol (HDL-C) higher in endurance runners. Weight, peripheral pulse pressure, and pulse pressure amplification were higher and HDL-C lower in the IRT group. Left ventricular mass and creatine phosphokinase were higher in trained participants. Relative wall thickness was similar among groups. The ratio of the velocity of peak E and A waves (E/A) was higher and PWV significantly lower in endurance runners (7.2 ± 0.14 m/s) and IRT (7.5 ± 0.14 m/s) as compared with CON (8.2 ± 0.16 m/s) even after adjustments for age, Ht, HR and mean arterial pressure (MAP), or mean systolic pressure. Differences in central augmentation pressure (cAP) adjusted for age, height, systolic or MAP, PWV, and HR (IRT equal to 0.08 ± 0.9, CON equal to 3.4 ± 0.9 and endurance running equal to 3.6 ± 1) were no longer significant after further adjustments to aortic diameter or weight. CONCLUSION: Long-term resistance training in men is associated with preserved cardiac structure/function, decreased aortic stiffness, and lower cAP.

Long-term use of low-dose spironolactone in spontaneously hypertensive rats: effects on left ventricular hypertrophy and stiffness.

The aim of the present study was to evaluate the effect of low-dose spironolactone initiated during the early stages of hypertension development and to assess the effects of chronic pressure overload on ventricular remodeling in rats. Male spontaneously hypertensive rats (SHRs) (4 weeks) were randomized to receive daily spironolactone (20 mg/kg) or vehicle (mineral oil) from 4 weeks to 8 months of age. Systolic blood pressure was measured non-invasively by tail-cuff pletysmography at baseline, 4 and 8 months. Hemodynamic assessment was performed at the end of treatment by arterial and ventricular catheterization. An in situ left ventricular pressure-volume curve was created to evaluate dilatation and wall stiffness. Systolic blood pressure at 1 month of age was higher in SHRs than in the Wistar group; it increased throughout the follow-up period and remained elevated with treatment (Wistar: 136 ± 2, SHR: 197 ± 6.8, SHR-Spiro: 207 ± 7.1 mmHg; p < 0.05). Spironolactone reduced cardiac hypertrophy (Wistar: 1.25 ± 0.03 SHR: 1.00 ± 0.03, SHR-Spiro: 0.86 ± 0.02 g; p < 0.05) and left ventricular mass normalized to body weight (Wistar: 2.51 ± 0.06, SHR: 2.70 ± 0.08, 2.53 ± 0.07 mg/g; p < 0.05). Moreover, the left ventricular wall stiffness that was higher in SHRs was partially reduced by spironolactone treatment (Wistar: 0.370 ± 0.032; SHR: 0.825 ± 0.058; SHR-Spiro: 0.650 ± 0.023 mmHg/ml; p < 0.05). Our results show that long-term spironolactone treatment initiated at the early stage of hypertension development reduces left ventricular hypertrophy and wall stiffness in SHRs.