Thoracic Aortic Intima-Media Thickness in Preschool Children Born Small for Gestational Age.

OBJECTIVE: To assess thoracic aortic intima-media thickness (aIMT) as a marker of thoracic aortic remodeling in children born small for gestational age (SGA). STUDY DESIGN: We assessed thoracic aIMT, carotid intima-media thickness (cIMT), and pulse wave velocity (PWV) in 239 patients (117 SGA; 122 appropriate for gestational age controls) age 6-8 years. Each SGA participant was matched 1:1 based on sex, gestational age, and birth date. Thoracic aIMT was determined by 2-dimensional transthoracic echocardiography. RESULTS: SGA children showed a significant increase in both aIMT (0.89 mm [0.12] vs 0.79 mm [0.11], P < .001) and cIMT (.50 mm [0.05] vs 0.49 mm [0.04], P < .001) compared with appropriate for gestational age controls, but the magnitude of the difference in aIMT was greater than that in cIMT (standardized difference of the means: +84% vs +27%). aIMT was linearly correlated with aortic arch PWV as measured by echocardiography (r = 0.211, P < .001) but not with carotid-femoral PWV (r = 0.113, P = .111). Born SGA was independently associated with increased aIMT after controlling for perinatal, anthropometric, and biochemical determinants in linear regression models. CONCLUSIONS: SGA children exhibit increased thoracic aIMT and aortic arch PWV in early childhood that may suggest the presence of structural changes in the thoracic aorta wall architecture. Measurement of ascending aIMT by transthoracic echocardiography is feasible and reproducible and may be a useful marker of vascular disease.

Scientific mapping of the research output on hypertension in children and adolescents, 2010-2018.

OBJECTIVE: The area of pediatric hypertension (HTN) research has seen substantial progress over the last two decades, but no bibliometric analysis has yet been undertaken to describe these advances. This study aims to describe the published research examining HTN in children and adolescents from 2000 to 2018. METHODS: Articles were retrieved using PubMed and the Web of Science. Analyses were performed to quantify the evolution of scientific output, identifying the leading journals, authors, and countries as well as the existing collaboration networks. Likewise, we identified the most cited articles, describing their document type, main topic focus, and the age of the patients studied. RESULTS: In total, we identified 8317 articles in the Web of Science. The annual number of publications doubled over the study period. Articles were published in 1415 journals, mainly in the categories of Peripheral & Vascular Diseases and Pediatrics. The USA dominated scientific production in the field. Regarding researcher productivity, the top 202 authors participated in 20% of the articles, and there were 47 stable research clusters, with the largest component made up of 17 authors. Altogether, there were 145 most cited articles, with an irregular annual distribution; about half focus on HTN itself, while the rest study associated disorders and conditions. CONCLUSION: This is the first study to analyze scientific output on HTN in children and adolescents. The snapshot that emerges is of a research area that is growing but is still in a relatively early phase of development.

[Examining hypertension in children and adolescents: Clinical implications of the differences between the European and American Guidelines]. / La hipertensión arterial en niños y adolescentes a examen: implicaciones clínicas de las diferencias entre la Guía Europea y la Americana.

Over the past 2 years, new guidelines for hypertension in children and adults have been published. The first, developed by the European Hypertension Society Working Group on Hypertension in Children and Adolescents, recognised the need for an update of the of the 2009 European Guidelines of in order to incorporate the new information acquired over the last few years. Subsequently, an update of the American guidelines (the most recent of which was in 2004), has been published. In both guidelines there are aspects which are agreed on, and in others, there are marked differences in the basic elements that have an influence on daily clinical practice. The main differences are centred on the criteria for the diagnosis and classification of hypertension, with the subsequent impact on its prevalence. Future studies should offer responses to all the questions that still remain unresolved.