updated 8:09 PM BST, Sep 30, 2021

2021 July-September Volume 7 Issue 3

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INVITED REVIEW

Post-COVID-19 sequelae or persistent COVID-19 disease

Victor A. Voicu
Romanian Academy, Bucharest, Romania

Abstract

The post-COVID-19 syndrome, post-acute COVID-19, long-term COVID, long-COVID, or post-sepsis syndrome terminology suggests that COVID-19 disease is frequently persistent. COVID-19 induces sequelae of variable severity and clinical significance in multiple systems and organs affected by the acute disease. The post-COVID-19 condition is an umbrella term for a complex, multisystemic disease that immediately or even after apparent recovery follows the acute phase of COVID-19, irrespective of severity. This review discusses the multiple manifestations, causes, and current treatment and evaluation recommendations in the post-COVID-19 syndrome.

J Hypertens Res (2021) 7(3):84–88 [download PDF]

REVIEW

High blood pressure in children and adolescents - a review of diagnosis and management

Silvia Deaconu 1, 2, Gabriela Marascu 1, Alexandru Deaconu 1, 2, Maria Dorobantu 1, 2
1 Department of Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
2 Department of Cardiology, Clinical Emergency Hospital, Bucharest, Romania

Abstract

Hypertension (HTN) is an important risk factor for cardiovascular morbidity and mortality in both adults and children. Previous studies have suggested that elevated blood pressure values in childhood were associated with the development of HTN in adult life. Secondary HTN is seen more often in children and adolescents, but the prevalence of essential HTN is increasing due to the global pediatric obesity epidemic. HTN is frequently underdiagnosed in childhood because blood pressure values vary with age, sex, and height, and guidelines propose different cut-offs to define pediatric HTN. It is mandatory for clinicians to know how to distinguish primary from secondary HTN, identify target organ damage and apply necessary interventions to control blood pressure.

J Hypertens Res (2021) 7(3):89–95 [download PDF]

ORIGINAL ARTICLES

Correlation between caffeinated soft drinks consumption and overweight/hypertension in Romanian children and adolescents: results of a cross-sectional survey

Eliza Cinteza 1, 2 *, Dan Stefan 2, Cristiana Voicu 2, Alin Nicolescu 2, Mihaela Balgradean 1, 2
1 Department of Pediatric Cardiology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
2 Department of Pediatric Cardiology, Marie Curie Emergency Children’s Hospital, Bucharest, Romania

Abstract

Knowledge of the existence of a prolonged action of cardiovascular risk factors since childhood is extremely important in a country with one of the highest cardiovascular mortality in Europe. We aimed to identify a possible correlation between caffeinated soft drinks consumption (CSDC) and overweight/hypertension in Romanian children and adolescents. Children and adolescents (2407 males, 2459 females), aged 3 to 17 years from Bucharest and Ilfov County were admitted in a cross–sectional survey. Body weight, height, and blood pressure (BP) were measured and the percentiles for height, BP and body mass index were established. An interviewer-administered questionnaire about CSDC and other presumed risk factors was used. The prevalence of AH in our population was 7.4%. AH prevalence was higher both in overweight (12.4%) and obese (24.4%) groups comparing with normal weight (5.8%), (P<0.0001). Daily CSDC was present in 10.4% of all children and adolescents. 10.2% of the obese children and adolescents (n=82) were daily CSDC. Regarding correlations with AH, 12.5% of the daily CSDC were hypertensives (n=45) and 9.7% of the hypertensive children and adolescents are daily CSDC. We found no significant correlation between AH in children and adolescents, overweight/obesity and consumption of caffeinated beverages, family history of cardiovascular disease, smoking, low birth weight, sleep disorders and abnormal sleep duration, absence of extra-school sport activity. The high AH prevalence together with overweight or obesity represent cardiovascular risk factors, identified within our population but we could not establish a statistically significant correlation with CSDC.

J Hypertens Res (2021) 7(3):96–101 [download PDF]

The role of echocardiography in risk stratification of excess weight, hypertensive children

Cristina Ramona Radulescu 1 *, Ioana Adriana Ghiorghiu 1, 2, Ana-Maria Berchimis 2, 3, Mihaela Dascalasu 1, 2, 3, Gabriela Vlad 2, Doina Anca Plesca 1, 2
1 Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
2 Department of Pediatrics, Dr. Victor Gomoiu Clinical Children’s Hospital, Bucharest, Romania
3 Ponderas Academic Hospital, Bucharest, Romania

Abstract

Given the increasing burden of excess weight in pediatric patients and its relationship with blood pressure (BP) levels, we employed echocardiography to identify cardiac changes in a cohort of excess-weight children and the potential additional effect of raised BP. Forty-six excess-weight children and 28 normal weight controls underwent clinical examination, ambulatory blood pressure monitoring (ABPM), and echocardiography. Left ventricular (LV) mass was similar in the two groups when normalizing to body surface area (BSA). LV mass was greater in excess-weight children by normalizing to height to a power of 2.7 (t(58)=3.27, p=0.002, C.I.[1.97, 8.19]) and also to height to a power of 2.16 with a correction factor of 0.09 (t(70.33)=3.98, p<0.001, 95% C.I. [2.5, 7.51]). Left ventricular hypertrophy (LVH), defined as >45g/m2.16 was present in 13 participants (28.3%) from the excess weight arm and one participant (3.7%) from the control arm (p=0.012). One excess weight participant (2.17%) exhibited LVH based on the >51g/m2.7 threshold and none when LV mass was normalized to BSA. Relative wall thickness (RWT) was significantly higher in the excess weight group (M=0.41, SD=0.5) compared to controls (M=0.38, SD=0.4), t(71)=2.36, p=0.021, C.I. [0.004, 0.049]. Neither LV wall thickness, LV mass, presence of LVH, nor RWT correlated with abnormal BP levels. We could not demonstrate a clear connection between the observed minor changes and BP status. Depending on the severity and duration of exposure to risk factors, an echocardiogram may point out subtle changes in cardiac size and geometry; such features will identify children at greater risk.

J Hypertens Res (2021) 7(3):102–108 [download PDF]

Child and adolescent hypertension – a public health matter. The point of view of a family medicine team

Valeria Herdea 1, 2, Ileana Brinza 2 *, Liliana Chitanu 2, Raluca Ghionaru 2, Laura Comnea 2, Petruta Tarciuc 1, 2, Diana Herdea 3, Smaranda Diconescu 4
1 Department of Family Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
2 Romanian Association for Pediatric Education in Family Medicine (AREPMF), Bucharest, Romania
3 Department of Pediatric Cardiology, Sf. Ioan Hospital, Bucharest, Romania
4 Department of Pediatrics, Gr. T. Popa University of Medicine and Pharmacy, Iasi, Romania

Abstract

High blood pressure (HBP) is a global public health issue. The disease affects over 1 billion people, 1 in 4 men, 1 in 5 women, 60% people over 60, and causes 7.1 million deaths annually. Between 4–24% of children and adolescents may have hypertension. Our working hypothesis was that in schoolchildren between 6–21 years old, with a family risk of hypertension, obesity, diabetes, mental illness, there is a correlation between obesity and pathological blood pressure values (BP). Our purpose was to evaluate the role of health education in controlling risk factors, and our objectives were identifying the personal risk factors of the participants, mapping the familial risk factors allow to prepare the “Family Predictive Model” and develop the educational strategy for a healthy lifestyle in the 6–21 age group. Between 2017–2021, an observational, prospective study was carried out in primary health care with two study stages, targeting the educational intervention. Two groups of 36 children were monitored: female/male ratio – 2/1, urban/rural – 33/3. Monitored parameters: weight (W), height (H), blood pressure (BP), body mass index (BMI), personal, intrafamilial, and environmental risk factors that can influence children’s health were assessed. Families were involved as well. We found that the cardio-metabolic pathology of the child and adolescent can be influenced by family history, that overweight/obesity in the context of persistence of environmental risk factors may associate child hypertension, and that early education for a healthy lifestyle, accessible from school age, can be an effective mechanism for controlling the evolution towards chronic diseases.

J Hypertens Res (2021) 7(3):109–118 [download PDF]