A comparison of health and fitness-related variables in a small sample of children of Japanese descent on 2 continents

OBJECTIVE: To compare physical characteristics, health and fitness-related variables, and nutrient intake between children of Japanese ancestry living in the United States and Japan. DESIGN: Cross-sectional study. SETTING: Miami, Fla, and Tsukuba, Japan. SUBJECTS: Fourteen children of Japanese descent living in the United States and 14 sex- and age-matched children living in Japan. MAIN OUTCOME MEASURES: US and Japanese resident groups were compared on physical characteristics, health and fitness-related variables, and nutrient intake using the t test for paired samples. To assess differences between groups in variables not statistically significant, effect sizes were calculated using the Cohen d test of standardized differences. RESULTS: The following significant differences were found between US and Japanese resident groups, respectively: body mass index, 19.3 and 16.9, P =.02; percentage of body fat, 22.0% and 14.3%, P =.002; diastolic blood pressure, 65.8 and 58.9 mm Hg, P =.01; total cholesterol, 169.8 and 138.7 mg/dL (4.39 and 3.59 mmol/L, P =.001); low-density lipoprotein cholesterol, 108.2 and 88.0 mg/dL (2.80 and 2.28 mmol/L, P =.01); triglycerides, 92.5 and 59.0 mg/dL (1.04 and 0.67 mmol/L, P =.02); percentage of fat intake, 26.1% and 20.3%, P =.001; percentage of saturated fat intake, 7.9% and 6.1%, P<.002; percentage of carbohydrate intake, 57.9% and 63.9% (P =.004); vertical jump, 28.9 and 34.4 cm, P =.02; and flexibility, 58.2 and 42.6 cm, P =.002. Using the Cohen d test, US residents showed a moderately greater systolic blood pressure (107.5 vs 101.9 mm Hg, P =.10) and leg strength (81.5 vs 55.8 kg, P =.11) than did Japanese residents. CONCLUSIONS: A small sample (n = 14) of children of Japanese descent living in Florida showed more adverse health-related characteristics than did a comparable group of their peers living in Japan. The results are probably related to differences in their diets. It remains to be seen whether the differences in diets are related to where the children live.     

Placental weight, birth measurements, and blood pressure at age 8 years

OBJECTIVE: To examine relationships between blood pressure during childhood and both placental weight and body size at birth, in an Australian population. DESIGN: A follow up study of a birth cohort, undertaken when cohort members were aged 8 years. SETTING: Adelaide, South Australia. SUBJECTS: 830 children born in the Queen Victoria Hospital in Adelaide, South Australia, during 1975-6. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressure measured when the children were aged 8 years. RESULTS: Blood pressure at 8 years was positively related to placental weight and inversely related to birth weight, after adjusting for the child's current weight. For diastolic pressure there was a decrease of 1.0 mm Hg for each 1 kg increase in birth weight (95% confidence interval (CI) = -0.4 to 2.4) and an increase of 0.7 mm Hg for each 100 g increase in placental weight (95% CI = 0.1 to 1.3). Diastolic pressure was also inversely related to chest circumference at birth, independently of placental weight, with a decrease of 0.3 mm Hg for each 1 cm increase in chest circumference (95% CI = 0.2 to 0.5). CONCLUSIONS: These findings are further evidence that birth characteristics, indicative of fetal growth patterns, are related to blood pressure in later life.     

Impact of overweight and obesity in carotid intima-media thickness of portuguese adolescents

Aim: To measure carotid intima‐media thickness (cIMT) in obese, overweight and normal‐weight Portuguese adolescents, to evaluate the association between body weight early signs of atherosclerosis. Methods: Cross‐sectional study, enrolling 150 adolescents (50 normal weight, 50 overweight and 50 obese) with mean age of 12.9 years. All underwent clinical, analytical and carotid common artery ultrasonographic evaluation. Results: After adjusting for systolic blood pressure and plasma High‐density lipoprotein, Low‐density lipoprotein and Triglycerides levels, higher mean cIMT values were observed in both overweight and obese patients, when compared to normal‐weight group. Moreover, adolescents with metabolic syndrome (MS) had greater cIMT [normal‐weight: cIMT mean 0.418 mm (95% confidence intervals (95% CI) 0.399–0.437); overweight: 0.461 mm (95% CI: 0.444–0.477); obese: 0.472 mm (95% CI: 0.455–0.488); MS: 0.482 mm (95% CI: 0.444–0.520) p = 0.001]. When normal‐weight and overweight adolescents were exclusively compared, differences in cIMT remained significant (p < 0.001). cIMT was positively correlated with body mass index (BMI) (r = 0.439, p < 0.001), waist circumference (r = 0.301, p = 0.018) and diastolic blood pressure (r = 0.266, p = 0.001). Conclusions: We have shown that cIMT is positively associated with BMI increase in adolescents, even in moderate overweight ranges, independent of age, gender, systolic blood pressure and plasma lipid concentrations.     

Placental weight,birth measurements,and blood pressure at age 8 years.

OBJECTIVE: To examine relationships between blood pressure during childhood and both placental weight and body size at birth, in an Australian population. DESIGN: A follow up study of a birth cohort, undertaken when cohort members were aged 8 years. SETTING: Adelaide, South Australia. SUBJECTS: 830 children born in the Queen Victoria Hospital in Adelaide, South Australia, during 1975-6. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressure measured when the children were aged 8 years. RESULTS: Blood pressure at 8 years was positively related to placental weight and inversely related to birth weight, after adjusting for the child''s current weight. For diastolic pressure there was a decrease of 1.0 mm Hg for each 1 kg increase in birth weight (95% confidence interval (CI) = -0.4 to 2.4) and an increase of 0.7 mm Hg for each 100 g increase in placental weight (95% CI = 0.1 to 1.3). Diastolic pressure was also inversely related to chest circumference at birth, independently of placental weight, with a decrease of 0.3 mm Hg for each 1 cm increase in chest circumference (95% CI = 0.2 to 0.5). CONCLUSIONS: These findings are further evidence that birth characteristics, indicative of fetal growth patterns, are related to blood pressure in later life.     

Dietary nutrients and blood pressure in urban minority adolescents at risk for hypertension

OBJECTIVE: To determine if blood pressure (BP) level is associated with dietary micronutrients in adolescents at risk for hypertension. DESIGN: Adolescents aged 14 to 16 years, with BP higher than the 90th percentile on 2 separate measurements in a school setting, had diet assessments. A 24-hour intake recall was obtained on 180 students (108 boys and 72 girls). Folic acid intake was used as an index of fruit, vegetable, and whole grain intake; the high folate group had a folate intake greater than the recommended daily allowance and the low folate group had a folate intake less than the recommended daily allowance. Data were analyzed by 2-way analysis of variance. RESULTS: Mean diastolic BP was significantly higher in the low folate vs the high folate group (boys: 72 vs. 67 mm Hg; girls: 76 vs. 73 mm Hg; P =.008). The difference in systolic blood pressure was not significant. There was no difference in body mass index between the diet groups. Sodium intake per 4184 kJ was not different. The low folate group had significantly lower intakes per 4184 kJ of potassium (P =.002), calcium (P = .001), magnesium (P<.001), and total intake of beta carotene, cholecalciferol, vitamin E, and all B vitamins. CONCLUSIONS: Among adolescents at risk for hypertension, BP was lower in those with higher intakes of a combination of nutrients, including potassium, calcium, magnesium, and vitamins. Dietary benefits on BP observed on diets rich in a combination of nutrients derived from fruits, vegetables, and low-fat dairy products could contribute to primary prevention of hypertension when instituted at an early age.     

Nearly half of the adolescents in an Italian school‐based study exceeded the recommended upper limits for daily caffeine consumption

Aim

No data are available on caffeine consumption among Italian adolescents. We investigated caffeine intake from coffee, soft drinks and energy drinks in a sample of Italian adolescents and determined if they exceeded the recommended limits.

Methods

The study comprised 1213 adolescents with a mean age of 15.1 years (range 12–19) from four schools in Foggia, southern Italy. Caffeine intake was assessed using an anonymous self‐reported questionnaire during the 2013/2014 school year. We calculated the percentage of daily caffeine consumers, their mean intake of caffeine from beverages and the contribution of each beverage category to the total caffeine intake.

Results

Approximately 76% of the sample consumed caffeine every day, amounting to 125.5 ± 69.2 mg/day and 2.1 ± 1.2 mg/kg/day. When we applied the reference values from the Academy of Pediatrics, we found that 46% of the adolescents exceeded the recommended upper limits. Coffee was the most frequently consumed caffeinated drink and the main contributor to daily caffeine intake.

Conclusion

More than three quarters (76%) of the Italian adolescents in our study drank coffee on a daily basis and nearly half (46%) exceeded the recommended upper limits. Strategies are needed to reduce caffeine consumption by adolescents.     

Early predictors of hypertension in prematurely born adolescents

Objective: To assess the blood pressure of former preterm and term matched adolescent controls and to identify risk factors associated with blood pressure at 16 years. Design: Observational cohort study. Secondary analysis of a randomized clinical trial. Setting: Three academic centres participating in the Multicenter Indomethacin IVH Prevention Trial. Participants: A total of 296 children born in 1989–1992 with birth weights 600 to <1250 g who participated in the Multicenter Indomethacin IVH Prevention Trial and 95 term controls were evaluated at 16 years. Main outcome measures: Blood pressure and predictors of blood pressure. Results: The adjusted mean difference in blood pressure for preterm adolescents was 5.1 mm Hg; p = 0.002 for systolic and 2.1 mm Hg; p = 0.027 for diastolic blood pressure. Among preterms, the primary predictors of increased systolic blood pressure were weight gain velocity between birth and 36 months (b = 8.54, p < 0.001), pre‐eclampsia (b = 5.67, p = 0.020), non‐white race (b = 3.77, p = 0.04) and male gender (b = 5.09). Predictors of diastolic blood pressure were weight gain velocity between birth and 36 months (b = 4.69, p = 0.001), brain injury (b = 6.51, p = 0.002) and male gender (b = ?2.4, p = 0.02). Conclusions: Early programming secondary to increased early weight gain velocity, intrauterine stress and neonatal brain injury may all contribute to risk of increased blood pressure among former preterm adolescents.     

Ambulatory blood pressure patterns in children and adolescents: influence of renin-sodium profiles

A renin-sodium nomogram for normotensive children and adolescents was developed at our institution. The ambulatory blood pressure patterns of subjects classified by the nomogram were then compared. A biracial sample of 159 children and adolescents were classified as having a low, intermediate, or high renin-sodium profile based on the relationship between their plasma renin activity and 24-hour urinary sodium excretion. Casual (106/58 vs 107/61 vs 106/62 mm Hg) and awake (116/69 vs 117/69 vs 116/70 mm Hg) blood pressure values were comparable among subjects with low, intermediate, and high renin-sodium profiles. Subjects with high renin-sodium profiles, however, had a smaller decline in systolic blood pressure with sleep than did subjects with low renin-sodium profiles (7 vs 11 mm Hg; P less than .04), and higher diastolic blood pressure readings during sleep than subjects with intermediate renin-sodium profiles (65 vs 62 mm Hg; P less than .05). Subjects with high renin-sodium profiles also had greater variance of diastolic blood pressure readings during sleep than either subjects with low renin-sodium profiles (P less than .01) or those with intermediate renin-sodium profiles (P less than .02). The blunted nocturnal decline and increased nocturnal variance of blood pressure among subjects with high renin-sodium profiles may be a marker or mechanism for the future development of essential hypertension.     

Hemodynamic effects of rescue protocol hydrocortisone in neonates with low cardiac output syndrome after cardiac surgery.

OBJECTIVE: To assess the hemodynamic effects and safety of hydrocortisone in neonates with low cardiac output syndrome requiring high levels of inotropic support and fluid resuscitation after cardiac surgery. DESIGN: Retrospective chart review. SETTING: Fifteen-bed pediatric cardiovascular intensive care unit. PATIENTS: Twelve neonates with low cardiac output syndrome after cardiac surgery to whom hydrocortisone was administered according to one of two dosing regimens (100 mg/[m.day] for 2 days, 50 mg/[m.day] for 2 days, and 25 mg/[m.day] for 1 day or 100 mg/[m.day] for 1 day, 50 mg/[m.day] for 2 days, and 25 mg/[m.day] for 2 days) were identified from the Department of Pharmacy database between September 2002 and January 2004. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The mean and systolic blood pressure increased significantly 3 hrs after hydrocortisone treatment from the values preceding hydrocortisone administration. The mean blood pressure increased from 44.0+/-3.0 to 55.4+/-2.3 mm Hg (p=.01) and the systolic blood pressure increased from 64.2+/-4.7 to 78.3+/-3.4 mm Hg (p=.04). Comparable beneficial changes were also seen in the heart rate, which decreased from 168.3+/-4.6 to 148.3+/-5.6 beats/min (p=.004) after 24 hrs of hydrocortisone administration and remained at this level during the 72 hrs of follow-up. Significant weaning of epinephrine infusions was possible, from a mean dose of 0.16 to 0.06 microg/(kg.min) (p=.008), within 24 hrs after the initiation of steroid administration, and this reduction was not offset by increases in other inotropic agents. hydrocortisone administration caused nonsignificant increases in mean blood glucose concentration (from 116.2+/-20.6 to 156.0+/-25.6 mg/dL; p=.64), mean white blood cell count (from 16.6+/-1.6 to 18.9+/-2.6 x 10 U/L; p=.35), and sodium level (from 144.7+/-1.3 to 145.3+/-1.3 mmol/L; p=.51). Ten of the 12 patients (83.3%) survived. CONCLUSION: Most of the hemodynamically compromised neonates who were unresponsive to high doses of inotropic agents and fluid resuscitation after heart surgery responded to hydrocortisone with improvement of hemodynamic parameters and a decrease in inotropic requirements.     

Birthweight and serum uric acid in American adolescents

Elevated serum uric acid is associated with hypertension and chronic kidney disease. We evaluated the relationship between birthweight and uric acid in a nationally representative sample of 5390 US adolescents aged 12–15 in the National Health and Nutrition Examination Survey from 1999 to 2012. There was an inverse association between birthweight and uric acid after adjustment for sex, age, race, obesity, and dietary sodium intake. Each 1 kg increase in birthweight was associated with decreased uric acid by 0.11 mg/dL (95% CI: ?0.16 to ?0.06; model R² = 0.32). This relationship was stronger in adolescents with elevated blood pressure (β = –0.25; 95% CI: ?0.44 to ?0.06; R² = 0.50) but persisted in adolescents with normal blood pressure (β = –0.10; 95% CI: ?0.15 to ?0.05; R² = 0.31). In conclusion, lower birthweight is associated with higher uric acid in US adolescents. These findings may support the hypothesis that reduced nephron number is associated with elevated uric acid.     

A randomized, placebo-controlled trial of amlodipine in children with hypertension

OBJECTIVES: Evaluation of the efficacy and safety of amlodipine in hypertensive children. STUDY DESIGN: A randomized, double blinded, placebo-controlled, parallel-group, dose-ranging study was conducted at 49 centers in North and South America. The primary end point was the effect of amlodipine on systolic blood pressure (BP); secondary end points included the effect of amlodipine on diastolic BP, the effect of amlodipine as a function of dose and body size, and evaluation of safety. RESULTS: We enrolled 268 hypertensive children (mean age, 12.1 +/- 3.3 years); 84 (31.3%) had primary hypertension, and 177 (66%) were boys. Amlodipine produced significantly greater reductions in systolic BP than placebo; these were -6.9 mm Hg for 2.5 mg daily (P=.045 vs placebo) and -8.7 mm Hg for 5 mg daily (P=.005 vs placebo). The underlying cause of hypertension had no effect on the response to amlodipine. There was a significant dose-response effect of amlodipine on both systolic and diastolic BP beginning at doses > or =0.06 mg/kg per day. Systolic BP < or =95(th) percentile was achieved in 34.6% of subjects with systolic hypertension. Amlodipine was well tolerated, with just 6 children withdrawn from treatment because of drug-related adverse events. CONCLUSIONS: Amlodipine effectively lowers systolic BP in a dose-dependent manner in hypertensive children who require drug treatment.     

Maternal age and other predictors of newborn blood pressure

OBJECTIVE: To investigate perinatal predictors of newborn blood pressure. STUDY DESIGN: Among 1059 mothers and their newborn infants participating in Project Viva, a US cohort study of pregnant women and their offspring, we obtained five systolic blood pressure readings on a single occasion in the first few days of life. Using multivariate linear regression models, we examined the extent to which maternal age and other pre- and perinatal factors predicted newborn blood pressure level. RESULTS: Mean (SD) maternal age was 32.0 (5.2) years, and mean (SD) newborn systolic blood pressure was 72.6 (9.0) mm Hg. A multivariate model showed that for each 5-year increase in maternal age, newborn systolic blood pressure was 0.8 mm Hg higher (95% CI, 0.2, 1.4). In addition to maternal age, independent predictors of newborn blood pressure included maternal third trimester blood pressure (0.9 mm Hg [95% CI, 0.2, 1.6] for each increment in maternal blood pressure); infant age at which we measured blood pressure (2.4 mm Hg [95% CI 1.7, 3.0] for each additional day of life); and birth weight (2.9 mm Hg [95% CI, 1.6, 4.2] per kg). CONCLUSIONS: Higher maternal age, maternal blood pressure, and birth weight were associated with higher newborn systolic blood pressure. Whereas blood pressure later in childhood predicts adult hypertension and its consequences, newborn blood pressure may represent different phenomena, such as pre- and perinatal influences on cardiac structure and function.     

Longitudinal data of blood pressure and pulse frequency during childhood (author's transl)

From 1968-1980 the development of blood pressure and pulse frequency in 221 healthy boys and 230 healthy girls aged 2-16 years was studied longitudinally. An automatic blood pressure device recording on a paper tape pulse frequence as well was used. Systolic readings are taken at the first appearance, diastolic readings at the disappearance of the Korotkoff sounds. A steady increase of the systolic, and to a lesser extent, of the diastolic pressure can be observed. Boys have a more pronouned increase of systolic pressure than girls. From year 2-16 the 50th percentile increases from 90 mm Hg to 128 mm Hg in boys and from 92 mmHg to 116 mm Hg in girls. The 50th percentile of diastolic pressure increases from 61 to 66 mm Hg in boys and 65 to 71 mm Hg in girls. Pulse frequency of boys is comparable to that of girls. The 50th percentile decreases from 100 to 75 beats. Increasing age is paralleled by decreasing pulse frequency.     

Establishing standards of orthostatic measurements in normovolemic adolescents.

OBJECTIVE--To determine normal orthostatic heart rate and blood pressure changes in healthy adolescents. DESIGN--Survey. SETTING--General adolescent clinic at a military teaching medical center in Honolulu, Hawaii. PARTICIPANTS--One hundred healthy normovolemic patients aged 12 to 19 years representing a cross section of individuals from a diverse military population during a 5-month study period. SELECTION PROCEDURE--Convenience sample. INTERVENTIONS--None. MEASUREMENTS/MAIN RESULTS--The mean (+/- 2 SDs) orthostatic heart rate change in beats per minute was 21.5 +/- 21.2, with a range of 50 to -3 beats per minute. The mean (+/- 2 SDs) systolic blood pressure change was -0.9 +/- 15.7 mm Hg, with a range of 19 to -17 mm Hg. Orthostatic measurements in a normal adolescent population may result in a heart rate increase of 40 to 50 beats per minute and a systolic blood pressure decrease of 15 mm Hg. There were no significant differences between individuals with respect to age, race, sex, and body habitus. CONCLUSIONS--Healthy adolescents display wide variation in orthostatic measurements that exceed previously accepted standards. Further study is required to determine if sensitivity and specificity values exist for orthostatic measurements that can identify individuals with intravascular volume depletion.     

Response of hypertensive adolescents to dynamic and isometric exercise stress.

Isometric handgrip and dynamic exercise stress tests were performed on 109 hypertensive and 74 normotensive subjects 14 to 17 years old. The hypertensive subjects had resting systolic or diastolic pressures persistently above the 95th percentile on four consecutive examinations. Blood pressures and ECGs were recorded during isometric handgrip (25% maximum effort for four minutes) and bicycle ergometry until the subject was exhausted. The hypertensive subjects increased systolic pressure by an average 16 mm Hg with isometric exercise and 53 mm Hg with dynamic exercise. Control subjects had similar pressure changes, averaging 18 and 54 mm Hg, respectively. During isometric handgrip stress, diastolic pressures increased 12 mm Hg in hypertensive subjects and 18 mm Hg in control subjects. Only two hypertensive adolescents developed systolic pressures exceeding 200 mm Hg during dynamic exercise stress, and none developed systolic pressures above 200 mm Hg during isometric exercise stress. None of the normotensive or hypertensive subjects developed cardiac arrhythmias and the prevalence of ST segment depression during maximal stress was less than 2% in both groups. Therefore, in adolescents with mild to moderate hypertension the risk of developing significant ECG or hemodynamic abnormalities during mild isometric or heavy dynamic exercise is small. We believe the decision to restrict physical activity of an adolescent with elevated pressures should be based on the development of abnormal ST segment depression, cardiac arrhythmias, or excessive blood pressures at the time of exercise stress testing.     

Blood pressure response to dynamic exercise in adolescents before and after percutaneous transluminal renal artery angioplasty

The blood pressure response to maximal bicycle exercise was studied using the James protocol in two adolescents with renal artery stenosis before and after percutaneous transluminal renal artery angioplasty. Prior to angioplasty, one patient (pt A) had persistent and one patient (pt B) had labile elevation of the resting blood pressure above the 95th percentile for age; both patients had elevated systolic blood pressure at maximal exercise (pt A: 215 mm Hg; James expected 170 +/- 20; pt B: 228 mm Hg; James expected 156 +/- 15). Following angioplasty, both patients had resting blood pressures below the 95th percentile for age; patient A had improved systolic pressure at maximal exercise (195 mm Hg) while patient B had persistent elevation in the exercise systolic blood pressure (215 mm Hg). Angiography confirmed the presence of residual/recurrent renal artery stenosis in patient B. We conclude that measurement of blood pressure during exercise may reveal residual abnormalities not apparent at rest and thus may be useful in assessing the result of renal artery angioplasty in children with renal artery stenosis.     

Comparison of auscultatory and oscillometric blood pressures

OBJECTIVE: To study the differences in blood pressure readings between the auscultatory and oscillometric (Dinamap model 8100; Critikon, Tampa, Fla) methods. DESIGN: Survey of 2 blood pressure instruments. SETTING: Public schools. PARTICIPANTS: Seven thousand two hundred eight schoolchildren aged 5 through 17 years. MAIN OUTCOME MEASURE: Blood pressure levels. RESULTS: For all children combined, Dinamap systolic pressure readings were 10 mm Hg higher (95% confidence interval, -4 to 24 mm Hg) than the auscultatory systolic pressure readings. Dinamap diastolic pressure readings were 5 mm Hg higher (95% confidence interval, -14 to 23 mm Hg) than the auscultatory Korotkoff phase V diastolic pressure readings. CONCLUSION: These findings preclude the interchange of readings by the 2 methods. Caution must be exercised in the diagnosis of hypertension when an automated device is used.     

Impact of a school-based interdisciplinary intervention on diet and physical activity among urban primary school children: eat well and keep moving.

OBJECTIVE: To evaluate the impact of a school-based interdisciplinary health behavior intervention on diet and physical activity among children in grades 4 and 5. DESIGN: A quasiexperimental field trial with 6 intervention and 8 matched control schools. Outcomes were assessed longitudinally using preintervention (fall 1995) and follow-up (spring 1997) student survey food frequency and activity measures and follow-up 24-hour recall measures of diet and activity. Change was also assessed using yearly repeated cross-sectional surveys of all grade 5 students from 1995 through 1997. PARTICIPANTS: Longitudinal data were collected from 479 students initially in grade 4 in Baltimore, Md, public schools; 91% were African American. Repeated 24-hour recall measures in 1997 were collected for a random subsample of 336 students. Cross-sectional survey data were collected from all grade 5 students in 1995,1996, and 1997 (n = 2103). INTERVENTION: The Eat Well and Keep Moving Program was taught by classroom teachers over 2 years in math, science, language arts, and social studies classes. Materials provided links to school food services and families and provided training and wellness programs for teachers and other staff members. Intervention materials focused on decreasing consumption of foods high in total and saturated fat and increasing fruit and vegetable intake, as well as reducing television viewing and increasing physical activity. MAIN OUTCOME MEASURES: Dietary intake and physical activity measured via repeated 24-hour recall were primary end points, with additional food frequency and activity measures. RESULTS: The 24-hour recall measures indicated that, after controlling for baseline covariates, the percentages of total energy from fat and saturated fat were reduced among students in intervention compared with control schools (-1.4%; 95% confidence interval [CI], -2.8 to -0.04; P = .04 and -0.60%; 95% CI, -1.2 to -0.01; P = .05). There was an increase in fruit and vegetable intake (0.36 servings/4184 kJ; 95% CI, 0.10-0.62; P=.01), in vitamin C intake (8.8 mg/4184 kJ; 95% CI, 2.0-16; P=.01), and in fiber consumption (0.7 g/4184 kJ; 95% CI, 0.0-1.4; P=.05). Television viewing was marginally reduced (-0.55 h/d; 95% CI, -1.04 to 0.04; P=.06). Analysis of longitudinal and repeated cross-sectional food frequency data indicated similar significant decreases in the percentages of total energy from fat and saturated fat. CONCLUSION: Evaluation of the Eat Well and Keep Moving Program indicates effectiveness in improving dietary intake of students and reducing television viewing.     

北京地区儿童及青少年血压分布特征

目的了解北京地区儿童青少年血压的现况。方法按分层整群随机抽样法在北京市4个城区和3个郊区县的3—18岁儿童和青少年中,用“美国高血压教育项目工作组”和“中国高血压防治指南”推荐的测量方法进行收缩压（SBP）和舒张压（DBP）测量。记录、整理、分析血压测量的结果。结果北京地区3—18岁儿童青少年血压调查的有效数据人数20780人,城区10582人（50．9％）,郊县10198人（49．1％）;男10398人（50．0％）,女10382人（50．0％）。男童血压高于女童[SBP：（106±12）mmHgVS（101±11）mmHg,u=27．14,P〈0．01;DBP：（67±9）mmHgvs（65±8）mmHg,u=14．14,P〈0．01]（1mmHg=0．133kPa）。男女童血压均随年龄增长有逐渐增高的趋势,且SBP上升幅度较DBP高。城区儿童SBP和DBP的平均水平低于郊县儿童[SBP：（103±12）mmHgVS（104±12）mmHg,u=2．55,P〈O．05;DBP：（66±8）mmHgVS（67±9）mmHg,u=6．73,P〈0．01]。血压与年龄、身高、体重及体块指数（BMI）均有显著的正相关（P〈0．001）,收缩压与各变量的相关程度均较舒张压高。依据1987年北京市6—18岁儿童青少年性别年龄别血压标准,本次调查6～18岁儿童青少年高血压检出率为8．1％。结论获得了北京地区儿童青少年血压的分布特征;血压值与儿童的性别、年龄、身高、体重和BMI相关。     

Intravenous diazoxide in acute poststreptococcal glomerulonephritis.

Twenty-six patients with hypertension secondary to acute poststreptococcal glomerulonephritis were treated by the rapid intravenous infusion of diazoxide. The average pretreatment systolic pressure was 159 mm Hg. Five minutes after administration, the average systolic pressure was 122 mm Hg (a 23% reduction). The average initial diastolic pressure was 104 mm Hg, which fell 5 minutes after diazoxide injection to 71 mm Hg (a 32% reduction). No hypotensive episodes were noted. Occasional episodes of nausea occurred. Concentrations of blood glucose increased after administration of diazoxide; however, no values were above 155 mg/dl. Diazoxide appears to be a safe antihypertensive drug that is effective in the treatment of hypertension secondary to acute poststreptococcal glomerulonephritis.