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Hypertension in Children and Adolescents pp 65–83Cite as

Large Vessels in Hypertension: Central Blood Pressure

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Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

Abstract

Children and adolescents with high normal blood pressure and/or high arterial stiffness have a high risk for developing hypertension. Modifiable cardiovascular risk factors, such as dietary salt intake, fructose, and lifestyles including food sources—processed and fast foods—, sleep patterns, stress, and reductions in physical activity, play a crucial role in the transition between high-normal BP and hypertension. In this review, we will analyze the epidemiological and hemodynamic evidence that increased arterial stiffness is a determinant of incident hypertension. We will also address the complexity of this relationship by discussing the hemodynamic and biomechanical pathways involved in the bidirectional influence between arterial stiffness and blood pressure. And then, we will discuss how the concept of early vascular ageing—EVA—can help in understanding the relationship between arterial stiffness and high-normal BP. Finally, we will apply these concepts to the relationship between metabolic syndrome, arterial stiffness and high-normal BP in children. We will demonstrate that it is of crucial importance to increase physical activity and reduce obesity in children in order to reduce arterial stiffness, and thus, decrease the prevalence of high BP in childhood.

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Authors and Affiliations

  1. Department of Pharmacology, INSERM U970, Hôpital Européen Georges Pompidou, Paris-Descartes University, Assistance Publique—Hôpitaux de Paris, Paris, France

    Stéphane Laurent

  2. Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Serviço de Medicina Interna do Hospital da Senhora da Oliveira, Guimarães, Portugal

    Pedro Guimarães Cunha

  3. Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Guimarães, Portugal

    Pedro Guimarães Cunha

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  1. Stéphane Laurent
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Correspondence to Stéphane Laurent .

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Editors and Affiliations

  1. Head of Pediatrics Department, Hospital General Universitario Valencia, Valencia, Spain

    Empar Lurbe

  2. Center for Pediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany

    Elke Wühl

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Laurent, S., Cunha, P.G. (2019). Large Vessels in Hypertension: Central Blood Pressure. In: Lurbe, E., Wühl, E. (eds) Hypertension in Children and Adolescents. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-030-18167-3_5

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