BACKGROUND: High prevalence of arterial hypertension is known in pediatric renal transplant patients, but how blood pressure (BP) distribution and control differ between age groups and whether sex and age interact and potentially impact BP after transplantation have not been investigated. METHODS: This retrospective analysis included 336 pediatric renal transplant recipients (62% males) from the Cooperative European Pediatric Renal Transplant Initiative Registry (CERTAIN) with complete BP measurement at discharge and 1, 2 and 3 years post-transplant. RESULTS: At discharge and 3 years post-transplant, arterial hypertension was highly prevalent (84% and 77%); antihypertensive drugs were used in 73% and 68% of the patients. 27% suffered from uncontrolled and 9% from untreated hypertension at 3 years post-transplant. Children transplanted at age < 5 years showed sustained high systolic BP z-score and received consistently less antihypertensive treatment over time. Younger age, shorter time since transplantation, male sex, higher body mass index (BMI), high cyclosporine A (CSA) trough levels, and a primary renal disease other than congenital anomalies of the kidney and urinary tract (CAKUT) were significantly associated with higher systolic BP z-score. Sex-stratified analysis revealed a significant association between high CSA and higher systolic BP in older girls that likely had started puberty already. An association between BP and estimated glomerular filtration rate was not detected. CONCLUSIONS: BP control during the first 3 years was poor in this large European cohort. The description of age- and sex-specific risk profiles identified certain recipient groups that may benefit from more frequent BP monitoring (i.e. young children) or different choices of immunosuppression (i.e. older girls).

• Klíčová slova
• Children, Cyclosporine, Hypertension, Immunosuppression, Kidney transplantation, Sex differences,
• MeSH
• časové faktory MeSH
• cyklosporin aplikace a dávkování   škodlivé účinky   farmakokinetika   MeSH
• dítě MeSH
• hypertenze diagnóza   epidemiologie   etiologie   MeSH
• imunosupresiva aplikace a dávkování   škodlivé účinky   farmakokinetika   MeSH
• lidé MeSH
• longitudinální studie MeSH
• měření krevního tlaku statistika a číselné údaje   MeSH
• mladiství MeSH
• následné studie MeSH
• předškolní dítě MeSH
• prevalence MeSH
• příjemce transplantátu statistika a číselné údaje   MeSH
• registrace statistika a číselné údaje   MeSH
• rejekce štěpu imunologie   prevence a kontrola   MeSH
• retrospektivní studie MeSH
• sexuální faktory MeSH
• takrolimus aplikace a dávkování   škodlivé účinky   farmakokinetika   MeSH
• transplantace ledvin škodlivé účinky   MeSH
• věkové faktory MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa epidemiologie   MeSH
• Názvy látek
• cyklosporin MeSH
• imunosupresiva MeSH
• takrolimus MeSH

The cross-spectral analysis of heart rate (HR) and blood pressure (BP) variabilities provides "amplitude" and "phase" related measures. Compared to the amplitude measure, that is the baroreflex gain, the phase related measure characterizing the time lag between HR and BP oscillations has been studied to a much lesser extent. A population of 103 patients (73 men, 30 women, aged 53 +/- 12, range 20-82 years) referred for the management of coronary artery disease and/or hypertension were studied. In each subject, electrocardiogram and BP recordings were obtained in the supine and sitting positions of 5 minutes of rest (spontaneous respiration), 3 minutes of controlled respiration at 0.1 Hz (slow-controlled respiration), and 3 minutes of controlled respiration at 0.33 Hz (fast-controlled respiration). The frequency of maximum coherence (above the arbitrary threshold of 0.5) of BP and RR interval variabilities was searched between 0.033-0.133 Hz and 0.200-0.400 Hz to obtain baroreflex gain and phase shift in low and high frequency bands, respectively. Mean phase shifts of -79.1 and -67.0 degrees (-2.4 and -2.1 s) were found during slow-controlled respiration in the supine and sitting body positions, respectively. The mean phase shift between systolic BP and RR interval in the low frequency band was found between 83 and -109 degrees for body positions and respiration regimes. The actual baroreflex related time lag between systolic BP and RR variations was found between 3.5 and 5.1 seconds. The study concludes that the appropriate, and not always easy, selection of the frequency of maximum coherence between BP and HR oscillation is crucial for an accurate cross-spectral assessment of baroreflex sensitivity.

• MeSH
• diabetes mellitus 2. typu patofyziologie   MeSH
• dospělí MeSH
• elektrokardiografie metody   statistika a číselné údaje   MeSH
• hypertenze patofyziologie   MeSH
• infarkt myokardu patofyziologie   MeSH
• koronární nemoc patofyziologie   MeSH
• krevní tlak * MeSH
• lidé středního věku MeSH
• lidé MeSH
• měření krevního tlaku metody   statistika a číselné údaje   MeSH
• postura těla fyziologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• srdeční frekvence * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVE: To determine the reproducibility of parameters estimated by pulse wave analysis (PWA), mainly of central systolic blood pressure in the aorta (CSP), central systolic pressure-time index (CSPTI, area under the systolic part of the curve in the pressure-time graph per minute), and central augmentation index (CAI, pressure peak caused by wave reflection divided by pressure peak caused by ventricular ejection). METHODS: In 88 healthy subjects, aged 19-53 years, radial pulse wave was registered by two investigators on separate visits in a random sequence, twice during each visit RESULTS: Variability within and among subjects was significantly different for peripheral systolic pressure (PSP) and for all the above-mentioned parameters (P < 0.0001 by ANOVA for all). Variability within and between observers was tested by Bland-Altman plots; they did not show any trend for the variability to be dependent on the underlying mean value. PSP, CSP and CSPTI decreased significantly during one visit (by 4.6, 4.7 and 4.2%, respectively), PSP and CSP were higher at the first than at the second visit (by 2.2, 2.2%, respectively, and not significant for CSPTI), and there were also significant interobserver differences in all the three parameters as one observer measured higher values (by 2.4, 3.2 and 6.0%, respectively). CAI did not change within and between visits; the same applied to the difference between PSP and CSP since these pressures always changed in parallel. CONCLUSIONS: PWA gives estimates of several parameters characterizing the pressure load of central circulation and the wave reflection. The reproducibility of CSP and CSPTI is similar to that of PSP. CAI and the difference between PSP and CSP is not influenced by order of measurement, of visit or by investigator. Therefore, CAI is a more stable parameter than PSP measured by an oscillometric device. Since these parameters may contribute to a better assessment of cardiovascular risk, PWA might be used in prospective studies.

• MeSH
• arteria brachialis fyziologie   MeSH
• časové faktory MeSH
• dospělí MeSH
• hemodynamika fyziologie   MeSH
• interpretace statistických dat MeSH
• krevní tlak fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• měření krevního tlaku statistika a číselné údaje   MeSH
• reprodukovatelnost výsledků MeSH
• srdeční frekvence fyziologie   MeSH
• stárnutí fyziologie   MeSH
• systola fyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky MeSH
• práce podpořená grantem MeSH