Tracking and Prediction of Arterial Blood Pressure From Childhood to Young Adulthood in 868 Patients With Type 1 Diabetes

Author:

Knerr Ina1,Dost Axel2,Lepler Rudolf3,Raile Klemens4,Schober Edith5,Rascher Wolfgang1,Holl Reinhard W.6,

Affiliation:

1. Children's and Adolescents’ Hospital, University of Erlangen-Nuremberg, Erlangen, Germany

2. University Children's Hospital, Jena, Germany

3. Children's Hospital Wilhelmstift, Hamburg, Germany

4. University Children's Hospital, Berlin, Germany

5. University Children's Hospital, Vienna, Austria

6. Division of Applied Information Technology, University of Ulm, Ulm, Germany

Abstract

OBJECTIVE—Arterial blood pressure was followed in 868 patients with type 1 diabetes aged 6.0–19.9 years in 95 centers in Germany and Austria. RESEARCH DESIGN AND METHODS—European blood pressure reference data for 28,043 children and adolescents were used with respect to age and sex. Data were stratified into three groups: prepubertal, pubertal, and postpubertal. RESULTS—Up to 4% of the participants in the younger age-groups and 13.9% of the postpubertal patients exhibited blood pressure values >97th centile. Blood pressure levels correlated with A1C level and BMI Z score. Tracking of blood pressure revealed that children with elevated blood pressure had higher blood pressure in adolescence and young adulthood. CONCLUSIONS—Patients with higher blood pressure in childhood showed elevated blood pressure later in life. We need to focus on the diagnosis of hypertension in children with type 1 diabetes and to study the efficacy of early intervention.

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

Reference10 articles.

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2. Schwab KO, Doerfer J, Hecker W, Grulich-Henn J, Wiemann D, Kordonouri O, Beyer P, Holl RW, the DPV Initiative of the German Working Group for Pediatric Diabetology: Spectrum and prevalence of atherogenic risk factors in 27,358 children, adolescents, and young adults with type 1 diabetes: cross-sectional data from the German diabetes documentation and quality management system (DPV). Diabetes Care 29:218–225, 2006

3. Knerr I, Wolf J, Reinehr T, Stachow R, Grabert M, Schober E, Rascher W, Holl RW: The ‘accelerator hypothesis’: relationship between weight, height, body mass index and age at diagnosis in a large cohort of 9,248 German and Austrian children with type 1 diabetes mellitus. Diabetologia 48:2501–2504, 2005

4. de Man SA, Andre JL, Bachmann H, Grobbee DE, Ibsen KK, Laaser U, Lippert P, Hofman A: Blood pressure in childhood: pooled findings of six European studies. J Hypertens 9:109–114, 1991

5. Krohmeyer-Hauschild K, Wabitsch M, Kunze D, Geller F, Geiß HC, Hesse V, von Hippel A, Jaeger U, Johnson D, Korte W, Menner K, Müller G, Müller JM, Niemann-Pilatus A, Remer T, Schaefer F, Wittchen H-U, Zabransky S, Zellner K, Ziegler A, Hebebrand J: [Percentiles of body mass index in children and adolescents evaluated from different regional German studies]. Monatsschr Kinderheilkd 149:807–818, 2001 [in German]

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