BLOOD PRESSURE CONTROL IN JUVENILES - LONGITUDINAL STUDY

描述：(改编自申请者摘要)本提案为 继续对儿童(双胞胎)进行纵向研究 6-16岁人群)荷尔蒙对血液的影响 目前正在审查压力。孩子们一年有两次流血 测量了血压和人体测量值，收集了过夜尿液样本 用于测定醛固酮、肾上腺雄激素(AA)、黄体生成素 (黄体生成素)、钠、钾和肌酐。增长速度和变化 血压随年龄的变化已被很好地描述为这一点 人口。从最初的观察来看，有几个不同之处 在种族群体之间观察；具体地说，黑人儿童被发现 摄入更少的钾，产生大约40%的醛固酮，并拥有更高的 血压比白人儿童要高。据观察，患有这种疾病的儿童 有高血压阳性家族史的人更有可能有较低的 醛固酮-排泄率。作为拟议的延续 纵向研究，这一假设将得到检验，患有 低醛固酮水平容易导致较高的血压。虽然 横断面数据显示，黑人儿童的钾摄入量较低 醛固酮产量的种族差异只有一部分是 继发于较低的钾摄入量(钾是一种已知的刺激 醛固酮生产)。已知有低醛固酮产生的受试者 (黑人和白人)将有补充钾的饮食来测试 有一种假说认为，低醛固酮分泌的黑人 与患有钾的白人儿童相比，对钾的反应性 低醛固酮。钾抵抗儿童的家庭 将对低醛固酮生产进行筛查，以寻找 将进行低醛固酮生产和分离分析，以 建立“低醛”表型的遗传模式。在……里面 横断面研究表明，AA排泄率与 大于或等于10岁的受试者的血压， 提示肾上腺素在血液测定中起着重要作用 年轻人的压力水平。在未来的纵向研究中所扮演的角色 随着更多的儿童达到 青春期(该队列目前的平均年龄为12.7岁)。此外, 为了更好地区分肾上腺，性腺， 以及体型增加对血压的影响，一系列的患者 这些现象都是离解的，将予以研究。

DESCRIPTION: (Adapted from Applicant's Abstract) The present proposal is for a continuation of a longitudinal study of children (a biracial population, ages 6-16 years) for whom influences of hormones on blood pressure are being examined. Twice yearly the children have had blood pressure and anthropometics measured, and overnight urine samples collected for measurement of aldosterone, adrenal androgens (AA), luteinizing hormone (LH), sodium, potassium, and creatinine. Rates of growth and the changes in blood pressure with age have been well characterized for this population. From the original observations, several differences were observed between racial groups; specifically, black children were found to consume less potassium, produce about 40% less aldosterone and have higher blood pressures than white children. It was observed that children with positive families histories of hypertension were more likely to have lower aldosterone-excretion rates. As part of the proposed continuation of longitudinal studies, the hypothesis would be tested that children with low-aldosterone levels are predisposed to higher blood pressures. Although black children had lower potassium intakes, cross-sectional data indicated that only part of the racial difference in aldosterone production was secondary to a lower intake of potassium (potassium is a known stimulus of aldosterone production). Subjects with known low-aldosterone production (blacks and whites) would have diets supplemented with potassium to test the hypothesis that blacks with low-aldosterone production have a reduced responsiveness to potassium when compared to white children with low-aldosterone. Families of children with potassium-resistant low-aldosterone production would be screened for evidence of low-aldosterone production, and segregation analyses would be performed to establish the mode of inheritance of the "low-aldosterone" phenotype. In cross-sectional studies, AA-excretion rates were positively related to blood pressure in subjects greater than or equal to 10 years of age, suggesting an important role for the adrenarche in determining blood pressure levels in young people. In future longitudinal studies the role of AA as well as gonadal hormones would be studied as more children reach adolescence (the current mean age of the cohort is 12.7 yr). In addition, to better distinguish the individual influences of adrenarche, gonadarche, and increases in body size on blood pressure, a series of patients where these phenomenon are dissociated would be studied.