Effects of Somatic Growth and Sodium Retention on Blood Pressure

描述(申请人提供)：高血压是一种病因不明的疾病。大多数研究人员同意，过量钠(Na)的滞留是高血压的特征--血压(BP)持续升高的基础。在儿童中，血压升高伴随着身高和体重的体格发育。虽然已知BP与各种躯体测量相关，但所观察到的关联背后的生理机制仍不清楚。此外，很少有研究检查躯体生长的任何特征是否与血压升高或高血压前期或高血压的早期发病有关。我们的初步数据有力地表明，体细胞的生长过程与BP的发育过程很好地同步。有了令人信服的数据证据，我们建议进行一项流行病学研究，利用现有儿童队列的数据来描述躯体生长、钠滞留和血压之间的关系。我们假设，在青春期生长期间，体细胞生长与血压的强烈关系至少部分是通过增加钠的保留量来调节的。沿着这条路线，我们将研究身体变化对钠保留指标的影响，以及身体生长特征对青春期后血压和高血压前期和高血压发病的影响。这项研究解决了关于青春期血压变化机制的一些至关重要但以前没有得到解答的问题。这些假设是从强有力的、令人信服的初步数据证据中得出的。如果成功进行，这项研究可能会发现高血压的早期风险因素，提供及时干预的机会。为了评估青春期后血压和高血压前期和高血压的发病情况，我们试图将队列中的350名受试者的随访期再延长5年，直到受试者成年。现有的队列和新的扩展将提供一个难得的机会来评估青春期和青春期后BP之间的躯体生长模式之间的联系，以及钠滞留的调节。为了实施，我们提出了一项综合分析计划。通过关注高血压的开始，在血压达到高血压水平之前，这项研究为研究机制提供了一种新的方法。虽然这项研究具有重要的科学意义，但它也具有成本效益，因为它充分利用了现有的纵向数据。公共卫生相关性： 这项研究使用纵向数据来检验青春期发育和钠滞留对青春期后血压的影响。这项研究可能会对血压升高背后的生理机制提供至关重要的见解。它与公共卫生的关系是，它可能有助于识别预示未来高血压风险的躯体生长模式。

DESCRIPTION (provided by applicant): Hypertension is a disease of unknown etiology. Most investigators agree that retention of excess sodium (Na) underlies the sustained increase in blood pressure (BP) that characterizes hypertension. In children, BP elevation accompanies somatic growth in height and weight. While BP is known to be correlated to various somatic measurements, physiological mechanisms that underlie the observed associations remain unclear. Additionally, few investigations have examined whether any characteristics of somatic growth relate to the rise of BP or to the early onset of pre-hypertension or hypertension. Our preliminary data strongly suggest that the process of somatic growth is well synchronized with that of BP development. With the compelling data evidence, we propose to conduct an epidemiological study to delineate the relations among somatic growth, Na retention, and BP using data from an existing cohort of children. We hypothesize that a strong relationship of somatic growth with BP during the period of pubertal growth is mediated at least partially by increases in retention of Na. Along this line, we will examine the effects of somatic changes on measures of Na retention, and the effects of somatic growth characteristics on post-pubertal BP and the onset of pre- hypertension and hypertension. The study addresses some of the critically important but previously unanswered questions about the mechanisms of BP change during puberty. The hypotheses are derived from strong and compelling preliminary data evidence. If successfully carried out, the research may uncover early risk factors for hypertension, affording opportunities of timely interventions. To assess the post-pubertal BP and onset of pre-hypertension and hypertension, we seek to extend the follow-up period for 350 subjects in the cohort for five additional years till the subjects become adults. The existing cohort and the new extension will afford a rare opportunity to assess the linkage between somatic growth patterns in puberty and post-pubertal BP, with accommodation of Na retention. To implement, we have proposed an integrated analytical plan. By focusing on the beginnings of hypertension, before BP reaches hypertensive levels, this research provides a new approach for investigating mechanisms. While scientifically significant, the study is also cost effective because it fully utilizes the existing longitudinal data. PUBLIC HEALTH RELEVANCE: This study uses longitudinal data to examine the effects of pubertal growth and sodium retention on post-pubertal blood pressure. The research may provide crucial insight on the physiological mechanisms that underlie the elevation of blood pressure. Its public health relevance is that it may facilitate the identification of somatic growth patterns that signal future risk of hypertension.