Obstructive sleep apnea and blood pressure in young hypertensives: does it matter?
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Obstructive sleep apnea and blood pressure in young hypertensives: does it matter? Maria Rosaria Bonsignore1,2 · Calogero Davide Giuseppe Barbera1 · Enrico Clini3 Received: 25 February 2020 / Accepted: 29 February 2020 © Società Italiana di Medicina Interna (SIMI) 2020
In the modern era, and in industrialized countries in particular, major health problems are frequently associated to the age period going from childhood to adulthood. This is highly due to bad lifestyles which may anticipate the further development of chronic diseases life-long. Hypertension, the most common risk factor in the pathogenesis of cardiovascular (CV) disease, is not just an adult disorder. Young-onset hypertension increases all-cause mortality and results in subclinical organ damage early in its natural history. The exact prevalence of hypertension in young people is relatively difficult to assess, because studies differ according to age, ethnicity, selection criteria, methodology used for blood pressure (BP) measurements and number of BP determinations [1, 2]. In the National Longitudinal Study of Adolescent Health in the United States, about 19% of 14,000 participants aged 24–32 years had high BP levels [2]. In 85,371 young subjects of the Chinese province of Shandong, Zhao and colleagues found that prevalence of hypertension increased from 1991 to 2007, from 4.4 to 14.1% in the age range18–29 years, and from 7.9 to 28.5% in the age range 30–39 years [3]. The lifestyle of young generations includes several emerging factors that can cause or promote the development of hypertension, such as sedentary lifestyle, high salt diet, frequent assumption of junk food or energizing drinks, anabolizing or illicit drugs, use of stimulating or vasoconstricting drugs, reduced sleep time, excessive time spent with mobile phone, tablets, computers or psychiatric condition of the youth [4]. Moreover, the current epidemic of childhood obesity has a substantial impact on the prevalence of elevated * Maria Rosaria Bonsignore [email protected] 1
PROMISE Department, Sleep and Respiratory Failure Clinic, University of Palermo, Palermo, Italy
2
IRIB-CNR, Palermo, Italy
3
Department of Medical and Surgical Science SMECHIMAI, University of Modena Reggio Emilia, Modena, Italy
BP in children and adolescents, as confirmed by crosssectional studies [5, 6]. In children, a stable relationship of blood pressure and body mass index (BMI) was found up to the 85th percentile of BMI; beyond this threshold the risk for elevated BP in children and adolescents markedly increased [7]. Thus, the risk for elevated BP is not limited to obese children (BMI > 95th percentile), but also involves overweight children (BMI in the 85th–94th percentile). The childhood obesity epidemic, with the associated increase in prevalence of elevated BP, predicts heightened risk for premature cardiovascular disease in adulthood. The International Childhood Cardiovascular Cohort Consortium on > 6000 individuals collected prospective data from childhood
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