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Thürmann, L.* ; Bauer, M.* ; Ferland, M. ; Messingschlager, M.* ; Schikowski, T.* ; von Berg, A.* ; Heinrich, J. ; Herberth, G.* ; Lehmann, I.* ; Standl, M. ; Trump, S.*

Undiagnosed pediatric elevated blood pressure is characterized by induction of pro-inflammatory and cytotoxic mediators.

Hypertension 80, 2425-2436 (2023)
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BACKGROUND: Inflammatory processes have been suggested as a culprit of vascular damage in pediatric hypertension. We aimed to investigate transcriptional changes of immune modulators and determine their association with office blood pressure in adolescents who were not diagnosed with hypertension at the time of the study visit. METHODS: Office blood pressure measurements and blood samples were taken from adolescents of 2 German birth cohorts, GINIplus (The German Infant Study on the Influence of Nutrition Intervention Plus Air Pollution and Genetics on Allergy Development; discovery cohort, n=1219) and LISA (Influences of Lifestyle-related factors on the Immune System and the Development of Allergies in Childhood; validation cohort, n=809), during the 15-year follow-up visit and categorized based on the European Society of Hypertension Guideline. Hs-CRP (high-sensitivity C-reactive protein) and expression of 51 genes encoding cytokines/receptors and transcription factors were analyzed. RESULTS: The prevalence of elevated systolic blood pressure (overweight/obese) was 14.0% (5.1%) and 16.4% (5.2%) in the discovery and validation cohorts, respectively. An enhanced cytotoxic (GZMB, PRF1, IL2RB) and proinflammatory (FOS, IL1B, hs-CRP) immune profile was observed in association with the hypertension class in both cohorts. Expression of hs-CRP and IL1B was driven by overweight with IL1B being identified as a mediator between body mass index and elevated systolic blood pressure (adj.β/95% CI, 0.01/0.0002-0.02). The association of GZMB (adjusted odds ratio/95% CI, 1.67/1.26-2.21; P=0.0004) and PRF1 (adjusted odds ratio/95% CI, 1.70/1.26-2.29; P=0.0005) in the hypertension class remained significant in normal-weight individuals without parental predisposition. These effects were confirmed in LISA. CONCLUSIONS: Adolescent hypertension is not limited to known risk groups. As adolescents in the hypertension class show an inflammatory profile similar to that of established hypertension in adults, blood pressure monitoring at a young age is critical to ensure early intervention and prevention of adverse sequelae.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Child ; Cytokines ; Gene Expression ; Hypertension ; Immune System ; Overweight ; Risk Factor; Cd8(+) T-cells; Risk-factors; C-fos; Hypertension; Infiltration; Metabolism; Activation; Expression; Guidelines; Adults
ISSN (print) / ISBN 0194-911x
e-ISSN 1524-4563
Journal Hypertension
Quellenangaben Volume: 80, Issue: 11, Pages: 2425-2436 Article Number: , Supplement: ,
Publisher Lippincott Williams & Wilkins
Publishing Place Two Commerce Sq, 2001 Market St, Philadelphia, Pa 19103 Usa
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Epidemiology (EPI)
Grants Commission of the European Communities, the seventh Framework Program: MeDALL project
Federal Ministry for Environment (IUF)
center (Helmholtz-Zentrum fuer Umweltforschung, Pediatric Practice, Bad Honnef)
center (Technische Universitaet Munich)
center (LMU Munich)
center (Research Institute at Marien-Hospital Wesel/Evangelisches Krankenhaus Duesseldorf)
center (Helmholtz Zentrum Muenchen - Deutsches Forschungszentrum fuer Gesundheit und Umwelt)
Federal Ministry for Education, Science, Research and Technology
BIH at Charite-Universitaets medizin Berlin