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Runmei Zou - One of the best experts on this subject based on the ideXlab platform.
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T wave and ST segment amplitude changes in the supine and standing electrocardiograms of children with Orthostatic Hypertension and their clinical significance
Chinese journal of contemporary pediatrics, 2019Co-Authors: Runmei Zou, Ping Lin, Cheng WangAbstract:OBJECTIVE To examine the changes in T wave and ST segment amplitude in the supine and standing electrocardiograms (ECG) of children with Orthostatic Hypertension (OHT) and to determine their clinical significance. METHODS A total of 49 children with OHT were included in the OHT group. Forty-three age- and sex-matched healthy children were included in the control group. Heart rate and T wave and ST segment amplitude were measured in both groups. T wave amplitude and ST segment amplitude in supine ECG were compared with those in standing ECG within each group. The differences in supine vs standing T wave amplitude and ST segment amplitude were compared between the OHT and control groups. RESULTS In the control group, T wave amplitude in leads aVR, V1, and V4-V6 were significantly lower in standing ECG than in supine ECG (P
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t wave and st segment amplitude changes in the supine and standing electrocardiograms of children with Orthostatic Hypertension and their clinical significance
Chinese journal of contemporary pediatrics, 2019Co-Authors: Runmei Zou, Ping Lin, Cheng WangAbstract:OBJECTIVE To examine the changes in T wave and ST segment amplitude in the supine and standing electrocardiograms (ECG) of children with Orthostatic Hypertension (OHT) and to determine their clinical significance. METHODS A total of 49 children with OHT were included in the OHT group. Forty-three age- and sex-matched healthy children were included in the control group. Heart rate and T wave and ST segment amplitude were measured in both groups. T wave amplitude and ST segment amplitude in supine ECG were compared with those in standing ECG within each group. The differences in supine vs standing T wave amplitude and ST segment amplitude were compared between the OHT and control groups. RESULTS In the control group, T wave amplitude in leads aVR, V1, and V4-V6 were significantly lower in standing ECG than in supine ECG (P<0.05); ST segment amplitude in leads V4 and V5 were significantly higher in standing ECG than in supine ECG (P<0.05). In the OHT group, T wave amplitude in leads II, aVR, aVF, and V4-V6 were significantly lower in standing ECG than in supine ECG (P<0.05); ST segment amplitude in lead II was significantly higher in standing ECG than in supine ECG (P<0.05). The differences in T wave amplitude in lead II and V6 between supine and standing ECG were significantly higher in the OHT group than in the control group (P<0.05). Difference in T wave amplitude in lead V6 between supine and standing ECG was a significant diagnostic marker for OHT (P<0.05). This marker had 72.10% sensitivity and 57.10% specificity for the diagnosis of OHT at the optimal cut-off value of 0.105 mV. CONCLUSIONS Difference in T wave amplitude in lead V6 between supine and standing ECG has certain diagnostic value for OHT.
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Association between Orthostatic Hypertension and body mass index in school-age children
Chinese Pediatric Emergency Medicine, 2019Co-Authors: Wenhua Zhang, Ping Lin, Runmei Zou, Shuo Wang, Yuwen Wang, Chuanmei TanAbstract:目的 探讨学龄期儿童直立性高血压(Orthostatic Hypertension，OHT)与体重指数(body mass index，BMI)的相关性。 方法 收集2015年1月至2018年10月在中南大学湘雅二医院儿童医学中心儿童心血管专科诊断为OHT的学龄期儿童76例(年龄7～13岁，男45例，女31例)为研究组，按年龄和性别匹配同期在我院儿童保健专科进行健康检查的健康儿童76例(年龄7～13岁，男45例，女31例)为对照组，比较两组身高、体重、BMI并分析。 结果 两组超重/肥胖人数及性别比较差异未见统计学意义(P>0.05)。两组男、女童在身高、体重、BMI比较差异未见统计学意义(P>0.05)。不同年龄段比较，13岁研究组男童的身高[(162.88±7.59)cm比(154.29±8.14)cm，t＝3.181，P 0.05)。 结论 学龄期儿童OHT与BMI之间不存在明显相关性。
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Changes in 25 hydroxyvitamin D level in school-aged children with Orthostatic Hypertension
Chinese Journal of Applied Clinical Pediatrics, 2018Co-Authors: Xiaohuan Sun, Runmei Zou, Xuemei Luo, Ji-hong Liu, Ping LiuAbstract:Objective To explore the change in 25 hydroxyvitamin D[25-(OH)D] level in school-aged children with Orthostatic Hypertension (OHT). Methods Nineteen cases of school-aged children with OHT confirmed diagnosis by head-up tilt table test at the Department of Pediatric Cardiovasology, Children′s Medical Center, the Second Xiangya Hospital, Central South University, from October 2014 to February 2017, were selected as OHT group, including 17 males and 2 females, and their ages were from 7 to 14(11.21±2.70) years old.Nineteen healthy children including 17 males and 2 females and aged 8 to 14(11.05±2.35) years old who had a healthy examination of child care at the hospital in the same period were selected as healthy control group.In two groups of children all possible basic diseases were eliminated, such as severe liver and kidney disease, abnormal thyroid function and metabolic bone disease and/or the long-term use of 25-(OH)D metabolism drugs, accepted the serum 25-(OH) D detection. Results (1)There was no significant difference in age and gender between the OHT group and the healthy control group(t=0.559, P>0.05; χ2=0.000, P>0.05). The 25-(OH)D levels were significantly lower in the OHT group than those in the healthy control group [(39.62±10.65) nmol/L vs.(64.83±10.28) nmol/L, t=-7.422, P 0.05). Taking 25-(OH)D level as dependent variable, age, gender, height, body mass, systolic pressure, diastolic blood pressure as independent variables, multiple stepwise regression equation to predict 25-(OH)D level was not fit. Conclusion Lower level of 25-(OH)D may be one of the mechanisms for the onset of the school-aged children with OHT. Key words: 25 hydroxyvitamin D; School-aged children; Orthostatic Hypertension
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Differences of age and gender in Orthostatic Hypertension-a single-center study
Journal of Central South University. Medical sciences, 2016Co-Authors: Mei-hua Kang, Runmei Zou, Ping Lin, Cheng WangAbstract:OBJECTIVE To explore the differences of Chinese people's age and gender in Orthostatic Hypertension (OHT) by a single-center experience study. METHODS A total of 2 994 patients with unexplained syncope and dizziness, who were outpatients or had been hospitalized in Second Xiangya Hospital, Central South University from January 2000 to August 2012, were chosen and subjected to the head-up tilt table test (HUTT). Their ages ranged from 2.00 to 78.00 years old, with an average at 19.07±14.78 years old. There were 1 406 and 1 588 cases for male and female, respectively. A total of 745 patients were OHT, who were divided into a adult group (≥18 years old, 247/904 cases) and a children group ( 0.05), but it was higher in the adult group compared with that in the children group (27.05% vs 23.83%, χ2=4.125, P=0.042). There were 52 cases (6.98%) of high systolic and high diastolic blood pressure (sOHT merge dOHT), 16 cases (2.15%) of simple high systolic blood pressure OHT (sOHT), and 677 cases (90.87%) of simple high diastolic blood pressure OHT (dOHT) in the 745 patients with OHT. The incidence of dOHT and sOHT merge sOHT in the adults group were significantly higher than those in the children group (1.11% vs 0.29%, χ2=7.965, P 0.05); there was also no statistical difference in sOHT plus dOHT and dOHT between males and females (sOHT merge dOHT: 1.71% vs 1.76%, χ2=0.014, P>0.05; dOHT: 23.68% vs 21.66%, χ2=1.742, P>0.05; 1.71% vs 1.76%, χ2=0.014, P>0.05, respectively); but the dOHT was significantly higher in the males than that in the females in the children group (24.53% vs 19.74%, χ2=6.933, P>0.05). 2) There was no difference in the increment of systolic blood pressure in sOHT plus dOHT [(25.62±4.96) mmHg vs (23.54±5.83) mmHg, t=1.385, P>0.05] and the increment of diastolic blood pressure in dOHT [(13.46±3.49) mmHg vs (13.23±3.22) mmHg, t=0.840, P>0.05] between the adults group and the children group. There was no difference in the increment of systolic blood pressure in sOHT [(25.44±4.96) mmHg vs (23.68±5.35) mmHg, t=1.411, P>0.05] and the increment of diastolic blood pressure in dOHT [(14.09±4.28) mmHg vs (13.05±3.82) mmHg, t=1.887, P>0.05] between the adults group and the children group. CONCLUSION The incidence of OHT is higher in the adults group than that in the children group. There is no difference in systolic and diastolic blood pressure increment within 3 minutes during HUTT between the adults and children.
Kazuomi Kario - One of the best experts on this subject based on the ideXlab platform.
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Orthostatic Hypertension a new haemodynamic cardiovascular risk factor
Nature Reviews Nephrology, 2013Co-Authors: Kazuomi KarioAbstract:Orthostatic Hypertension—a condition characterized by a hyper-reactive pressor response to Orthostatic stress—is an emerging new risk factor for the development of Hypertension, hypertensive target-organ damage and subsequent cardiovascular events. In this Review, Kazuomi Kario describes the diagnosis, epidemiology and pathophysiology of Orthostatic Hypertension and discusses its clinical implications. Orthostatic Hypertension—a condition characterized by a hyperactive pressor response to Orthostatic stress—is an emerging risk factor for cardiovascular disease and is associated with hypertensive target-organ damage (resulting in silent cerebrovascular disease, left ventricular hypertrophy, carotid atherosclerosis and/or chronic kidney disease) and cardiovascular events (such as coronary artery disease and lacunar stroke). The condition is also considered to be a form of preHypertension as it precedes Hypertension in young, normotensive adults. Orthostatic blood pressure changes can be assessed using Orthostatic stress tests, including clinic active standing tests, home blood pressure monitoring and the head-up tilting test. Devices for home and for ambulatory blood pressure monitoring that are equipped with position sensors and do not induce a white-coat effect have increased the sensitivity and specificity of diagnosis of out-of-clinic Orthostatic Hypertension. Potential major mechanisms of Orthostatic Hypertension are sympathetic hyperactivity (as a result of hypersensitivity of the cardiopulmonary and arterial baroreceptor reflex) and α-adrenergic hyperactivation. Orthostatic Hypertension is also associated with morning blood pressure surge and extreme nocturnal blood pressure dipping, both of which increase the pulsatile haemodynamic stress of central arterial pressure and blood flow in patients with systemic haemodynamic atherothrombotic syndrome.
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Orthostatic Hypertension—a new haemodynamic cardiovascular risk factor
Nature Reviews Nephrology, 2013Co-Authors: Kazuomi KarioAbstract:Orthostatic Hypertension—a condition characterized by a hyper-reactive pressor response to Orthostatic stress—is an emerging new risk factor for the development of Hypertension, hypertensive target-organ damage and subsequent cardiovascular events. In this Review, Kazuomi Kario describes the diagnosis, epidemiology and pathophysiology of Orthostatic Hypertension and discusses its clinical implications. Orthostatic Hypertension—a condition characterized by a hyperactive pressor response to Orthostatic stress—is an emerging risk factor for cardiovascular disease and is associated with hypertensive target-organ damage (resulting in silent cerebrovascular disease, left ventricular hypertrophy, carotid atherosclerosis and/or chronic kidney disease) and cardiovascular events (such as coronary artery disease and lacunar stroke). The condition is also considered to be a form of preHypertension as it precedes Hypertension in young, normotensive adults. Orthostatic blood pressure changes can be assessed using Orthostatic stress tests, including clinic active standing tests, home blood pressure monitoring and the head-up tilting test. Devices for home and for ambulatory blood pressure monitoring that are equipped with position sensors and do not induce a white-coat effect have increased the sensitivity and specificity of diagnosis of out-of-clinic Orthostatic Hypertension. Potential major mechanisms of Orthostatic Hypertension are sympathetic hyperactivity (as a result of hypersensitivity of the cardiopulmonary and arterial baroreceptor reflex) and α-adrenergic hyperactivation. Orthostatic Hypertension is also associated with morning blood pressure surge and extreme nocturnal blood pressure dipping, both of which increase the pulsatile haemodynamic stress of central arterial pressure and blood flow in patients with systemic haemodynamic atherothrombotic syndrome.
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Orthostatic Hypertension home blood pressure monitoring for detection and assessment of treatment with doxazosin
Hypertension Research, 2012Co-Authors: Satoshi Hoshide, Kazuo Eguchi, Gianfranco Parati, Yoshio Matsui, Seiichi Shibazaki, Kazuomi KarioAbstract:To determine the role of home blood pressure (BP) monitoring for a reproducible assessment of Orthostatic Hypertension (OHT) and the effectiveness of Hypertension control by doxazosin. In this study, 605 medicated hypertensive outpatients were enrolled. Home BP in the sitting and standing positions was monitored in all patients in the morning and evening for 6 months. According to an open-label multicenter trial design, the patients were randomly allocated to either an intervention group that took doxazosin (1–4 mg) at bedtime or to a control group that did not receive any add-on medication. The patients were divided into deciles of Orthostatic BP change as evaluated by home BP monitoring at baseline. Those in the top decile, in the lowest decile and in deciles two through eight were then assigned to the OHT group, the Orthostatic hypotension group and the Orthostatic normotension group, respectively.Orthostatic BP in the OHYPO group did not change, whereas that of the OHT group was markedly reduced by doxazosin (P<0.01). In the control group, classification into Orthostatic BP categories using home BP monitoring was more reproducible (κ coefficient: 0.42–0.50) than when using clinical BP (κ coefficient: 0.13–0.24). In all groups, a reduction in the urinary albumin/creatinine ratio was significantly associated with a reduction in Orthostatic BP doxazosin (P<0.001).The identification of OHT based on home BP monitoring was highly reproducible. The administration of doxazosin might control OHT and consequently prevent target organ damage.
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Orthostatic Hypertension: home blood pressure monitoring for detection and assessment of treatment with doxazosin
Hypertension Research, 2011Co-Authors: Satoshi Hoshide, Kazuo Eguchi, Gianfranco Parati, Yoshio Matsui, Seiichi Shibazaki, Kazuomi KarioAbstract:To determine the role of home blood pressure (BP) monitoring for a reproducible assessment of Orthostatic Hypertension (OHT) and the effectiveness of Hypertension control by doxazosin. In this study, 605 medicated hypertensive outpatients were enrolled. Home BP in the sitting and standing positions was monitored in all patients in the morning and evening for 6 months. According to an open-label multicenter trial design, the patients were randomly allocated to either an intervention group that took doxazosin (1–4 mg) at bedtime or to a control group that did not receive any add-on medication. The patients were divided into deciles of Orthostatic BP change as evaluated by home BP monitoring at baseline. Those in the top decile, in the lowest decile and in deciles two through eight were then assigned to the OHT group, the Orthostatic hypotension group and the Orthostatic normotension group, respectively.Orthostatic BP in the OHYPO group did not change, whereas that of the OHT group was markedly reduced by doxazosin (P
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Orthostatic Hypertension a measure of blood pressure variation for predicting cardiovascular risk
Japanese Circulation Journal-english Edition, 2009Co-Authors: Kazuomi KarioAbstract:Abstract Orthostatic Hypertension, a measure of blood pressure (BP) variability, is a clinically important pathologic condition associated with the progression of target organ damage and subsequent cardiovascular risk. Orthostatic Hypertension precedes Hypertension and could be considered as preHypertension if a patient has seated clinic BP <140/90 mmHg. The simple examination of Orthostatic BP changes using a self-measured home BP monitoring, through which abnormal pathological conditions can be detected with high reproducibility without the white-coat effect. Orthostatic Hypertension is associated with morning Hypertension and increased neurohumoral activation; however, the precise mechanism of Orthostatic Hypertension remains unclear, and accumulation of further clinical evidence is necessary.
Cheng Wang - One of the best experts on this subject based on the ideXlab platform.
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T wave and ST segment amplitude changes in the supine and standing electrocardiograms of children with Orthostatic Hypertension and their clinical significance
Chinese journal of contemporary pediatrics, 2019Co-Authors: Runmei Zou, Ping Lin, Cheng WangAbstract:OBJECTIVE To examine the changes in T wave and ST segment amplitude in the supine and standing electrocardiograms (ECG) of children with Orthostatic Hypertension (OHT) and to determine their clinical significance. METHODS A total of 49 children with OHT were included in the OHT group. Forty-three age- and sex-matched healthy children were included in the control group. Heart rate and T wave and ST segment amplitude were measured in both groups. T wave amplitude and ST segment amplitude in supine ECG were compared with those in standing ECG within each group. The differences in supine vs standing T wave amplitude and ST segment amplitude were compared between the OHT and control groups. RESULTS In the control group, T wave amplitude in leads aVR, V1, and V4-V6 were significantly lower in standing ECG than in supine ECG (P
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t wave and st segment amplitude changes in the supine and standing electrocardiograms of children with Orthostatic Hypertension and their clinical significance
Chinese journal of contemporary pediatrics, 2019Co-Authors: Runmei Zou, Ping Lin, Cheng WangAbstract:OBJECTIVE To examine the changes in T wave and ST segment amplitude in the supine and standing electrocardiograms (ECG) of children with Orthostatic Hypertension (OHT) and to determine their clinical significance. METHODS A total of 49 children with OHT were included in the OHT group. Forty-three age- and sex-matched healthy children were included in the control group. Heart rate and T wave and ST segment amplitude were measured in both groups. T wave amplitude and ST segment amplitude in supine ECG were compared with those in standing ECG within each group. The differences in supine vs standing T wave amplitude and ST segment amplitude were compared between the OHT and control groups. RESULTS In the control group, T wave amplitude in leads aVR, V1, and V4-V6 were significantly lower in standing ECG than in supine ECG (P<0.05); ST segment amplitude in leads V4 and V5 were significantly higher in standing ECG than in supine ECG (P<0.05). In the OHT group, T wave amplitude in leads II, aVR, aVF, and V4-V6 were significantly lower in standing ECG than in supine ECG (P<0.05); ST segment amplitude in lead II was significantly higher in standing ECG than in supine ECG (P<0.05). The differences in T wave amplitude in lead II and V6 between supine and standing ECG were significantly higher in the OHT group than in the control group (P<0.05). Difference in T wave amplitude in lead V6 between supine and standing ECG was a significant diagnostic marker for OHT (P<0.05). This marker had 72.10% sensitivity and 57.10% specificity for the diagnosis of OHT at the optimal cut-off value of 0.105 mV. CONCLUSIONS Difference in T wave amplitude in lead V6 between supine and standing ECG has certain diagnostic value for OHT.
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Differences of age and gender in Orthostatic Hypertension-a single-center study
Journal of Central South University. Medical sciences, 2016Co-Authors: Mei-hua Kang, Runmei Zou, Ping Lin, Cheng WangAbstract:OBJECTIVE To explore the differences of Chinese people's age and gender in Orthostatic Hypertension (OHT) by a single-center experience study. METHODS A total of 2 994 patients with unexplained syncope and dizziness, who were outpatients or had been hospitalized in Second Xiangya Hospital, Central South University from January 2000 to August 2012, were chosen and subjected to the head-up tilt table test (HUTT). Their ages ranged from 2.00 to 78.00 years old, with an average at 19.07±14.78 years old. There were 1 406 and 1 588 cases for male and female, respectively. A total of 745 patients were OHT, who were divided into a adult group (≥18 years old, 247/904 cases) and a children group ( 0.05), but it was higher in the adult group compared with that in the children group (27.05% vs 23.83%, χ2=4.125, P=0.042). There were 52 cases (6.98%) of high systolic and high diastolic blood pressure (sOHT merge dOHT), 16 cases (2.15%) of simple high systolic blood pressure OHT (sOHT), and 677 cases (90.87%) of simple high diastolic blood pressure OHT (dOHT) in the 745 patients with OHT. The incidence of dOHT and sOHT merge sOHT in the adults group were significantly higher than those in the children group (1.11% vs 0.29%, χ2=7.965, P 0.05); there was also no statistical difference in sOHT plus dOHT and dOHT between males and females (sOHT merge dOHT: 1.71% vs 1.76%, χ2=0.014, P>0.05; dOHT: 23.68% vs 21.66%, χ2=1.742, P>0.05; 1.71% vs 1.76%, χ2=0.014, P>0.05, respectively); but the dOHT was significantly higher in the males than that in the females in the children group (24.53% vs 19.74%, χ2=6.933, P>0.05). 2) There was no difference in the increment of systolic blood pressure in sOHT plus dOHT [(25.62±4.96) mmHg vs (23.54±5.83) mmHg, t=1.385, P>0.05] and the increment of diastolic blood pressure in dOHT [(13.46±3.49) mmHg vs (13.23±3.22) mmHg, t=0.840, P>0.05] between the adults group and the children group. There was no difference in the increment of systolic blood pressure in sOHT [(25.44±4.96) mmHg vs (23.68±5.35) mmHg, t=1.411, P>0.05] and the increment of diastolic blood pressure in dOHT [(14.09±4.28) mmHg vs (13.05±3.82) mmHg, t=1.887, P>0.05] between the adults group and the children group. CONCLUSION The incidence of OHT is higher in the adults group than that in the children group. There is no difference in systolic and diastolic blood pressure increment within 3 minutes during HUTT between the adults and children.
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Research advance in children's Orthostatic Hypertension
Chinese Journal of Applied Clinical Pediatrics, 2014Co-Authors: Cheng WangAbstract:Orthostatic Hypertension (OHT) is defined as an increase in blood pressure from supine to Orthostatic position.Its mechanism involves a greater venous pooling in the lower extremities, sympathetic activation, change of neurohumoral factors and hypersensitivity of baroreflex.The diagnosis of OHT mainly depends on head-up tilt test.OHT is closely related to Hypertension, coronary artery diseases and asymptomatic cerebral infarction.It might be a new predictor of cardiovascular and cerebrovascular diseases and a long-term marker for evaluating target organs damage in Hypertension.Studies about OHT in children are rare.To some extent, blood pressure exists tracking phenomenon, further study of OHT in children is beneficial to predict the risk of cardiovascular and cerebrovascular disease and evaluate the target organ damage in adulthood. Key words: Child; Orthostatic Hypertension; Head-up tilt test; Pathophysiology; Treatment
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Differences of age and gender in children with Orthostatic Hypertension
Chinese Journal of Applied Clinical Pediatrics, 2012Co-Authors: Mei-hua Kang, Cheng Wang, Ping Lin, Jing Ran, Liping Zhu, Weihong ChuAbstract:Objective To explore the differences of age and gender in children with Orthostatic hypotension(OH).Methods A total of 1 158 cases of pediatric patients with unexplained syncope,headache,dizziness in syncope specialist children′s clinic of the Second Xiangya Hospital,Central South University,were chosen from Jan.2000 to May 2010.Forty-five patients with OH were diagnosed among 1 158(597 cases were male and 561 cases were female) ones with syncope and dizziness by head-up tilt table test(HUTT),who were 3.1-17.0 years old,mean(10.72±2.80) years old.The patients were divided into ≥12 years old group and 12 years old group according to the age.The course of disease,diagnostic rate,changes of blood pressure in OH children and their relationship with age and gender were analyzed.Results 1.The diagnostic rate:the diagnostic rate of OH was not different in age and gender(χ2=0.631,0.584;Pa0.05).2.The course and onset age of OH:the course was 0.03-60.00(8.13±14.06) months in 12 years old group,which was not different in gender [(4.77±7.86) months vs(10.59±17.10) months;t=0.634,P0.05)].In ≥12 years old group,the course was 0.30-72.00(20.10±22.20) months,there was no difference in gender [(16.55±1.80) months vs(26.03±2.87) months;t=0.273,P0.05].There was no diffe-rence of course between the different age groups[(8.73±16.07) month vs(20.11±22.20) month;t=1.932,P0.05].3.Changes in blood pressure of OH children:there was no difference in systolic and diastolic blood pressure decline within 3 minutes during HUTT between ≥12 years old group and 12 years old group(t=1.495,0.079;Pa0.05).In 12 years old group,there was no difference in systolic and diastolic blood pressure decrease within 3 minutes during HUTT in gender(t=0.019,1.730;Pa0.05).In ≥12 years old group,there was no difference in systolic and diastolic blood pressure decrease within 3 minutes during HUTT in gender(t=0.364,0.843;Pa0.05).Conclusions There is no difference in the course of disease and systolic and diastolic blood pressure decrease within 3 minutes during HUTT of OH in age and gender.There is also no difference of age and gender either in the diagnostic rate.
Ping Lin - One of the best experts on this subject based on the ideXlab platform.
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T wave and ST segment amplitude changes in the supine and standing electrocardiograms of children with Orthostatic Hypertension and their clinical significance
Chinese journal of contemporary pediatrics, 2019Co-Authors: Runmei Zou, Ping Lin, Cheng WangAbstract:OBJECTIVE To examine the changes in T wave and ST segment amplitude in the supine and standing electrocardiograms (ECG) of children with Orthostatic Hypertension (OHT) and to determine their clinical significance. METHODS A total of 49 children with OHT were included in the OHT group. Forty-three age- and sex-matched healthy children were included in the control group. Heart rate and T wave and ST segment amplitude were measured in both groups. T wave amplitude and ST segment amplitude in supine ECG were compared with those in standing ECG within each group. The differences in supine vs standing T wave amplitude and ST segment amplitude were compared between the OHT and control groups. RESULTS In the control group, T wave amplitude in leads aVR, V1, and V4-V6 were significantly lower in standing ECG than in supine ECG (P
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t wave and st segment amplitude changes in the supine and standing electrocardiograms of children with Orthostatic Hypertension and their clinical significance
Chinese journal of contemporary pediatrics, 2019Co-Authors: Runmei Zou, Ping Lin, Cheng WangAbstract:OBJECTIVE To examine the changes in T wave and ST segment amplitude in the supine and standing electrocardiograms (ECG) of children with Orthostatic Hypertension (OHT) and to determine their clinical significance. METHODS A total of 49 children with OHT were included in the OHT group. Forty-three age- and sex-matched healthy children were included in the control group. Heart rate and T wave and ST segment amplitude were measured in both groups. T wave amplitude and ST segment amplitude in supine ECG were compared with those in standing ECG within each group. The differences in supine vs standing T wave amplitude and ST segment amplitude were compared between the OHT and control groups. RESULTS In the control group, T wave amplitude in leads aVR, V1, and V4-V6 were significantly lower in standing ECG than in supine ECG (P<0.05); ST segment amplitude in leads V4 and V5 were significantly higher in standing ECG than in supine ECG (P<0.05). In the OHT group, T wave amplitude in leads II, aVR, aVF, and V4-V6 were significantly lower in standing ECG than in supine ECG (P<0.05); ST segment amplitude in lead II was significantly higher in standing ECG than in supine ECG (P<0.05). The differences in T wave amplitude in lead II and V6 between supine and standing ECG were significantly higher in the OHT group than in the control group (P<0.05). Difference in T wave amplitude in lead V6 between supine and standing ECG was a significant diagnostic marker for OHT (P<0.05). This marker had 72.10% sensitivity and 57.10% specificity for the diagnosis of OHT at the optimal cut-off value of 0.105 mV. CONCLUSIONS Difference in T wave amplitude in lead V6 between supine and standing ECG has certain diagnostic value for OHT.
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Association between Orthostatic Hypertension and body mass index in school-age children
Chinese Pediatric Emergency Medicine, 2019Co-Authors: Wenhua Zhang, Ping Lin, Runmei Zou, Shuo Wang, Yuwen Wang, Chuanmei TanAbstract:目的 探讨学龄期儿童直立性高血压(Orthostatic Hypertension，OHT)与体重指数(body mass index，BMI)的相关性。 方法 收集2015年1月至2018年10月在中南大学湘雅二医院儿童医学中心儿童心血管专科诊断为OHT的学龄期儿童76例(年龄7～13岁，男45例，女31例)为研究组，按年龄和性别匹配同期在我院儿童保健专科进行健康检查的健康儿童76例(年龄7～13岁，男45例，女31例)为对照组，比较两组身高、体重、BMI并分析。 结果 两组超重/肥胖人数及性别比较差异未见统计学意义(P>0.05)。两组男、女童在身高、体重、BMI比较差异未见统计学意义(P>0.05)。不同年龄段比较，13岁研究组男童的身高[(162.88±7.59)cm比(154.29±8.14)cm，t＝3.181，P 0.05)。 结论 学龄期儿童OHT与BMI之间不存在明显相关性。
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Differences of age and gender in Orthostatic Hypertension-a single-center study
Journal of Central South University. Medical sciences, 2016Co-Authors: Mei-hua Kang, Runmei Zou, Ping Lin, Cheng WangAbstract:OBJECTIVE To explore the differences of Chinese people's age and gender in Orthostatic Hypertension (OHT) by a single-center experience study. METHODS A total of 2 994 patients with unexplained syncope and dizziness, who were outpatients or had been hospitalized in Second Xiangya Hospital, Central South University from January 2000 to August 2012, were chosen and subjected to the head-up tilt table test (HUTT). Their ages ranged from 2.00 to 78.00 years old, with an average at 19.07±14.78 years old. There were 1 406 and 1 588 cases for male and female, respectively. A total of 745 patients were OHT, who were divided into a adult group (≥18 years old, 247/904 cases) and a children group ( 0.05), but it was higher in the adult group compared with that in the children group (27.05% vs 23.83%, χ2=4.125, P=0.042). There were 52 cases (6.98%) of high systolic and high diastolic blood pressure (sOHT merge dOHT), 16 cases (2.15%) of simple high systolic blood pressure OHT (sOHT), and 677 cases (90.87%) of simple high diastolic blood pressure OHT (dOHT) in the 745 patients with OHT. The incidence of dOHT and sOHT merge sOHT in the adults group were significantly higher than those in the children group (1.11% vs 0.29%, χ2=7.965, P 0.05); there was also no statistical difference in sOHT plus dOHT and dOHT between males and females (sOHT merge dOHT: 1.71% vs 1.76%, χ2=0.014, P>0.05; dOHT: 23.68% vs 21.66%, χ2=1.742, P>0.05; 1.71% vs 1.76%, χ2=0.014, P>0.05, respectively); but the dOHT was significantly higher in the males than that in the females in the children group (24.53% vs 19.74%, χ2=6.933, P>0.05). 2) There was no difference in the increment of systolic blood pressure in sOHT plus dOHT [(25.62±4.96) mmHg vs (23.54±5.83) mmHg, t=1.385, P>0.05] and the increment of diastolic blood pressure in dOHT [(13.46±3.49) mmHg vs (13.23±3.22) mmHg, t=0.840, P>0.05] between the adults group and the children group. There was no difference in the increment of systolic blood pressure in sOHT [(25.44±4.96) mmHg vs (23.68±5.35) mmHg, t=1.411, P>0.05] and the increment of diastolic blood pressure in dOHT [(14.09±4.28) mmHg vs (13.05±3.82) mmHg, t=1.887, P>0.05] between the adults group and the children group. CONCLUSION The incidence of OHT is higher in the adults group than that in the children group. There is no difference in systolic and diastolic blood pressure increment within 3 minutes during HUTT between the adults and children.
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Ambulatory blood pressure monitoring effect with health education in children with Orthostatic Hypertension
Chinese Pediatric Emergency Medicine, 2015Co-Authors: Deyu Liu, Jibing Xiang, Ping Lin, Runmei ZouAbstract:Objective To analyse the 24 h ambulatory blood pressure monitoring(ABPM)characteristics and effect of health education in children with Orthostatic Hypertension (OHT) retrospectively. Methods A total of 19 children[11 males and 8 females with mean age of (11.26±2.16) years] who were outpatients or had been hospitalized in the Second Xiangya Hospital of Central South University due to unexplained syncope, presyncope, and finally diagnosed as OHT after head up tilt test(HUTT). HUTT and ABPM were reexamined at 12~190(47±48)days after receiving health education (including psychological guidance, avoiding sudden changes in posture, increasing the amount of water, avoiding syncope inducement, etc). Results (1) ABPM parameters: there were no significant differences of ABPM parameters before and after health education respectively(P>0.05, respectively). (2) After the health education, HUTT 3 min diastolic pressure[(71.89±1.60) mmHg vs.(76.47±8.49) mmHg, 1 mmHg=0.133 kPa, t=2.785, P 0.05, respectively]. (4) OHT cure rate: after health education, to review the HUTT, within 3 minutes in HUTT, blood pressure changes of 14 cases were normal range.The cure rate was 73.7%. Conclusion OHT children's blood type is given priority to with"non-dipper blood pressure" , and the ratio of"dipper blood pressure" increase and the HUTT 3 min diastolic pressure and diastolic blood pressure change decrease after health education.It suggests that the health education of OHT children has a certain clinical effect. Key words: Ambulatory blood pressure monitoring; Orthostatic Hypertension; Children; Health education; Treatment effect
Hongfang Jin - One of the best experts on this subject based on the ideXlab platform.
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Orthostatic Hypertension in Children: An Update.
Frontiers in Pediatrics, 2020Co-Authors: Hongfang JinAbstract:The concept of Orthostatic Hypertension in children was first proposed in 2012. The pathogenesis is not clear by now. Orthostatic Hypertension is one of the important causes of Orthostatic intolerance in children and is related to the development of essential Hypertension in the future. It is commonly seen in older children, with dizziness and syncope as their main clinical manifestations. Non-drug therapy is the commonly used treatment strategy, which is effective to improve the Orthostatic intolerance symptoms. In this paper, we reviewed the clinical studies on the pathogenesis, clinical characteristics, diagnostic criteria, and treatment of Orthostatic Hypertension in children, aiming to provide new insights for the future studies on pediatric Orthostatic Hypertension.
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Risk Factors for Orthostatic Hypertension in Children.
The Journal of Pediatrics, 2020Co-Authors: Zhenhui Han, Yuanyuan Wang, Chunyan Tao, Yaru Wang, Hongfang JinAbstract:Objective To investigate the risk factors for Orthostatic Hypertension in children. Study design Eighty children with Orthostatic Hypertension were enrolled in the group with Orthostatic Hypertension, and 51 healthy children served as the control group. Demographic characteristics, clinical history, daily water intake, nightly sleep duration, the results of the standing test, and complete blood count were recorded and compared between the 2 groups. The risk factors for pediatric Orthostatic Hypertension were determined by logistic regression analysis. Results Body mass index and red blood cell distribution width were higher in the group with Orthostatic Hypertension than in healthy children, whereas daily water intake and sleep duration were lower. Logistic regression analyses showed that, if a child suffered from overweight, suffered from obesity, had a daily water intake of less than 800 mL, or had a red blood cell distribution width that was increased by 1%, the risk of Orthostatic Hypertension would be increased by 6.069 times (95% CI, 1.375-26.783; P Conclusions Increased body mass index, inadequate water intake and sleep duration, and elevated red blood cell distribution width were identified as risk factors for pediatric Orthostatic Hypertension.
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Clinical study advance of Orthostatic Hypertension in children
Chinese Journal of Applied Clinical Pediatrics, 2016Co-Authors: Hongfang JinAbstract:Orthostatic Hypertension (OHT) in children was first proposed by Chinese scholars in 2012.The diagnostic criterion was revised in 2015.OHT in children was not rare in clinical practice.Children and adolescents are susceptible to OHT when they suddenly change posture or standing for a long time.The mechanisms of OHT were not clear.Dizziness, headache, nausea and vomiting were the main manifestations of OHT.Severe symptom in childhood OHT includes syncope.The prognosis of OHT was good, but the abnormal blood pressure will last to adults.Further study in OHT will help to predict the risk of cardiovascular and cerebrovascular diseases and help to evaluate target organ injury.The treatment of OHT has been explored, and non-medical treatment is the main option.Study in medical treatment for OHT has not been conducted.Now, the diagnostic criteria in children, epidemiologic status, clinical features and treatment of OHT were focused to deepen the understanding of OHT in children and improve the clinical standard of the disease. Key words: Orthostatic Hypertension; Child; Clinical manifestations; Diagnosis; Treatment
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Changes of atrial natriuretic peptide and antidiuretic hormone in children with postural tachycardia syndrome and Orthostatic Hypertension: a case control study.
Chinese Medical Journal, 2014Co-Authors: Juan Zhao, Chaoshu Tang, Jinyan Yang, Hongfang JinAbstract:BACKGROUND The abnormal blood volume regulation is one of the most important pathogenesis in postural tachycardia syndrome in children. This study was designed to investigate the plasma atrial natriuretic peptide and antidiuretic hormone levels in postural tachycardia syndrome children, and their associations with the changes in heart rate and blood pressure in head-up test. METHODS Twenty-one postural tachycardia syndrome patients ((12 ± 2) years) and 26 healthy children ((12 ± 1) years) were included. According to blood pressure changes in head-up test, the postural tachycardia syndrome patients were divided into two subgroups: postural tachycardia syndrome with Orthostatic Hypertension and postural tachycardia syndrome without Orthostatic Hypertension. The plasma atrial natriuretic peptide and antidiuretic hormone levels were measured using enzyme-linked immunosorbent assay. RESULTS The plasma atrial natriuretic peptide level in postural tachycardia syndrome patients was higher than the control (P = 0.004), whereas the difference in plasma antidiuretic hormone level between postural tachycardia syndrome and controls was not significant (P = 0.222). The plasma antidiuretic hormone level of patients suffering from postural tachycardia syndrome with Orthostatic Hypertension was much higher than that of children having postural tachycardia syndrome without Orthostatic Hypertension (P < 0.05). In postural tachycardia syndrome patients, the upright max heart rate was positively correlated with the plasma atrial natriuretic peptide level (r = 0.490, P < 0.05) and the upright systolic blood pressure was positively correlated with the plasma antidiuretic hormone levels (r = 0.472, P < 0.05). CONCLUSIONS There was a disturbance of plasma atrial natriuretic peptide and antidiuretic hormone in postural tachycardia syndrome children.
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clinical analysis of Orthostatic Hypertension in children
Chinese journal of pediatrics, 2012Co-Authors: Juan Zhao, J Y Yang, Hongfang JinAbstract:Objective To study the clinical characteristics of Orthostatic Hypertension (OHT) in children. Method A total of 96 children with OHT who met the diagnostic criteria and clinical manifestations were recruited in the Department of Pediatrics, Peking University First Hospital. Age and sex distributions were observed. The duration of disease, the frequencies of symptoms and the predisposing factors were recorded. The hemodynamic changes from supine to up-right positions were also analyzed. Result There were 50 boys and 46 girls in the study group. The mean age was (11.8±2.7) years. Thirty-two children were from 6 to 10 years old, accounting for 33.3% of all subjects, while 64 patients were from 11 to 17 years old, accounting for 66.7%. Durations of symptoms of OHT were less than 1 month in 22.9% children, from 1 month to 1 year in 51.1% children and longer than 1 year in 26.0% children. The most common clinical manifestations were syncope and dizziness. The incidence of them was 70.8% and 46.9%, respectively. Other clinical manifestations included transitional amaurosis, nausea and/or vomiting, pallor and so on. These clinical manifestations often occurred on position change (24.0%) and long-time standing (57.3%) in children. Other predisposing factors included exercise, emotion changes and fuggy environment. The baseline systolic and diastolic blood pressures were (103±8) mm Hg (1 mm Hg=0.133 kPa) and (59±6) mm Hg, respectively, the up-right systolic and diastolic blood pressure at 3 min were (113±8) mm Hg and (73±6) mm Hg and the differences were significant (t=27.674, P<0.01; t=17.936, P<0.01). The baseline heart rate in supine position was (81±11) bpm and the maximum heart rate in up-right position was (113±12) bpm (t=33.092, P<0.01). Conclusion OHT is commonly seen in puberty of children. The chief complaints are syncope and dizziness. They were mostly induced by position change and long-time standing. Blood pressure was significantly increased from supine to up-right position. Key words: Child; Disease attributes; Orthostatic Hypertension
