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Biomedical subjects

L J Beilin

Publications and source records attributed to L J Beilin.

At least 37 records · Page 2Linked to original sources

Prenatal ultrasound biometry related to subsequent blood pressure in childhood.

STUDY OBJECTIVE: To relate measures of fetal growth/size other than birth weight with subsequent blood pressure measured on the same individuals within the context of the "fetal origins of adult disease". DESIGN: A prospective cohort study in which measurements of fetal dimensions obtained by serial ultrasound imaging between 18 and 38 weeks gestation were analysed with reference to systolic blood pressure measurements on the offspring at age 6 years. SETTING: Perth, Western Australia. PARTICIPANTS: A subgroup of 707 eligible mother-fetus pairs from a cohort of 2876 pregnant women and their offspring. The number of mother-fetus pairs varied at each gestational age and by measurement of fetal dimension. Subsequent blood pressure recordings were obtained on approximately 300 of the offspring at age 6 years. MAIN RESULTS: The findings confirmed the inverse association between birth weight and systolic blood pressure at age 6. There was, also, an inverse relation between fetal femur length and systolic blood pressure at age 6, adjusted for current height. Furthermore, an inverse association was demonstrated between a statistically derived measure of fetal growth (conditional z score) between 18 and 38 weeks gestation and later systolic blood pressure at age 6. The effect sizes for all three relations were in the order of 1-2 mm Hg per standard deviation change. CONCLUSION: The mechanisms underpinning the "fetal origins" hypothesis may be operative early in pregnancy and may be reflected in the length of the fetal femur in early to mid-pregnancy.

Anthropometry↗

Red wine polyphenols, in the absence of alcohol, reduce lipid peroxidative stress in smoking subjects.

Phenolic compounds in red wine can exert antioxidant effects on in vitro lipoprotein oxidation. This has led to speculation that red wine consumption mediates unique anti-atherosclerotic effects compared to other alcoholic beverages. However, studies assessing the effects of red wine consumption on lipoprotein oxidation ex vivo have not been conclusive. The recent identification of the F2-isoprostanes as oxidative products of arachidonic acid has provided a reliable measure of in vivo lipid peroxidation. This randomized trial investigated changes in plasma and urinary F2-isoprostane concentrations following red wine, white wine, or dealcoholized red wine consumption in humans. Eighteen male smokers consumed, in random order, red wine, white wine, or dealcoholized red wine, for two weeks with one week washout between beverages. Plasma and urinary F2-isoprostane concentrations were measured before and after each beverage. Serum gamma-glutamyl transpeptidase (gamma-GT) and urinary 4-O -methylgallic acid were measured as markers of alcohol consumption and phenolic acid absorption, respectively. Plasma F2-isoprostanes (p < .05) decreased significantly with dealcoholized red wine but not with the alcohol-containing beverages. Urinary excretion of F2-isoprostanes showed a similar trend. gamma-GT decreased significantly with dealcoholized red wine and increased with both alcohol-containing beverages (p < .01). Urinary excretion of 4-O-methylgallic acid increased significantly (p < .001) in the 24 h urine samples following red wine or dealcoholized red wine ingestion, but not with white wine. Serum urate increased and beta-carotene decreased with both alcoholic beverages relative to dealcoholized red wine. There was no change in the antioxidants alpha- and gamma-tocopherol or vitamin C with any of the beverages. The results suggest that polyphenols in dealcoholized red wine can reduce in vivo lipid peroxidation as measured by F2-isoprostanes in smoking subjects. However, no reduction in lipid peroxidation was observed following red or white wine consumption, suggesting that any protective effects of wine drinking on cardiovascular disease are unlikely to be related to inhibition of lipid oxidation.

Adult↗

Effects of regular ingestion of black tea on haemostasis and cell adhesion molecules in humans.

OBJECTIVE: To assess the effects in humans of regular ingestion of black tea on haemostasis-related variables and cell adhesion molecules. DESIGN: Twenty-two subjects were recruited from the general population to a randomised-controlled crossover study. Subjects stopped drinking tea, apart from that provided, for the duration of the study. During a 4-week baseline period all subjects drank 5 cups/day (250 ml) of hot water. The effects of 5 cups/day of black tea for 4 weeks were then compared with hot water. Platelet aggregation in response to three doses of collagen and ADP, plasma concentrations of coagulation and fibrinolytic factors (fibrinogen, factor VII, tPA, PAI-1) and plasma concentrations of cell adhesion molecules (soluble P-selectin, E-selectin, ICAM-1, VCAM-1) were assessed twice, one week apart, at the end of each period. Twenty-four hour urinary concentration of 4-O-methylgallic acid (4OMGA), assessed once at the end of each period, was used as a marker of black tea polyphenol intake. RESULTS: The 24 h urinary excretion of 4OMGA was increased during regular ingestion of black tea in comparison to hot water (P<0.0001). Black tea resulted in lower soluble P-selectin (P=0.01) in comparison to hot water, but did not influence other adhesion molecules. Soluble P-selectin was significantly correlated with mean collagen-stimulated platelet aggregation at baseline (r=0.61, P=0.003), and during regular ingestion of hot water (r=0.70, P<0.0001) and black tea (r=0.51, P=0.01). However, platelet aggregation was not different between the black tea and hot water periods for collagen- or ADP-stimulated aggregation at any dose. Coagulation and fibrinolytic factors were also not different between periods. CONCLUSIONS: The effect of black tea on soluble P-selectin provides a potential mechanism for cardiovascular benefits of regular ingestion of tea. SPONSORSHIP: This study was supported by grants from the Tea Trade Health Research Association and the National Heart Foundation of Australia.

Adult↗

Family lifestyle and parental body mass index as predictors of body mass index in Australian children: a longitudinal study.

OBJECTIVE: To investigate associations between body mass index (BMI) and family characteristics, including lifestyle, in parents and offspring from Australian families. DESIGN AND SUBJECTS: Longitudinal survey of 219 families of Australian children who had been surveyed 3-yearly between the ages of 9 and 18 y. MEASUREMENTS: Socio-economic status, weight and height, diet from 3 day records or food frequency questionnaires, alcohol consumption, smoking habits and physical fitness in offspring (bicycle ergometry in 18-y-olds). RESULTS: In 18-y-olds, in models examining offspring's lifestyle variables, BMI was predicted negatively by physical fitness (P=0.012), and positively by alcohol intake (P=0.046) in sons while, in daughters, only a negative association with physical fitness was significant. In models including parental characteristics, BMI in 18-y-old sons and daughters was significantly predicted by mothers' and fathers' BMI, independently of offsprings' alcohol intake, smoking, physical fitness and parents' education, and, in daughters, by fathers' alcohol intake. These models explained 48% of variance in daughters and 33% in sons. In both sons and daughters, BMI over the 9 y of the survey was consistently higher in offspring with overweight or obese fathers (P=0.033 for sons, P=0.024 for daughters) or mothers (P=0.031 for sons, P=0.037 for daughters). Physical fitness at the ages of 12, 15 and 18 y was negatively related to fathers' obesity in daughters and mothers' obesity in sons. Obesity in fathers was associated with a four-fold increase in risk of obesity at the age of 18 y in both sons and daughters with an independent eight-fold increase in risk for daughters if mothers were obese. Birthweight was unrelated to overweight or obesity in the 18-y-olds. Alcohol intake in sons related significantly to alcohol intake in either parent while, for daughters, there was a significant association only with fathers' alcohol consumption. In daughters, fat intake was positively associated with fat intake score in both fathers and mothers. CONCLUSION: Parental overweight or obesity may identify children at risk for a range of unhealthy behaviours. Promotion of a healthy lifestyle targeting overweight families, particularly in lower socio-economic groups, should be a priority.

Adolescent↗

Recent developments concerning diet and hypertension.

1. Recent data from randomized controlled dietary trials have shown blood pressure-lowering effects of foodstuffs and dietary patterns to be of practical importance for both individual and population blood pressure control. 2. The salient studies include Dietary Approaches to Stop Hypertension (DASH) trials, on complex dietary patterns and of additive effects of salt restriction, Trial of Nonpharmacologic Interventions in the Elderly (TONE), on weight control and sodium restriction as substitutes for drug therapy, and two Australian trials showing additive effects of dietary fish and weight control and of dietary protein and fibre in treated hypertensives. 3. Regular coffee drinking raised blood pressure in older hypertensives, whereas potential antihypertensive effects of dietary anti-oxidants require further scrutiny.

Animals↗

Alcohol and endothelial function: a brief review.

1. In spite of the dose-related effects of alcohol consumption to increase blood pressure, regular light to moderate alcohol intake appears to confer protection against both coronary artery disease and ischaemic stroke. In contrast, heavy alcohol consumption increases the risk of coronary artery disease and the risk of both haemorrhagic and ischaemic stroke. 2. Effects of alcohol consumption on endothelial cell function may be relevant to these disparate effects on cardiovascular outcomes. In in vitro animal studies, low doses of alcohol have been demonstrated to increase release of nitric oxide and augment endothelium-mediated vasodilatation, whereas higher doses impair endothelium-dependent relaxation responses. In contrast, chronic administration of alcohol to rats has generally been associated with tolerance to the acute inhibitory effects of alcohol on endothelium-mediated vasodilatation and may even result in augmentation of such responses. 3. The few human studies to date that have examined the effects of alcohol on endothelial function have focused on postischaemic flow-mediated dilation of the brachial artery (FMD). Although blunted FMD responses have been reported in alcoholic subjects, acute administration of alcohol or short-term interventions to reduce alcohol intake have had no effect to either improve or impair FMD. 4. Further studies in humans assessing acute and longer term dose-related effects of alcohol on endothelial function in both conduit and resistance vessels will be necessary if the relevance of the findings from in vitro and in vivo animal studies are to be understood in the context of the complex interrelationships of alcohol with cardiovascular disease.

Alcohol Drinking↗

Non pharmacologic therapy and lifestyle factors in hypertension.

Lifestyle factors are now recognised to be key determinants of both the rise in blood pressure with ageing and the cardiovascular disease associated with essential hypertension. This paper summarises recent evidence for independent or additive effects of different aspects of diet and behavioural factors on blood pressure levels and some related cardiovascular risk factors. The influence of single nutrients, fats, fibre, protein, antioxidants, caffeine, complex dietary patterns, physical activity, alcohol and smoking will be considered against a background of obesity and psychological factors contributing to blood pressure elevation.

Blood Pressure↗

Placental weight and placental ratio as predictors of later blood pressure in childhood.

OBJECTIVE: A significant inverse relationship between blood pressure and birth weight is firmly established. This association may be the result of fetal adaptations to an adverse intrauterine environment. Further markers of intrauterine growth include the weight of the placenta and the placental ratio (the ratio of placental weight to birth weight). A number of studies suggest that a decreased placental weight or an elevated placental ratio may be independent risk factors for subsequent high blood pressure. The overall evidence for this is, however, inconclusive. The purpose of the present study was to clearly define the relationships between placental weight, placental ratio and subsequent blood pressure during childhood. DESIGN: Prospective cohort study of 2507 singleton children, born at term during 1989-1992. Blood pressures were recorded at ages 1, 3 and 6 years, using a semi-automated oscillometric device. RESULTS: Inverse relationships existed between both systolic and diastolic blood pressure and placental weight, adjusted for current weight at ages 1, 3 and 6 years. The relationships between placental weight and systolic blood pressure were statistically significant at ages 1 and 3 years. There was no consistent relationship between placental weight and later blood pressure within birth weight categories. No clinically or statistically significant association was seen between the placental ratio and either systolic or diastolic blood pressures at any age. CONCLUSIONS: Birth weight, rather than placental weight or their ratio, is the early life factor most importantly related to subsequent blood pressure in childhood.

Birth Weight↗

Tracking of blood pressure in Australian children.

OBJECTIVE: Tracking of blood pressure (BP) from childhood occurs in populations but, for individuals, prediction of adult BP from childhood levels is poor. We examined factors that may influence tracking of BP to identify better predictors of higher BP in early adult life. DESIGN: A prospective study of children recruited at the age of 9 years by random sampling of Perth metropolitan schools stratified by socio-economic status. SETTING: Community based with re-surveys 3-yearly for 9 years. PARTICIPANTS: A total of 516 boys and 520 girls at 9 years; 680 boys and 630 girls at 12 years; 318 boys and 300 girls at 15 years; 330 men and 326 women at 18 years. MAIN OUTCOME MEASURES: Systolic (SBP) and diastolic (DBP) BP. RESULTS: Persistence in the highest quartile for SBP between surveys was seen in 34-48% of subjects and in 37% between the ages of 9 and 18 years. The proportion increased to around 60% in those in the highest quartile for body mass index (BMI), to 70% in those in the highest quartile for change in BMI and to 60% if there was a family history of hypertension. In log-linear models, persistence in a quartile for SBP was significantly related to a family history of hypertension, previous SBP, BMI and change in BMI. Relationships were similar for DBP. CONCLUSIONS: Excessive weight gain in adolescence and a family history of hypertension substantially increase the risk of higher BP persisting into early adult life. Recognition of children at risk would allow early intervention emphasizing weight control with potential long-term benefits.

Adolescent↗

Long-term effects of exercise on blood pressure and lipids in healthy women aged 40-65 years: The Sedentary Women Exercise Adherence Trial (SWEAT).

OBJECTIVES: To evaluate the long-term effects of regular moderate or vigorous intensity exercise on blood pressure and blood lipids in previously sedentary older women. DESIGN: Subjects were randomly assigned to either a supervised centre-based (CB) or a minimally supervised home-based (HB) exercise program, initially for 6 months. Within each program, subjects were further randomized to exercise either at moderate (40-55% heart rate reserve, HRres) or vigorous intensity (65-80% HRres). After 6 months, all groups continued a HB moderate or vigorous exercise program for another 12 months. METHODS: Healthy, sedentary women (aged 40-65 years) (n = 126) were recruited from the community. Subjects exercised three times per week for 30 min. They were evaluated at baseline, 6, 12 and 18 months. RESULTS: There was a significant fall of 2.81 mmHg in systolic blood pressure (P = 0.049) and 2.70 mmHg in diastolic blood pressure (P = 0.004) after correction for age and baseline values with moderate exercise, but not with vigorous-intensity exercise. When this analysis was repeated with the change in body mass included, the results were unchanged. After correction for potential confounding factors, there was a significant fall in total cholesterol and low density lipoprotein cholesterol with vigorous but not moderate exercise at 6 months (P < 0.05) but not at 18 months. CONCLUSIONS: In this largely normotensive population of older women, a moderate, but not vigorous exercise program, achieved sustained falls in resting systolic and diastolic blood pressure over 18 months. The study demonstrates that, in older women, moderate intensity exercise is well accepted, sustainable long-term and has the health benefit of reduced blood pressure.

Adult↗

Association between the endothelin-1 gene Lys198Asn polymorphism blood pressure and plasma endothelin-1 levels in normal and pre-eclamptic pregnancy.

OBJECTIVE: This study examined the frequency of the Lys198Asn polymorphism in the endothelin-1 (ET-1) gene in women with pre-eclampsia and normal pregnancy; and its contribution to levels of plasma ET-1 and blood pressure. DESIGN AND METHODS: This was a retrospective study examining the frequency of the ET-1 Lys198Asn polymorphism in 72 proteinuric pre-eclamptics and 81 normal pregnant women. Height, weight, blood pressure and plasma ET-1 were measured antenatally and at 6 weeks post-partum. Using specific mutagenic primers, the frequency of the G/G (normal), G/T heterozygote and T/T (mutant) genotypes of the Lys198Asn polymorphism were examined. RESULTS: The polymorphism was not associated with pre-eclampsia. However, in the combined pregnant groups after correction for BMI and group, a significant effect of the T-allele (T/T,G/T) on systolic blood pressure was found (121 +/- 1.5 mmHg compared with 116 +/- 1.3 mmHg in the G/G homozygotes). A significant interaction was found between the T-allele and pregnancy in determining systolic blood pressure, so that the effect was no longer seen post-partum. Pregnant women with the T/T genotype had significantly elevated plasma ET-1 levels 5.8 pg/ml [confidence interval (CI) 3.7-9.1] compared with 3.1 pg/ml (CI 2.6-3.8) in the G/T heterozygotes and 3.6 pg/ml (CI 3.0-4.1) in the normal G/G homozygotes. CONCLUSION: The Lys198Asn polymorphism does not directly contribute to the incidence of pre-eclampsia. However, the association of the T-allele with raised blood pressure and the T/T genotype with increased plasma ET-1 levels suggest that this polymorphism may interact with other genes or environmental factors to sensitize pregnant women to develop pre-eclampsia.

Adult↗

Long-chain omega 3 fatty acids, blood lipids and cardiovascular risk reduction.

Increasing evidence suggests that omega 3 fatty acids derived from fish and fish oils may play a protective role in coronary heart disease and its many complications, through a variety of actions, including effects on lipids, blood pressure, cardiac and vascular function, prostanoids, coagulation and immunological responses. Interesting differences between the effects of highly purified eicosapentaenoic acid and docosahexaenoic acid are emerging, which may be relevant in the choice of omega 3 fatty acid for incorporation into food products. On the basis of our current knowledge, we believe it is justified to recommend, particularly to high-risk populations, an increased dietary intake of omega 3 fatty acids through the consumption of fish.

Animals↗

Improved analysis of brachial artery ultrasound using a novel edge-detection software system.

Brachial artery ultrasound is commonly employed for noninvasive assessment of endothelial function. However, analysis is observer dependent and susceptible to errors. We describe studies on a computerized edge-detection and wall-tracking software program to allow more accurate and reproducible measurement. In study 1, three purpose-built Perspex phantom arteries, 3.00, 4.00, and 6.00 mm in diameter, were measured with the software. There was a mean bias of 11 microm (P < 0.001 at each level) between known and measured values; the mean resolving power of the software was estimated as 8.3 microm. In study 2, the mean intraobserver coefficient of variation of repeated measures of flow-mediated dilation (FMD) using the software (6.7%) was significantly lower than that for traditional manual measurements using the intima-lumen interfaces (24.8%, P < 0.05) and intima-media interfaces (32.5%, P < 0.05). In study 3, 24 healthy volunteers underwent repeat testing twice within 1 wk; the coefficients of variation for between-visit reproducibility of FMD and response to glyceryl trinitrate using the software were 14.7 and 17.6%, respectively. Assuming 80% power and an alpha of 0.05, eight subjects with matched controls would be required, in a parallel designed study, to detect an absolute 2.5% change in FMD. In summary, we have developed a semiautomated computerized vascular ultrasound analysis system that will improve the power of clinical intervention studies to detect small changes in arterial diameter.

Analysis of Variance↗

Dietary protein and soluble fiber reduce ambulatory blood pressure in treated hypertensives.

In population studies, higher blood pressure has been associated with lower intake of protein and, possibly, lower fiber consumption. In the present randomized controlled trial, we sought to determine whether dietary protein and fiber had additive effects on blood pressure reduction in hypertensives. Treated hypertensive patients changed for 4 weeks (familiarization) to a diet low in protein (12.5% energy) and fiber (15 g/d). Patients (n=41) were then randomized to 1 of 4 groups in an 8-week factorial study of parallel design in which they continued the low-protein, low-fiber diet alone or had supplements of soy protein to increase protein intake to 25% energy, of psyllium to provide an additional 12 g soluble fiber/d, or of both protein and fiber. The 24-hour ambulatory blood pressure was compared from the end of familiarization to the end of intervention. In the 36 subjects who provided complete data, protein and fiber had significant additive effects to lower 24-hour and awake systolic blood pressure. Relative to control subjects, the net reduction in 24-hour systolic blood pressure was 5.9 mm Hg with fiber and with protein. Findings were independent of age, gender, and change in weight, alcohol intake, or urinary sodium and potassium. Relative to reduced fiber and protein intake, dietary protein and soluble fiber supplements lower blood pressure additively in hypertensives. These findings have important implications for the prevention and management of hypertension, particularly in populations in which high blood pressure is prevalent in association with diets low in protein, fiber, or both.

Blood Pressure↗

Differential effects of eicosapentaenoic acid and docosahexaenoic acid on vascular reactivity of the forearm microcirculation in hyperlipidemic, overweight men.

BACKGROUND: Recent evidence supports differential effects of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the 2 major omega3 fatty acids of marine origin, on blood pressure in humans and vascular reactivity in adult spontaneously hypertensive rats. We investigated possible differences in the effects of purified EPA or DHA on forearm vascular reactivity in overweight hyperlipidemic men that might contribute to the blood pressure-lowering effects of fish oils. METHODS AND RESULTS: With a double-blind, placebo-controlled trial of parallel design, 59 overweight, mildly hyperlipidemic men were randomized to receive 4 g/d purified EPA, DHA, or olive oil (placebo) capsules while continuing their usual diets for 6 weeks. Forearm blood flow (FBF) was measured with venous occlusion, strain-gauge plethysmography during the sequential intra-arterial administration of acetylcholine (7.5, 15, and 30 microg/min), sodium nitroprusside (1.5, 3, and 10 microg/min), norepinephrine (10, 20, and 40 ng/min), a single-dose infusion of N:(G)-monomethyl-L-arginine (L-NMMA) (1 mg/min), and coinfusion of acetylcholine (7.5, 15, and 30 microg/min) and L-NMMA. Forty of the 56 subjects who completed the study underwent FBF measurements. Plasma phospholipid EPA levels increased significantly (P:<0.0001) after supplementation with EPA, and DHA composition increased with DHA supplementation (P:<0.0001). Relative to placebo, DHA, but not EPA, supplementation significantly improved FBF in response to acetylcholine infusion (P:=0.040) and coinfusion of acetylcholine with L-NMMA (P:=0.040). Infusion of L-NMMA alone showed no group differences. DHA significantly enhanced dilatory responses to sodium nitroprusside (P:<0.0001) and attenuated constrictor responses to norepinephrine (P:=0.017). CONCLUSIONS: Relative to placebo, DHA, but not EPA, enhances vasodilator mechanisms and attenuates constrictor responses in the forearm microcirculation. Improvements in endothelium-independent mechanisms appear to be predominant and may contribute to the selective blood pressure-lowering effect observed with DHA compared with EPA in humans.

Acetylcholine↗

Maternal cigarette smoking during pregnancy, low birth weight and subsequent blood pressure in early childhood.

Given the widely acknowledged inverse relationship between birth weight and blood pressure, a raised blood pressure in the offspring of smoking mothers as compared to those whose mothers did not smoke, would be anticipated by virtue of the reduction in birth weight associated with smoking during pregnancy. The objective of the present study was to test the hypothesis that maternal cigarette smoking during pregnancy has an effect on blood pressure in childhood independent of its effect on birth weight. Data was obtained from a prospective cohort study of 1708 pregnant women and their singleton offspring, delivered live at term, in Perth, Western Australia, commenced at 16 weeks gestation with serial blood pressure measurements through early childhood. Statistically significant associations were found between maternal smoking during pregnancy and systolic blood pressure at age six, between birth weight and systolic blood pressure at ages three and six, and between maternal smoking during pregnancy and birth weight. The relationship between birth weight and blood pressure in early childhood differed significantly on the basis of maternal cigarette smoking or not during pregnancy. This differential relationship persisted after adjustment for the child's current weight and socio-economic status. We concluded that intra-uterine exposure to maternal cigarette smoking increased children's blood pressure at age one through to age six. This was not wholly attributable to an effect on birth weight or confounding of the association between birth weight and subsequent blood pressure by the child's current weight or socio-economic factors. Furthermore, maternal smoking during pregnancy does not account for the acknowledged elevation in blood pressure associated with low birth weight. The present study is an exploration of a possible causal pathway underlying the birth weight/blood pressure association rather than simply a confirmation of such an association which has been detailed in many other papers.

Adult↗

Gallic acid metabolites are markers of black tea intake in humans.

Gallic acid is one of the main phenolic components of black tea. The objective of this study was to identify urinary gallic acid metabolites with potential for use as markers of black tea intake. In an initial study, nine compounds, assessed by using gas chromatography-mass spectrometry, were found to increase in concentration in urine after 3 cups of black tea over 3 h. A subsequent study employed a controlled crossover design in which 10 subjects consumed 5 cups per day of black tea or water for 4 weeks in random order. Twenty-four hour urine samples were collected at the end of each period. Of the 9 candidate compounds identified in the initial study, only 3 were present at higher concentrations in urine of all 10 subjects during tea-drinking in comparison to water-drinking periods. These compounds were identified as 4-O-methylgallic acid, 3-O-methylgallic acid, and 3, 4-O-dimethylgallic acid, all methyl ether derivatives of gallic acid. It is suggested that these compounds have the potential to be used as markers of black tea intake.

Biotransformation↗

Reference ranges for blood pressure in preschool Australians, obtained by oscillometry.

OBJECTIVE: To derive reference centiles for blood pressure in children aged 1-6 years which seek to address shortcomings in available reference ranges. METHODS: Prospective cohort study of 2876 children in Perth, Western Australia, commenced in 1989 with serial blood pressure measurements through early childhood obtained by oscillometry under standardized conditions. RESULTS: Gender-specific reference centile charts for systolic and diastolic blood pressure, (i) across ages 1-6 years and (ii) across the range of corrected Body Mass Index values at ages 1, 3 and 6 years, were generated by fitting linear models with both fixed and random effects. CONCLUSIONS: Reference values for blood pressure for young children are of clinical use and may be of long-term predictive value.

Blood Pressure↗