Direct numerical simulations of interface dynamics to link capillary pressure and total surface energy

The flow of two immiscible fluids through a porous medium depends on the complex interplay between gravity, capillarity, and viscous forces. The interaction between these forces and the geometry of the medium gives rise to a variety of complex flow regimes that are difficult to describe using continuum models. Although a number of pore-scale models have been employed, a careful investigation of the macroscopic effects of pore-scale processes requires methods based on conservation principles in order to reduce the number of modeling assumptions. In this work we perform direct numerical simulations of drainage by solving Navier-Stokes equations in the pore space and employing the Volume Of Fluid (VOF) method to track the evolution of the fluid-fluid interface. After demonstrating that the method is able to deal with large viscosity contrasts and model the transition from stable flow to viscous fingering, we focus on the macroscopic capillary pressure and we compare different definitions of this quantity under quasi-static and dynamic conditions. We show that the difference between the intrinsic phase-average pressures, which is commonly used as definition of Darcy-scale capillary pressure, is subject to several limitations and it is not accurate in presence of viscous effects or trapping. In contrast, a definition based on the variation of the total surface energy provides an accurate estimate of the macroscopic capillary pressure. This definition, which links the capillary pressure to its physical origin, allows a better separation of viscous effects and does not depend on the presence of trapped fluid clusters.

Gravity-driven slug motion in capillary tubes

The velocity of a liquid slug falling in a capillary tube is lower than predicted for Poiseuille flow due to presence of menisci, whose shapes are determined by the complex interplay of capillary, viscous, and gravitational forces. Due to the presence of menisci, a capillary pressure proportional to surface curvature acts on the slug and streamlines are bent close to the interface, resulting in enhanced viscous dissipation at the wedges. To determine the origin of drag-force increase relative to Poiseuille flow, we compute the force resultant acting on the slug by integrating Navier-Stokes equations over the liquid volume. Invoking relationships from differential geometry we demonstrate that the additional drag is due to viscous forces only and that no capillary drag of hydrodynamic origin exists (i.e., due to hydrodynamic deformation of the interface). Requiring that the force resultant is zero, we derive scaling laws for the steady velocity in the limit of small capillary numbers by estimating the leading order viscous dissipation in the different regions of the slug (i.e., the unperturbed Poiseuille-like bulk, the static menisci close to the tube axis and the dynamic regions close to the contact lines). Considering both partial and complete wetting, we find that the relationship between dimensionless velocity and weight is, in general, nonlinear. Whereas the relationship obtained for complete-wetting conditions is found in agreement with the experimental data of Bico and Quere [J. Bico and D. Quere, J. Colloid Interface Sci. 243, 262 (2001)], the scaling law under partial-wetting conditions is validated by numerical simulations performed with the Volume of Fluid method. The simulated steady velocities agree with the behavior predicted by the theoretical scaling laws in presence and in absence of static contact angle hysteresis. The numerical simulations suggest that wedge-flow dissipation alone cannot account for the entire additional drag and that the non-Poiseuille dissipation in the static menisci (not considered in previous studies) has to be considered for large contact angles.

Increased salt sensitivity of ambulatory blood pressure in women with a history of severe preeclampsia.

Cardiovascular diseases are the principal cause of death in women in developed countries and are importantly promoted by hypertension. The salt sensitivity of blood pressure (BP) is considered as an important cardiovascular risk factor at any BP level. Preeclampsia is a hypertensive disorder of pregnancy that arises as a risk factor for cardiovascular diseases. This study measured the salt sensitivity of BP in women with a severe preeclampsia compared with women with no pregnancy hypertensive complications. Forty premenopausal women were recruited 10 years after delivery in a case-control study. Salt sensitivity was defined as an increase of >4 mm Hg in 24-hour ambulatory BP on a high-sodium diet. The ambulatory BP response to salt was significantly increased in women with a history of preeclampsia compared with that of controls. The mean (95% confidence interval) daytime systolic/diastolic BP increased significantly from 115 (109-118)/79 (76-82) mm Hg on low-salt diet to 123 (116-130)/80 (76-84) on a high-salt diet in women with preeclampsia, but not in the control group (from 111 [104-119]/77 [72-82] to 111 [106-116]/75 [72-79], respectively, P<0.05). The sodium sensitivity index (SSI=Δmean arterial pressure/Δurinary Na excretion×1000) was 51.2 (19.1-66.2) in women with preeclampsia and 6.6 (5.8-18.1) mm Hg/mol per day in controls (P=0.015). The nocturnal dip was blunted on a high-salt diet in women with preeclampsia. Our study shows that women who have developed preeclampsia are salt sensitive before their menopause, a finding that may contribute to their increased cardiovascular risk. Women with a history of severe preeclampsia should be targeted at an early stage for preventive measures of cardiovascular diseases.

Brachial or wrist blood pressure in obese patients : which is the best ?

RESUME L'obésité et l'hypertension atteignent des niveaux épidémiques aussi bien dans les pays industrialisés que dans ceux en voie de développement. La coexistence de ces deux pathologies est associée à un risque cardiovasculaire augmenté. Traditionnellement on mesure la pression artérielle (PA) au bras au moyen d'un brassard qui détermine la pression systolique et diastolique en utilisant soit la méthode auscultatoire ou oscillométrique. L'utilisation d'un brassard de taille standard chez le patient avec un tour de bras augmenté peut surestimer la pression artérielle. Il semble même qu'il existe un rapport idéal entre le tour de bras, et la taille du brassard La mesure à domicile de la pression artérielle avec des appareils validés donne des valeurs de la PA valables. Plusieurs appareils existent sur le marché et depuis quelques années les appareils de mesure de la PA au poignet font leur apparition sur le marché. Cette étude vise à comparer chez des sujets sains et obèses les valeurs de PA obtenues au poignet avec celles obtenues au bras en utilisant deux appareils validés l'OMRON HEM 705-CP et l'OMRON R6. L'OMRON HEM 705-CP permet l'utilisation soit d'un brassard standard (13x30 cm) ou d'un brassard large (16x38 cm), et l'OMRON R6 mesure la PA au poignet. Nous avons comparé un groupe de sujets obèses [Body Mass Index (BMI) >35kg/m2] avec un groupe de sujets sains (BMI <25kg/m2). Ont été exclues de l'étudé les personnes prenant un traitement antihypertenseur ainsi que celles souffrant d'arythmies. La PA a été mesurée en position assise avec le bras gauche sur une table à hauteur du coeur. Un brassard large a été employé pour les sujets obèses et un brassard standard pour les sujets sains. Trois mesures ont été effectuées, la première après une pause de 5 min et chacune des suivantes avec un intervalle de 2 min. La pression d'inflation maximale a été fixée à 170 mmHg. Nous avons utilisé la formule proposée par Marks LA et al pour déterminer si le rapport entre la taille des brassards fournis avec l'OMRON .HEM 705-CP et le tour de bras de nos sujets était optimal (taille du brassard = 9.34 x log10 taille du bras). Nos résultats ne montrent pas de différence statistiquement significative de la PA diastolique entre les deux groupes, qu'elle soit mesurée au bras ou au poignet. La PA systolique mesurée au bras s'est par contre avérée significativement plus basse chez les sujets obèses que chez les sujets sains. Aucune différence n'a été trouvée lorsque la mesure est effectuée au poignet. En utilisant la formule fournie par Marks le rapport entre taille du brassard (large chez les obèses) et tour de bras a été de 10.30±30 chez les sujets obèses et 9.630.45 chez les sujets sains (p<0.001). Le rapport entre tour de bras et brassard chez les sujets obèses est nettement au-dessus de la valeur optimale, ce qui suggère une possible sous-estimation de la PA systolique chez ces sujets. Ces résultats suggèrent qu'il existe un risque de sous-estimer la PA chez le patient obèse lors de l'utilisation d'un brassard large. Cette erreur pourrait être réduite par l'utilisation d'appareils de mesure au poignet. validés chez le sujet obèse.

Cardiac hypertrophy, low blood pressure, and low aldosterone levels in mice devoid of the three circadian PAR bZip transcription factors DBP, HLF, and TEF.

The cardiovascular system is under the control of the circadian clock, and disturbed circadian rhythms can induce cardiovascular pathologies. This cyclic regulation is probably brought about by the circadian expression of genes encoding enzymes and regulators involved in cardiovascular functions. We have previously shown that the rhythmic transcription of output genes is, in part, regulated by the clock-controlled PAR bZip transcription factors DBP (albumin D-element Binding Protein), HLF (Hepatic Leukemia Factor), and TEF (Thyrotroph Embryonic Factor). The simultaneous deletion of all three PAR bZip transcription factors leads to increased morbidity and shortened life span. Here, we demonstrate that Dbp/Tef/Hlf triple knockout mice develop cardiac hypertrophy and left ventricular dysfunction associated with a low blood pressure. These dysfunctions are exacerbated by an abnormal response to this low blood pressure characterized by low aldosterone levels. The phenotype of PAR bZip knockout mice highlights the importance of circadian regulators in the modulation of cardiovascular functions.

Mesozoic oceanic terranes of southern Central America : geology, geochemistry and gedynamics

Abstract The Northwestern edge of the modern Caribbean Plate, located in central Middle America (S-Guatemala to N-Costa Rica), is characterized by a puzzle of oceanic and continental terranes that belonged originally to the Pacific façade of North America. South of the Motagua Fault Zone, the actual northern strike slip boundary of the Caribbean Plate, three continental slivers (Copán, Chortis s. str. and Patuca) are sandwiched between two complex suture zones that contain HP/LT mafic and ultramafic oceanic rocks: The Motagua Mélanges to the North, extensively studied in the last ten years and the' newly defined Mesquito Composite Oceanic Terrane (MCOT) to the South. No modem geological data were available for the oceanic terrane located in the southern part of the so called continental "Chortis Block". Classically, the southern limit of this block with the Caribbean Large Igneous Province (CLIP) was placed at a hypothetical fault line connecting the main E-W fault in the Santa Elena Peninsula (N-Costa Rica) with the Hess Escarpment. However, our study in eastern Nicaragua and northwestern Costa Rica evidences an extensive assemblage of oceanic upper mantle and crustal rocks outcropping between the Chortis/Patuca continental blocks and the CLIP. They comprise collided and accreted exotic terranes of Pacific origin recording a polyphased tectonic history. We distinguish: 1- The MCOT that comprises a Late Triassic to Early Cretaceous puzzle of oceanic crust and arc-derived rocks set in a serpentinite matrix, and 2- The Manzanillo and Nicoya Terranes that are made of Cretaceous plateau-like rocks associated with oceanic sediments older than the CLIP. This study has been focused on the rocks of the MCOT. The MCOT comprises the southern half of the former "Chortis Block" and is defined by 4 comer localities characterized by ultramafic and mafic oceanic rocks of Late Triassic, Jurassic and Early Cretaceous age: 1- The Siuna Serpentinite Mélange (NE-Nicaragua), 2- The El Castillo Mélange (Nicaragua/Costa Rica border), 3- DSDP Legs 67 and 84 (Guatemala fore-arc basin), and 4- The Santa Elena Peridiotite (NW-Costa Rica). The Siuna Serpentinite Mélange (SSM) is a HP/LT subduction zone mélange set in a serpentinite matrix that contains oceanic crust and arc-related greenschist to blueschist/eclogite facies metamafic and metasedimentary blocks. Middle Jurassic (Bajocian-Bathonian) radiolarites are found in original sedimentary contact with arc-derived greenstones. Late Jurassic black detrital chert possibly formed in a marginal (fore-arc?) basin shortly before subduction. A phengite 40Ar/39Ar -cooling age dates the exhumation of the high pressure rocks as 139 Ma. The El Castillo Mélange (ECM) is composed of serpentinite matrix with OIB metabasalts and Late Triassic (Rhaetian) red and green radiolarite blocks. Recent studies of the DSDP Legs 67/84 show that the Guatemala/Nicaragua fore-arc basin is composed of a pile of ultramafic, mafic (OIB-like) and arc related rocks with ages ranging from Late Triassic to Campanian. Finally, the Santa Elena peridiotites that mark the limit of the MCOT with the Manzanillo/Nicoya Terranes and correspond to an association of ultramafic rocks that comprise peridiotites, dunites and chromites of abyssal and fore-arc origin. The SSM is the result of a collision between a Middle Jurassic island arc and the Patuca Terrane, a fragment of the Western N-American active continental margin. The Siuna Mélange (SSM) and the South Montagna Mélange share common characteristics with the Pacific N-American suture zone (E-Franciscan and Vizcaino mélanges), in particular, the Mesozoic ages of HP/LT metamorphic and the arc-derived blocks. For us, these mélanges imply an originally continuous, but slightly diachronous suture that affected the entire W-American active margin. It may imply the arrival and collision of an exotic intraoceanic arc (Guerrero-Phoenix) related to the origin of the Pacific Plate that initiated as a back arc basin of this arc. The present disposition of the fragments of this suture zone is the result of a northward shift of the active left-lateral strike slip motion between the N-American and the Caribbean Plates. Résumé Le coin nord-ouest de la Plaque Caraïbe moderne se trouve en Amérique Centrale, entre le sud du Guatemala et le nord du Costa Rica. Cette région est composée d'un puzzle de terrains océaniques et continentaux dont les origines se situent sur la façade pacifique de l'Amérique du Nord. Au sud de la faille de Motagua, la limite septentrionale actuelle, décrochante, de la Plaque Caraïbe, se trouvent 3 copeaux continentaux (Copàn, Chortis s. str. et Patuca) coincés entre deux zones de suture complexes à roches mafiques et ultramafiques qui ont subi un métamorphisme de haute pression/basse température (HP/LT). Il s'agit des Mélanges de Motagua au nord, largement étudiés ces dernières années, et du Mesquito Composite Oceanic Terrane (MCOT), récemment défini par nous, au sud. En vue de l'absence de données géologiques modernes concernant les terrains océaniques qui se trouvent dans la partie sud du "Chortis Block" considérée comme continentale, nous avons dédié cette étude à cette région. Classiquement, la limite méridionale entre le "Chortis Block" et la "Caribbean Large Igneous Province" (CLIP) a été associée à une faille hypothétique reliant la faille E-W de Santa Elena (nord du Costa Rica) à l'Escarpement de Hess. Notre étude au Nicaragua oriental et au Costa Rica nord-occidental a révélé l'existence de larges terrains composés d'assemblages de roches mantéliques et océaniques qui se placent entre les blocs continentaux Chortis/Patuca et le CLIP. Ces assemblages révèlent des terrains collisionnés et accrétés d'origine pacifique enregistrant une histoire tectonique polyphasée. Nous distinguons: 1- Le MCOT, un puzzle de roches océaniques d'arc d'âge Triassique supérieur au Crétacée inférieur, 2- Les terrains de Manzanillo et de Nicoya, des morceaux de plateaux océaniques associés à des sédiments océaniques plus âgés que le CLIP. Cette étude se focalisera sur les roches du MCOT. Le MCOT occupe la moitié sud de l'ancien "Chortis Block" et peut se définir par 4 localités de référence qui montrent des roches mafiques et ultramafiques océaniques d'âges compris entre le Trias supérieur et le Crétacée inférieur. 1- Le Siuna Serpentinite Mélange (NE-Nicaragua), 2- Le El Castillo Mélange (Nicaragua/Costa Rica border), 3- Le DSDP Legs 67/84 (Guatemala fore-arc basin) et 4- La Santa Elena Peridiotite (nord-ouest du Costa Rica). Le Siuna Serpentinite Mélange (SSM) est un mélange de subduction HP/BT dans une matrice de serpentinite. On y trouve des éléments de croûte océanique et d'arc insulaire en faciès de schistes verts et schistes bleus. Des radiolarites du Jurassique moyen se trouvent en contact sédimentaire sur des roches vertes d'arc. En revanche, des cherts noirs détritiques datent du Jurassique supérieur et sont probablement issus d'un bassin marginal (fore-arc ?) peu avant leur subduction, car un âge 40Ar/39Ar de refroidissement des phengites date l'exhumation des roches de haute pression à 139 Ma. Le Mélange d'El Castillo (ECM) est constitué d'une matrice serpentinitique et contient des blocs de metabasaltes OIB et des blocs de radiolarites du Trias terminal. Des études récentes ont repris les roches forées lors des DSDP Legs 67 et 84 et montrent que le soubassement du bassin d'avant-arc du Guatemala-Nicaragua est composé de roches ultramafiques et mafiques (OIB et arc), dont les âges isotopiques vont du Trias au Crétacé supérieur. Finalement, les péridiotites de Santa Elena forment la limite sud du MCOT par rapport aux terrains de Manzanillo et Nicoya. Elles contiennent des serpentinites et localement des dunites et chromites à affinité abyssale et de fore-arc. Le SSM témoigne d'une collision entre un arc insulaire d'âge Jurassique moyen et le Patuca Terrane, un fragment de la marge active nord-américaine. Le SSM et le South Motagua Mélange ont des caractéristiques en commun avec les zones de suture de la façade pacifique de l'Amérique du nord (E-Franciscan et Vizcaino mélanges), notamment les âges Mésozoïques du métamorphisme HP/BT et les blocs de roches d'arc. Ce fait nous conduit à penser qu'il s'agit d'une grande zone de suture qui était à l'origine continue sur toute la marge ouest-américaine, mais légèrement diachrone. Cette suture implique l'arrivée et la collision d'un arc intraocéanique exotique (Guerrero-Phoenix) qui est à l'origine de la Plaque Pacifique qui s'ouvrait en back arc par rapport à celui-ci. La disposition actuelle des fragments de cette suture est due à la migration vers le nord du décrochement actif senestre entre la Plaque nord-américaine et la Plaque Caraïbe. K. Flores, 2009 Mesozoic oceanic terranes of southern central America Résumé Grand Public La présente thèse est le résultat de travaux de terrain effectués de 2005 à 2008 au nord-est et au sud du Nicaragua et au nord du Costa Rica, en Amérique Centrale, des analyses pétrologiques et géochimiques en laboratoire ainsi que de la modélisation de l'évolution géodynamique. La région étudiée se situe en bordure nord - ouest de la Plaque Caraïbe moderne. Dans la majorité des publications récentes cette région est représentée comme un vaste bloc continental (le "Bloc Chortis") qui serait limité, (i) au nord, par la faille décrochante de Motagua, la limite actuelle entre la Plaque Nord-Américaine et la Plaque Caraïbe, et (ii) au sud, par une suture hypothétique qui se trouverait aux confins entre le Nicaragua et le Costa Rica. La région du Costa Rica a été considérée presque entièrement comme une partie du Plateau Caraïbe ("Caribbean Large Igneous Province" (CLIP)). L'étude détaillée des affleurements nous a permis de mettre en évidence : - Au nord-est du Nicaragua (Siuna) : Des roches océaniques datées du Jurassique moyen, grâce aux faunes à radiolaires qui ont été extraites des radiolarites rouges. Ces roches ont subi un métamorphisme de haute pression typique des zones de collision. L'étude radio-isotopique Ar/Ar a permis de dater la collision du Crétacé basal (139 Ma). - Au sud du Nicaragua : Des roches océaniques d'âge Trias terminal (200 millions d'années), également datées à l'aide de faunes à radiolaires. Il s'agit actuellement des roches océaniques les plus anciennes connues de l'Amérique Centrale. - L'étude géochimique et les âges des fossiles démontrent que le tiers septentrional du Costa Rica possède un soubassement construit d'au moins deux terrains (Nicoya et Manzanillo), qui ont des caractéristiques de Plateau océanique (Nicoya) et d'arc volcanique du Crétacé moyen (Manzanillo). Ces deux terrains sont plus anciens que le CLIP. En conclusion, nous constatons que la région étudiée est constituée d'un puzzle de 3 blocs continentaux et d'un vaste terrain océanique composite que nous appelons Mesquito Composite Oceanic Terrane (MCOT). En plus, nous définissons les terrains de Nicoya et de Manzanillo comme plus âgés et distincts du CLIP. Le MCOT est caractérisé par la présence de roches du manteau supérieur (les serpentinites) et de la croûte océanique, ainsi que des morceaux d'arcs, d'âge allant du Trias supérieur au Crétacé. Ce terrain est comparable à d'autres zones de suture de la façade pacifique de l'Amérique du nord, notamment en ce qui concerne les âges Mésozoïques, le métamorphisme de haute pression et l'association de roches mantéliques et crustales océaniques. Ce fait nous conduit à penser qu'il s'agit d'une grande zone de suture qui était à l'origine continue sur toute la marge ouest-américaine. Cette suture implique l'arrivée et la collision d'un arc infra-océanique exotique qui serait à l'origine de la Plaque Pacifique qui se serait ouverte en bassin d'arrière arc par rapport à celui-ci. La disposition actuelle des fragments de cette suture est due à la migration vers le nord du décrochement actif senestre entre la Plaque nord-américaine et la Plaque Caraïbe.

Detection of metabolite induction in fungal co-cultures on solid media by high-throughput differential ultra-high pressure liquid chromatography-time-of-flight mass spectrometry fingerprinting.

Access to new biological sources is a key element of natural product research. A particularly large number of biologically active molecules have been found to originate from microorganisms. Very recently, the use of fungal co-culture to activate the silent genes involved in metabolite biosynthesis was found to be a successful method for the induction of new compounds. However, the detection and identification of the induced metabolites in the confrontation zone where fungi interact remain very challenging. To tackle this issue, a high-throughput UHPLC-TOF-MS-based metabolomic approach has been developed for the screening of fungal co-cultures in solid media at the petri dish level. The metabolites that were overexpressed because of fungal interactions were highlighted by comparing the LC-MS data obtained from the co-cultures and their corresponding mono-cultures. This comparison was achieved by subjecting automatically generated peak lists to statistical treatments. This strategy has been applied to more than 600 co-culture experiments that mainly involved fungal strains from the Fusarium genera, although experiments were also completed with a selection of several other filamentous fungi. This strategy was found to provide satisfactory repeatability and was used to detect the biomarkers of fungal induction in a large panel of filamentous fungi. This study demonstrates that co-culture results in consistent induction of potentially new metabolites.

Stable masking by H-2Dd cis ligand limits Ly49A relocalization to the site of NK cell/target cell contact.

Ly49A is an inhibitory receptor, which counteracts natural killer (NK) cell activation on the engagement with H-2D(d) (D(d)) MHC class I molecules (MHC-I) on target cells. In addition to binding D(d) on apposed membranes, Ly49A interacts with D(d) ligand expressed in the plane of the NK cells' membrane. Indeed, multivalent, soluble MHC-I ligand binds inefficiently to Ly49A unless the NK cells' D(d) complexes are destroyed. However, it is not known whether masked Ly49A remains constitutively associated with cis D(d) also during target cell interaction. Alternatively, it is possible that Ly49A has to be unmasked to significantly interact with its ligand on target cells. These two scenarios suggest distinct roles of Ly49A/D(d) cis interaction for NK cell function. Here, we show that Ly49A contributes to target cell adhesion and efficiently accumulates at synapses with D(d)-expressing target cells when NK cells themselves lack D(d). When NK cells express D(d), Ly49A no longer contributes to adhesion, and ligand-driven recruitment to the cellular contact site is strongly reduced. The destruction of D(d) complexes on NK cells, which unmasks Ly49A, is necessary and sufficient to restore Ly49A adhesive function and recruitment to the synapse. Thus, cis D(d) continuously sequesters a considerable fraction of Ly49A receptors, preventing efficient Ly49A recruitment to the synapse with D(d)+ target cells. The reduced number of Ly49A receptors that can functionally interact with D(d) on target cells explains the modest inhibitory capacity of Ly49A in D(d) NK cells. This property renders Ly49A NK cells more sensitive to react to diseased host cells.

Crystal size distribution of periclase in contact metamorphic dolomite marbles from the southern Adamello Massif, Italy

Crystal size distributions (CSD) of periclase in contact metamorphic dolomite marbles are presented for two profiles near the Cima Uzza summit in the southern Adamello Massif (Italy). The database was combined with geochemical and petrological information to deduce the controls on the periclase-forming reaction. The contact metamorphic dolomite marbles are exposed at the contact of mafic intrusive rocks and are partially surrounded by them. Brucite is retrograde and pseudomorphs spherical periclase crystals. Prograde periclase growth is the consequence of limited infiltration of water-rich fluid at T near 605C. Stable isotope data show depletion in (13)C and (18)O over a narrow region (40 cm) near the magmatic contact, whereas the periclase-forming reaction front extends up to 4 m from the contact. CSD analyses along the two profiles show that the median grain size of the periclase crystals does not change, but that there is a progressively greater distribution of grain sizes, including a greater proportion of larger grains, with increasing distance from the contact. A qualitative model, based on the textural and geochemical data, attributes these variations in grain size to changing reaction affinities along a kinetically dispersed infiltration front. This study highlights the need to invoke disequilibrium processes for metamorphic mineral growth and expands the use of CSDs to systems of mineral formation driven by fluid infiltration.

Association between growth and blood pressure during the life course in children and adolescents

Background: Little is known on the relative importance of growth at different periods between birth and adolescence on blood pressure (BP). Objective: To assess the association between birth weight, change in body weight (growth) and BP across the entire span of childhood and adolescence. Methods: School-based surveys were conducted annually between 1998 and 2006 among all children in four school grades (kindergarten, 4th, 7th, and 10th year of compulsory school) in the Seychelles, Indian Ocean. Height and weight and BP were measured. Three cohorts of children examined twice were analyzed: 1606 children surveyed at age 5.5 and 9.1, 2557 at age 9.2 and 12.5, and 2065 at age 12.5 and 15.5, respectively. Weights at birth and at one year were extracted from medical files. Weights were expressed as Z-scores and growth was defined as a change in weight Z-scores (corresponding to weight centile crossing). The association between BP (at age 5.5, 9.2, 12.5, and 15.5) and weight at different times was assessed by linear regression. Using results of regression models of BP on all successive weights, life course plots were drawn by plotting regression coefficients against age at which weight was measured. The figure shows a life course plot of systolic BP in boys aged 15.5. Results: Without adjustment for current weight (at the time of BP measurement), birth weight was not associated with current BP, irrespective of age, excepted for girls at age 15.5 for whom a modest positive association was found. When adjusted for current weight, birth weight was negatively and modestly associated with current BP. BP was strongly associated with current weight, irrespective of age. Life course plots showed that BP was strongly associated with growth during the few preceding years but not with growth during earlier years, except for growth during the first year of life which tended to be associated with systolic BP. Conclusions: Our findings suggest that BP during childhood and adolescence is mainly determined by current body weight and recent growth.

Upward hypertension trends: changes in blood pressure or in antihypertensive treatment?

Comment on: Cutler JA, Sorlie PD, Wolz M, Thom T, Fields LE, Roccella EJ. Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988-1994 and 1999-2004. Hypertension. 2008 Nov;52(5):818-27. PMID: 18852389.