Autonomic regulation and blood pressure in children

Vagal baroreflex sensitivity (BRS) is a measure of short term blood pressure (BP) regulation through alterations in heart rate. Low BRS reflects impaired autonomic system regulation and has been found to be a surrogate marker for cardiovascular health. In particular, it has found to be associated with the pathogenesis of adult hypertension. However, only limited information exists as to the negative consequences of childhood BP on baroreflex function. The objective of this study was to investigate BRS in children with 2 different BP profiles while controlling for the effects of age, maturation, sex, and body composition. A preliminary subsample of 11-14 year-old children from the HBEAT (Heart Behavioural Environmental Assessment Team) Study was selected. The children were divided into 2 BP groups; high BP (HBP; 2:95tl1 percentile, n=21) and normal BP (NBP; <90th percentile, n=85). Following an initial 15 minutes of supine rest, 5 minutes of continuous beat-to-beat BP (Finapres) and RR interval (RRI) were recorded (standard ECG). Spectral indices were computed using Fast Fourier Transform and transfer function analysis was used to compute BRS. High frequency (HF) and low frequency (LF) power spectral areas were set to 0.15-0.4 Hz and 0.04-0.15 Hz, respectively. Body composition was measured using body mass index. After adjusting for body composition, maturation, age and sex ANCOV A results were as follows; LF and HF BRS, LF and HF RRI, and RRI total power were lower in the HBP versus NBP participants (p<0.05). As well, LF IHF SBP ratio was significantly higher in the HBP compared to the NBP group (p<0.05). The regression coefficients (unstandardized B) indicated that in changing groups (NBP to HBP) LF and HF BRS decreases by 4.04 and 6.18 ms/mmHg, respectively. Thus, as BP increases, BRS decreases. These data suggest that changes in autonomic activity occur in children who have HBP, regardless of age, sex, maturation, and body composition. Thus, despite their young age and relatively short amount of time having high BP compared with adults, these children are already demonstrating poor BP regulation and reduced cardiovagal activity. Given that childhood BP is associated with hypertension in adulthood, there is a growing concern in regards to the current cardiovascular health of our children and future adults.

The Co-occurrence of Depressive Symptoms and Alcohol Use for Adolescent Boys and Girls: An Investigation of the Role of Self-Regulation and Approach Behavior

While many studies have been conducted on adolescent depressive symptoms and alcohol use, much of the research has examined these behaviors separately rather than examining their co-occurrence within individuals. In the present study, adolescents (N = 4412; 49% female) were surveyed at four time points (grade 9, 10, 11, and 12) and growth mixture modeling was used to identify groups of individuals reporting various patterns of depressive symptoms and alcohol use across the high school years. Four groups were identified, including co-occurrence (higher depressive symptoms and higher alcohol use relative to peers, comprising 6.1 % of boys and 7.1 % of the girls in the sample), pure depressive symptoms (higher depressive symptoms and lower alcohol use; 12.7% of boys and 12.5% of girls), pure alcohol use (higher alcohol use and lower depressive symptoms; 20.9% of boys and 19.9% of girls), and low co-occurrence (lower depressive symptoms and alcohol use, 60.3% of boys and 60.5% of girls). Groups were compared on self-regulatory (i.e., delay of gratification) and approach behaviors. For both boys and girls, delay of gratification was the strongest predictor of group membership, with the co-occurrence group scoring the lowest and the low co-occurrence group the highest. This finding emphasizes the importance of assessing delay of gratification in the identification of high risk youth.