African-American women have a substantially higher prevalence of hypertension and suffer greater morbidity and mortality due to blood pressure elevation than White-American women. Much of this ethnic difference in blood pressure is due to increased obesity in African-American women. In contrast, young African-American and White-American girls have similar levels of obesity and blood pressure. The hemodynamic changes that occur with developing obesity and result in this ethnic difference in blood pressure have not been well characterized. Crosssectional studies of adolescents have shown that despite similar blood pressure levels, African-Americans have higher total peripheral resistance while Whites have higher cardiac output. Cross-sectional studies of adults show that obesity is associated with elevation of cardiac output. If such an obesity-related increase in cardiac output is superimposed on the underlying elevation of total peripheral resistance in African-American girls, these hemodynamic factors could be responsible for the developing ethnic divergence in blood pressure seen in late adolescence as African-American girls develop an increasing prevalence and severity of obesity. The proposed investigation is a prospective cohort study of 355 African-American and 315 White-American females from the NHLBl Growth and Health Study as these women progress from age 18-19 years to age 21-22 years. The study will include yearly measurement of anthropometrics, blood pressure, and echocardiographic determination of cardiac output and total peripheral resistance. In addition, factors which may relate to changes in cardiac output and total peripheral resistance, such as circulating blood volume (left ventricular end-diastolic volume), heart rate, left ventricular contractility, whole blood viscosity, and left ventricular mass and geometry will be measured. This investigation will provide important new knowledge regarding the longitudinal changes and interrelationships among the potential hemodynamic factors which define the association between developing obesity and blood pressure elevation. In the clinical setting where obesity is very difficult to prevent or treat, it is important to understand the mechanisms by which obesity results in elevated blood pressure. The results of this cohort study will provide the basis for rational and specific clinical strategies to interrupt the pathophysiologic process by which obesity leads to hypertension and places African-American women at particularly increased risk for cardiovascular disease morbidity and mortality.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL052911-04
Application #
6056280
Study Section
Special Emphasis Panel (ZRG4-SOH (04))
Project Start
1996-09-01
Project End
2001-08-31
Budget Start
1999-09-01
Budget End
2000-08-31
Support Year
4
Fiscal Year
1999
Total Cost
Indirect Cost
Name
Cincinnati Children's Hospital Medical Center
Department
Type
DUNS #
071284913
City
Cincinnati
State
OH
Country
United States
Zip Code
45229
Glueck, Charles J; Woo, Jessica G; Khoury, Philip R et al. (2015) Adolescent oligomenorrhea (age 14-19) tracks into the third decade of life (age 20-28) and predicts increased cardiovascular risk factors and metabolic syndrome. Metabolism 64:539-53
Glueck, Charles J; Wang, Ping; Woo, Jessica G et al. (2015) Adolescent and young adult female determinants of visceral adipose tissue at ages 26-28 years. J Pediatr 166:936-46.e1-3
Dwyer, Terence; Sun, Cong; Magnussen, Costan G et al. (2013) Cohort Profile: the international childhood cardiovascular cohort (i3C) consortium. Int J Epidemiol 42:86-96
Jenkins, Todd M; Buncher, C Ralph; Akers, Rachel et al. (2013) Validation of a weight history questionnaire to identify adolescent obesity. Obes Surg 23:1404-12
Morrison, John A; Glueck, Charles J; Daniels, Stephen R et al. (2012) Determinants of ApoB, ApoA1, and the ApoB/ApoA1 ratio in healthy schoolgirls, prospectively studied from mean ages 10 to 19 years: the Cincinnati National Growth and Health Study. Metabolism 61:1377-87
Morrison, John A; Glueck, Charles J; Daniels, Stephen R et al. (2012) Race, childhood insulin, childhood caloric intake, and class 3 obesity at age 24: 14-year prospective study of schoolgirls. Obesity (Silver Spring) 20:597-604
Glueck, Charles J; Morrison, John A; Daniels, Stephen et al. (2011) Sex hormone-binding globulin, oligomenorrhea, polycystic ovary syndrome, and childhood insulin at age 14 years predict metabolic syndrome and class III obesity at age 24 years. J Pediatr 159:308-13.e2
Morrison, John A; Glueck, Charles J; Umar, Muhammad et al. (2011) Hyperinsulinemia and metabolic syndrome at mean age of 10 years in black and white schoolgirls and development of impaired fasting glucose and type 2 diabetes mellitus by mean age of 24 years. Metabolism 60:24-31
Morrison, John A; Glueck, Charles J; Daniels, Stephen et al. (2011) Paradoxically high adiponectin in obese 16-year-old girls protects against appearance of the metabolic syndrome and its components seven years later. J Pediatr 158:208-14.e1
Morrison, John A; Glueck, Charles J; Daniels, Stephen et al. (2011) Adolescent oligomenorrhea in a biracial schoolgirl cohort: a simple clinical parameter predicting impaired fasting glucose plus type 2 diabetes mellitus, insulin, glucose, insulin resistance, and centripetal obesity from age 19 to 25 years. Metabolism 60:1285-93

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