Blood atherogenic potential as a predictor of arterial hypertension among children living in ecologically unsafe territories of the Moldova Republic

According to WHO, arterial hypertension (AH) determines the structure of morbidity, mortality, and disability of adult populations. However, the origins of AH stem from the childhood, as the development period of regulatory mechanisms and structural disorders. 

Aim. To assess the blood atherogenic potential among children living in ecologically unsafe regions and to investigate the role of metabolic disorders in the AH development. 

Material and methods. In total, health status was assessed in 1500 children from ecologically unsafe regions of theMoldovaRepublic. All Moldovan regions were divided into 3 categories: moderate xenobiotic pollution; heavy xenobiotic pollution; and a control zone. Morbidity assessment was based on standard methods and unified diagnostic criteria. In addition, physical development, blood pressure, autonomic haemostasis, metabolic status, and atherogenic index were assessed. 

Results. AH was diagnosed in 3,1% of the examined children, and its prevalence was higher in more polluted regions. Among children and adolescents from ecologically unsafe regions, a relatively high prevalence of metabolic syndrome, reduced antioxidant protection, and pronounced hypothalamic dysfunction suggested an important role of xenobiotics in the AH development during childhood. Metabolic syndrome was characterised by a significant increase in the levels of lipids and low-density lipoproteins, as well as by elevated levels of total cholesterol and triglycerides. Atherogenic index was doubled in children from ecologically unsafe regions, compared to their peers from the control group. In all children with AH, dyslipidemia was observed. Compared to healthy children, atherogenic index was 2,4 and 1,7 times higher in hypertensive children with overweight or normal body weight, respectively. 

Conclusion. Assessment of blood atherogenic potential in children from ecologically unsafe regions could be used for the prediction of AH development and progression.

1. Moreno I. G., Neudahin E. V., Gur’eva E. N. et al. Metabolic syndrome in children and adolescents: aspects of pathogenesis and diagnosis. Pediatrija 2010; tom 89, № 4, str. 116–9. Russian (Морено И. Г., Неудахин Е. В., Гурьева Е. Н. и др. Метаболический синдром у детей и подростков: вопросы патогенеза и диагностики. Педиатрия 2010;

2. (4):116–9).

3. Mancia G., De Backer G., Dominiczak А. et al. Ghidul pentru managementul hipertensiunii arteriale 2007. Grupul de lucru pentru managementul hipertensiunii arteriale al Societ ii Europene de Hipertensiune (ESH) i al Societ ii Europene de Cardiologie (ESC). Revista Rom n de Cardiologie 2007; 22 (3): 225–319.

4. Popovici M., Ivanov V., Rudi V. et al. Prevalen a hipertensiunii arteriale i a factorilor de risc care o determin n popula ia rural a Republicii Moldova. Curierul Medical 2005; 4:5–10.

5. Hansen M. L., Gunn P. W., Kaelber D. C. Underdiagnosis of hypertension in children and adolescents. JAMA 2007; 298 (8): 874–9.

6. Mcniece K., Poffenbarger T., Turner J. et al. Prevalence of hypertension and prehypertension among adolescents. J Pediatr 2007; 150: 640–4.

7. Jago R., Harrell J. S., McMurray RGet al. Prevalence of abnormal lipid and blood pressure values among an ethnically diverse population of eighth-grade adolescents and screening implications. Pediatrics 2006; 117:2065–73.

8. Lurbe E., Cifkova R., Cruickshank K. et al. Management of high blood pressure in children and adolescents: recommendations of the European Society of Hypertension. J Hypertens 2009; 27 (9): 1719–42.

9. Dolgih V. V., Rychkova L. V., Bugun O. V. et al. Onset of the essential arterial hypertension in children of the Irkutsk region during the ontogenetic development. Bjulleten” Vostochno-Sibirskogo nauchnogo centra Sibirskogo otdelenija Rossijskoj Akademii medicinskih nauk 2007; 2 (54):24–8. Russian (В. В. Долгих, Л. В. Рычкова, О. В. Бугун и др. Формирование эссенциальной артериальной гипертензии у детей Иркутской области в процессе онтогенетического развития. Бюллетень ВСНЦ СО РАМН 2007; 2 (54):24–8).

10. Stroev Ju. I., Churilov L. P., Chernova L. A. et al. Obesity in adolescents. SPb.: JeLBI-SPb; 2006. Russian (Ю. И. Строев, Л. П. Чурилов, Л. А. Чернова и др. Ожирение у подростков. СПб.: ЭЛБИ-СПб; 2006.

11. Vasilos L., Cojocaru A. S n tatea copilului n corela ie cu mediul ambiant. Chi in u: Grafema Libris; 2007.

12. Sorvacheva T. N. Obesity in adolescents. Lechawij vrach 2006; (4):12–9. Russian (Т. Н. Сорвачева. Ожирение у подростков. Лечащий врач 2006; (4):12–9).