Cardiac Autonomic Modulation is a Key Factor for High Blood Pressure in Adolescentes

Background: The interest regarding hypertension among children and adolescents has increased since the blood pressure rating system was updated to be compared with the adult rating system, changing the terminology from "normal high" to "prehypertension". Objective: This study aimed to analyze the association between cardiac autonomic modulation and pressure levels of adolescents. Methods: 203 adolescents were grouped according to systolic blood pressure (SBP) and diastolic blood pressure (DBP). One group was characterized as prehypertension, and the other as normotensive. Anthropometric, cardiovascular and sleep quality characteristics were collected. Initially, the data were submitted to the Kolmogorov-Smirnov normality test. Continuous quantitative variables were analyzed using the unpaired Student t-test. For the analysis of categorical variables, a chi-square test was used. A logistic regression model was performed. The level of significance was set at p<0.05. The data were expressed as mean +/- standard deviation and confidence interval. The R software was used for data analysis. The effect size was calculated using the Cohen's formula. Results: The prehypertension group showed an increase in Shannon entropy and a decrease in total variance. Also, in the logistic regression model, adolescents in this group were 1.03 times more likely to have Shannon entropy's affected when SBP was adjusted for gender, sexual maturation, school time, age, waist circumference, and sleep quality. Conclusion: Our data show that autonomic modulation may play an important role in the development of elevated blood pressure in adolescents, when controlling for other factors, such as school time and sleep quality.