eLetters to:

EXPERIENCE & REASON: Riikka Pyhälä, Katri Räikkönen, Kimmo Feldt, Sture Andersson, Petteri Hovi, Johan G. Eriksson, Anna-Liisa Järvenpää, and Eero Kajantie Blood Pressure Responses to Psychosocial Stress in Young Adults With Very Low Birth Weight: Helsinki Study of Very Low Birth Weight Adults Pediatrics 2009; 123: 731-734 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

eLetters published:

Effect of Neurodisability on Blood Pressure Measurements in Infants

Vincenzo Zanardo, Diana Gharapetian, Daniele Trevisanuto, Giovanni Montini   (9 February 2009)

Effect of Neurodisability on Blood Pressure Measurements in Infants 9 February 2009
Vincenzo Zanardo, Aggregated Professor of Pediatrics Department of Pediatris, Padua University, Padua, Italy, Diana Gharapetian, Daniele Trevisanuto, Giovanni Montini Send letter to journal: Re: Effect of Neurodisability on Blood Pressure Measurements in Infants zanardo{at}pediatria.unipd.it Vincenzo Zanardo, et al.	We read with much interest the paper by Pyhälä and colleagues [1] about blood pressure responses to psychosocial stress in young adults with very low birth weight. They found that young adults with VLBW had stronger diastolic BP responses to psychosocial stress than did those born at term. A similar trend was found for systolic BP, but this effect did not reach statistical significance. This is relevant, considering that the effects in this study were not moderated by gender or SGA status and were not attributed to potential confounders. The reason why prematurity was frequently associated with an elevated systolic blood pressure in childhood, adolescence, and adulthood has not yet been clarified, however, the correlations between preterm birth or intrauterine growth retardation or a combination of both and higher blood pressure and adverse cardiovascular outcome are currently a major focus of research [2–5]. We are studying by 24-hour Holter (TM 2430 Intermed, San Giuliano Milanese, MI, Italy) the contribution of preterm birth, RDS, and PDA to later risk of hypertension, in a historical cohort of 84 school age premature infants (<32 weeks of gestation) discharged to the level III NICU of Department of Pediatrics of Padua University in Padua Italy between January 1998 and December 1999. We found that the 66.66% of them had nightly and/or daily hypertension, while in 8 (9.6%) with neurodisability, anxiety and restless surrounding Holter application did not consent accurate blood pressure determinations. The authors should be congratulated on showing very clearly that physiologic mechanisms that underlie heightened BP stress reactivity among young adults with VLBW may involve possible prematurity-related alterations in the regulation of the autonomic nervous system and hypothalamic-pituitary-adrenal axis. Unlike Pyhälä and colleagues, we did not separate infant subgroups with distinct BP responses to psychosocial stress. Nevertheless, our study results support the hypothesis that the feasibility and accuracy of blood pressure follow up in premature infants may account of effect of patient neurodisability characteristics. Conflict of Interest: None declared