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Wide pulse pressure (\n                      <jats:styled-content style=\"fixed-case\">PP<\/jats:styled-content>\n                      ) indicates mismatch between aortic impedance and pulsatile flow and increases risk for future systolic hypertension and cardiovascular disease (\n                      <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>\n                      ). We hypothesized that the rise of pediatric obesity would be associated with a temporal trend to higher\n                      <jats:styled-content style=\"fixed-case\">PP<\/jats:styled-content>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We analyzed demographic, anthropometric, and blood pressure (\n                      <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\n                      ) data for 8\u2010 to 17\u2010year\u2010old children (N=16\u00a0457) from the cross\u2010sectional National Health and Nutrition Examination Surveys (\n                      <jats:styled-content style=\"fixed-case\">NHANES<\/jats:styled-content>\n                      ) for 1976 through 2008. Multivariable adjusted survey regression was used to examine temporal trends in\n                      <jats:styled-content style=\"fixed-case\">PP<\/jats:styled-content>\n                      and mean arterial pressure (\n                      <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content>\n                      ) and the relation to obesity. Across this period, unadjusted\n                      <jats:styled-content style=\"fixed-case\">PP<\/jats:styled-content>\n                      was higher (0.29 mm Hg\/y, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      0.26 to 0.33 mm\u00a0Hg\/y;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001), while\n                      <jats:styled-content style=\"fixed-case\">MAP<\/jats:styled-content>\n                      was lower (\u22120.24 mm Hg\/y, 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      \u22120.27 to \u22120.20 mm\u00a0Hg\/y;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001) across examinations. Adjusting for body mass index partially attenuated the temporal trend for\n                      <jats:styled-content style=\"fixed-case\">PP<\/jats:styled-content>\n                      by 32% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001). Obesity amplified the relation between taller height and higher\n                      <jats:styled-content style=\"fixed-case\">PP<\/jats:styled-content>\n                      (from 0.23 [95% CI 0.19 to 0.28] to 0.27 [95% CI 0.21 to 0.34] mm\u00a0Hg\/cm height in boys and from 0.08 [95% CI 0.04 to 0.13] to 0.22 [95% CI 0.13 to 0.31] mm\u00a0Hg\/cm height in girls;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01 for both).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      <jats:styled-content style=\"fixed-case\">PP<\/jats:styled-content>\n                      has increased during the rise of pediatric obesity. Higher\n                      <jats:styled-content style=\"fixed-case\">PP<\/jats:styled-content>\n                      may indicate mismatch between aortic diameter, wall stiffness, and flow in obese children during a period of rapid somatic growth when the aorta is already under considerable remodeling stress.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.113.000725","type":"journal-article","created":{"date-parts":[[2014,5,9]],"date-time":"2014-05-09T05:25:58Z","timestamp":1399613158000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Temporal Trends in Pulse Pressure and Mean Arterial Pressure During the Rise of Pediatric Obesity in US Children"],"prefix":"10.1161","volume":"3","author":[{"given":"Justin P.","family":"Zachariah","sequence":"first","affiliation":[{"name":"Department of Cardiology, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dionne A.","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah D.","family":"de Ferranti","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramachandran S.","family":"Vasan","sequence":"additional","affiliation":[{"name":"Section of Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane W.","family":"Newburger","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary F.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Cardiovascular Engineering Inc, Norwood, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.160.5.523"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/ajh.2008.312"},{"key":"e_1_3_3_4_2","first-page":"29","article-title":"Prevalence of abnormal lipid levels among youths\u2014United States, 1999\u20132006","volume":"59","year":"2010","unstructured":"Prevalence of abnormal lipid levels among youths\u2014United States, 1999\u20132006. 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