Nutritive and endocrine-metabolic influences on long-term blood pressure development during growth

High blood pressure (BP) is a known risk factor for cardiovascular and renal diseases. Concurrently, hypertension has a high prevalence in the general population. Childhood BP is not only predictive of future hypertension risk but is also independently associated with early markers of atherosclerosis. Lifestyle-interventions, such as long-term dietary changes, are effective measures to influence BP in adults. In this regard, a reduction in dietary salt intake as well as a higher fruit and vegetable consumption are considered established dietary modifications for BP-reduction. Recent studies suggest that apart from these already established dietary BP-determinants, a higher diet-dependent acid load, contributing to a small shift in human acid-base balance, may also contribute to higher BP and an increased hypertension risk. However, evidence for the long-term relevance of these dietary factors for BP in childhood and beyond is currently limited. Apart from nutrition, endocrine factors such as glucocorticoids also importantly affect BP, but main evidence comes from studies on certain pathological conditions. It is less clear whether also physiological variation in enzymatic activity of 11ß-Hydroxysteroid-Dehydrogenase Type 2 (11ßHSD2), controlling tissue availability of cortisol in the kidney, is related to BP in normal pediatric populations. This thesis aimed to examine the associations of dietary salt intake, fruit and vegetable consumption and diet-dependent acid load as well as 11ßHSD2-activity with BP in healthy children and adolescents. Data came from the DOrtmund Nutritional and Anthropometric Longitudinally Designed (DONALD) Study, which includes regular assessments of BP, diet, growth and metabolism in healthy subjects from infancy until young adulthood.