Baroreceptor sensitivity, kidney function and cardiovascular risk in prepubescent boys with normal versus elevated blood pressure

In children reduced baroreceptor sensitivity (BRS) has been linked to obesity but not blood pressure (BP). Offspring of hypertensive parents have reduced BRS, with possibly increasing risk for hypertension development and kidney dysfunction. This study aimed to explore the relationships between BRS, kidney function, familial cardiovascular-and lifestyle risk in prepubescent boys with varying BP levels. We included 40 Black and 41 White boys (aged 6-8 years). Anthropometric measurements included calculated body mass index (BMI) and sex-and-age specific BMI z-scores (BMIz). Demographic data was collected with questionnaires and included information on familial cardiovascular-and lifestyle risk. Cardiovascular measures were resting BP and Finometer monitoring for BRS calculation. Kidney function was assessed using urinary albumin-to-creatinine ratio (uACR). Stratification was based on normal or elevated BP status. The elevated BP group had more Black boys (n = 37; 65.5%; p = 0.003). Notably, BRS (p = 0.56) and uACR (p = 0.92) were comparable between normal and elevated BP groups. In the normal BP group, single, partial and fully adjusted models revealed an inverse association between BRS and uACR (β = -0.38; p = 0.009). In the elevated BP group, BRS associated with familial risk (β = -0.52; p = 0.002), BMIz (β = 0.36; p = 0.020) and Black ethnicity (β = -0.37; p = 0.024), yet no association was evident between BRS and uACR. A cardioprotective relationship exists between BRS and kidney function in boys with normal BP. In boys with elevated BP, a positive familial cardiovascular-and lifestyle risk, adiposity and Black ethnicity seems to contribute to cardiovascular disease risk via a relationship with lower BRS.