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Hypertension-induced cardiac damage in children and adolescents
1Division of Cardiology, Department of Pediatrics, University of Cincinnati College of Medicine and the Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. sdaniels@chmcc.org
Insights
High blood pressure in adolescents can lead to significant heart changes, including left ventricular hypertrophy. Early assessment of cardiac effects is crucial for pediatric hypertension management.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Disease
- Hypertension Research
Background:
- Adult hypertension sequelae are well-documented, but effects on children's target organs are less studied.
- Cardiac effects of elevated blood pressure are critical indicators of cardiovascular risk.
Purpose of the Study:
- To investigate the prevalence and characteristics of cardiac effects in pediatric patients with hypertension.
- To establish the utility of left ventricular mass index in assessing cardiac impact.
Main Methods:
- Utilized echocardiography to measure cardiac effects.
- Defined normal standards for left ventricular mass in young patients, normalized by height to the power of 2.7.
- Assessed left ventricular hypertrophy and geometry in adolescents with essential hypertension.
Main Results:
- A high prevalence of left ventricular hypertrophy was observed in adolescents with essential hypertension.
- Some adolescents exhibited severe hypertrophy and abnormal left ventricular geometry, indicating increased cardiovascular risk.
- Established left ventricular mass index as an appropriate measure accounting for body size differences.
Conclusions:
- Pediatric hypertension can lead to significant cardiac remodeling, including left ventricular hypertrophy.
- Left ventricular mass index is a valuable tool for evaluating cardiac status in pediatric hypertension.
- Further research is needed to understand the regression of left ventricular hypertrophy in this population.
Abstract:
Blood pressure elevation has numerous sequelae, including myocardial infarction, stroke, congestive heart failure, end-stage renal disease, and peripheral vascular disease in adults. The impact of blood pressure elevation on target organs in children and adolescents has been less well studied. The most useful measure of cardiac effects of hypertension is the echocardiogram. Studies have now defined normal standards for left ventricular mass in young patients. In order to account for differences in body size, it is most appropriate to use left ventricular mass divided by the individual s height raised to a power of 2.7. It has been demonstrated that there is a high prevalence of left ventricular hypertrophy in adolescents with essential hypertension. Some adolescents develop severe hypertrophy and abnormal left ventricular geometry, even to a degree that would be associated with increased risk of cardiovascular disease morbidity in an adult patient. Further research is needed to better evaluate the regression of left ventricular hypertrophy. Clinicians should assess left ventricular mass index in the evaluation of pediatric patients with hypertension.