Related Experiment Videos
Ambulatory blood pressure and left ventricular mass index in hypertensive children
Jonathan M Sorof1, Gina Cardwell, Kathy Franco
1Department of Pediatrics, University of Texas-Houston Medical School, Houston, TX 77030, USA. jonathan.m.sorof@uth.tmc.edu
Insights
Ambulatory blood pressure monitoring is more predictive of left ventricular hypertrophy in hypertensive children than casual blood pressure. This method helps identify children at high risk for end-organ damage.
Area of Science:
- Pediatric Cardiology
- Hypertension Research
- Diagnostic Tools in Medicine
Background:
- Hypertension in children is a growing concern.
- Left ventricular hypertrophy (LVH) is a significant indicator of cardiovascular risk.
- Casual blood pressure measurements may not fully capture the hypertensive burden in children.
Purpose of the Study:
- To compare the predictive value of ambulatory blood pressure (ABP) versus casual blood pressure for left ventricular hypertrophy (LVH) in untreated hypertensive children.
- To assess the utility of ABP parameters like blood pressure index and load in identifying LVH.
Main Methods:
- Echocardiography was used to assess left ventricular mass index (LVMI) in 37 untreated hypertensive children.
- LVH was defined as LVMI >51 g/m(2.7).
- Ambulatory blood pressure data (24-hour, wake, sleep) were analyzed, calculating average blood pressure, blood pressure load, and blood pressure index.
Main Results:
- LVMI strongly correlated with 24-hour systolic blood pressure index (r=0.43, P=0.008) and other 24-hour and sleep systolic ABP parameters.
- LVMI did not correlate with age, weight, clinic blood pressure, or ambulatory diastolic blood pressure.
- The prevalence of LVH was 27% overall, significantly higher in children meeting specific ABP criteria (47% vs. 10%, P=0.015).
Conclusions:
- Ambulatory blood pressure monitoring, particularly systolic indices and loads, is more predictive of LVH in hypertensive children than casual blood pressure.
- ABP monitoring can aid in identifying hypertensive children at high risk for end-organ injury (LVH).
- These findings support the clinical use of ABP monitoring for risk stratification in pediatric hypertension.
Abstract:
To determine whether ambulatory blood pressure is more predictive of left ventricular hypertrophy than is casual blood pressure in hypertensive children, echocardiography and ambulatory blood pressure data from 37 untreated hypertensive children were analyzed. Left ventricular mass was calculated using the Devereux equation, left ventricular mass index was calculated as left ventricular mass (in grams)/height(2.7) (in meters), and left ventricular hypertrophy was defined as left ventricular mass index >51 g/m(2.7). Average blood pressure, blood pressure load, and blood pressure index (average blood pressure divided by pediatric ambulatory blood pressure 95th percentile) were calculated. Left ventricular mass index was strongly correlated with 24-hour systolic blood pressure index (r=0.43, P=0.008) and was also correlated with 24-hour systolic blood pressure (r=0.34, P=0.037), 24-hour systolic blood pressure load (r=0.38, P=0.020), wake systolic blood pressure load (r=0.37, P=0.025), sleep systolic blood pressure (r=0.33, P=0.048), and sleep systolic blood pressure load (r=0.38, P=0.021). Left ventricular mass index did not correlate with age, weight, clinic blood pressure, or ambulatory diastolic blood pressure. The overall prevalence of left ventricular hypertrophy was 27%. The prevalence of left ventricular hypertrophy was 47% (8 of 17) in patients with both systolic blood pressure load >50% and 24-hour systolic blood pressure index >1.0, compared with 10% (2 of 20) in patients without both criteria (P=0.015). These data suggest ambulatory blood pressure monitoring may be useful for the clinical assessment of hypertensive children by identifying those at high risk for the presence of end organ injury.