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[Target organ damage in children with newly diagnosed and untreated essential hypertension]

Jolanta Antoniewicz1, Mieczysław Litwin, Jadwiga Daszkoska

  • 1Klinika Nefrologii, Transplantacji Nerek i Nadciśnienia Tetniczego, Instytut-Pomnik Centrum Zdrowia Dziecka, Warszawa. j.antoniewicz@czd.pl

Przeglad Lekarski
|August 11, 2006
PubMed

Insights

Essential hypertension in children causes significant target organ damage, including left ventricular hypertrophy and arterial thickening, evident at diagnosis. Overweight is common, and damage markers correlate with blood pressure and specific biomarkers.

Area of Science:

  • Pediatric Cardiology
  • Hypertension Research
  • Vascular Biology

Background:

  • Essential hypertension (EH) can lead to target organ damage even in childhood.
  • Early detection of cardiovascular changes in pediatric EH is crucial for long-term health outcomes.

Purpose of the Study:

  • To determine the prevalence of left ventricular hypertrophy (LVH) and arterial damage in children with newly diagnosed, untreated EH.
  • To identify the main determinants of this organ damage in affected children.

Main Methods:

  • A cross-sectional, controlled study involving 87 children with EH and 104 healthy controls.
  • Evaluated anthropometrical data, birth weight, family history, serum biochemical risk factors, and intima-media thickness (cIMT, fIMT).
  • Assessed ambulatory blood pressure monitoring (ABPM), echocardiography, ophthalmoscopy, and microalbuminuria in EH patients.

Main Results:

  • Children with EH were significantly heavier, taller, and had higher BMI, with 59% overweight compared to 19% in controls.
  • Increased carotid (cIMT) and femoral artery (fIMT) intima-media thickness was observed in EH patients.
  • Prevalence of LVH was 45%, with 12% having severe LVH. LVMi correlated with birth weight, heart rate, uric acid, homocysteine, and apolipoprotein B.

Conclusions:

  • Target organ damage, including LVH and arterial injury, is present at diagnosis in a significant number of children with EH.
  • Overweight and arterial damage markers correlate with blood pressure, heart rate, and specific biomarkers like uric acid and homocysteine.
  • Early identification and management of pediatric hypertension are essential to prevent progressive organ damage.
Abstract

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