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Ability of blood pressure to predict left ventricular hypertrophy in children with primary hypertension

Tammy M Brady1, Barbara Fivush, Joseph T Flynn

  • 1Department of Pediatrics, Division of Pediatric Nephrology, Johns Hopkins University, Baltimore, Maryland, USA. tbrady8@jhmi.edu

The Journal of Pediatrics
|December 25, 2007
PubMed

Insights

Left ventricular hypertrophy (LVH) is common in children with newly diagnosed hypertension (HTN). Initial echocardiography is recommended, as blood pressure measurements do not predict LVH.

Area of Science:

  • Pediatric Cardiology
  • Hypertension Research
  • Cardiovascular Imaging

Background:

  • Left ventricular hypertrophy (LVH) is a significant concern in pediatric hypertension.
  • Predicting LVH in children with hypertension is crucial for timely intervention.
  • Current methods for predicting LVH in pediatric hypertension require further evaluation.

Purpose of the Study:

  • To assess if initial blood pressure (BP) measurements can predict left ventricular hypertrophy (LVH) in children with hypertension (HTN).
  • To determine if ambulatory BP monitoring (ABPM) can predict LVH in pediatric HTN.
  • To evaluate the necessity of echocardiography in the initial assessment of pediatric HTN.

Main Methods:

  • Cross-sectional study of 184 children (3-20 years) with confirmed hypertension.
  • Analysis of casual BP and various ABPM variables.
  • Echocardiography used to define LVH (cardiologist diagnosis or LV mass index ≥ 95th percentile).

Main Results:

  • 41% of children with hypertension exhibited LVH.
  • LVH was more prevalent in non-white children and those with higher BMI z-scores.
  • Neither casual BP nor ABPM parameters at initial diagnosis predicted LVH.

Conclusions:

  • Left ventricular hypertrophy (LVH) is prevalent in children with newly diagnosed hypertension (HTN).
  • Initial casual BP and ABPM results do not reliably predict LVH in pediatric HTN.
  • Echocardiography is recommended for initial evaluation of children with newly diagnosed HTN.
Abstract

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