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Left ventricular mass index in children with white coat hypertension

Marc B Lande1, Cecilia C Meagher, Susan Gross Fisher

  • 1Division of Pediatric Nephrourology, University of Rochester Medical Center, Rochester, NY, USA. marc_lande@urmc.rochester.edu

The Journal of Pediatrics
|June 24, 2008
PubMed

Insights

Children with white coat hypertension (WCH) show intermediate left ventricular mass index (LVMI) compared to normotensive and sustained hypertensive individuals, suggesting potential target-organ effects.

Area of Science:

  • Pediatric Cardiology
  • Hypertension Research
  • Cardiovascular Health

Background:

  • White coat hypertension (WCH) is characterized by elevated blood pressure in a clinical setting but normal readings elsewhere.
  • The potential for target-organ damage in pediatric WCH remains incompletely understood.
  • Assessing cardiac structural changes like left ventricular mass index (LVMI) is crucial for evaluating hypertensive end-organ effects.

Purpose of the Study:

  • To investigate whether children diagnosed with white coat hypertension exhibit early signs of target-organ damage.
  • To compare the left ventricular mass index (LVMI) in children with WCH against matched normotensive and sustained hypertensive controls.
  • To determine if WCH is associated with subclinical cardiac alterations.

Main Methods:

  • A case-control study involving 27 matched triplets of children.
  • Each WCH subject was matched with a normotensive and a sustained hypertensive control based on body mass index (BMI), age, and sex.
  • Left ventricular mass index (LVMI) was determined via echocardiography and analyzed using repeated-measures analysis of variance.

Main Results:

  • The mean LVMI was significantly higher in the WCH group (32.3 g/m(2.7)) compared to the normotensive group (29.2 g/m(2.7)), P = .028.
  • The LVMI in the WCH group was lower than in the sustained hypertensive group (35.1 g/m(2.7)), though the difference was not statistically significant (P = .07).
  • Left ventricular hypertrophy was absent in normotensive and WCH groups, but present in 26% of sustained hypertensive subjects (P < .001).

Conclusions:

  • Even after controlling for BMI, children with WCH demonstrated an LVMI intermediate between normotensive and sustained hypertensive individuals.
  • These findings suggest that white coat hypertension in children may be associated with early hypertensive end-organ effects, specifically cardiac changes.
  • Further longitudinal studies are warranted to confirm these associations and assess long-term cardiovascular risk.
Abstract

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