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Aortic dilatation in children with systemic hypertension

Monesha Gupta-Malhotra1, Richard B Devereux2, Archana Dave1

  • 1Division of Pediatric Cardiology, Department of Pediatrics, Children's Memorial Hermann Hospital, The University of Texas Medical School at Houston, Houston, TX, USA.

Journal of the American Society of Hypertension : JASH
|February 11, 2014
PubMed

Insights

Aortic dilatation was detected in 2.8% of hypertensive children, a condition linked to increased aortic valve insufficiency and left ventricular hypertrophy. This finding highlights the importance of monitoring aortic size in pediatric hypertension.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Imaging
  • Hypertension Research

Background:

  • Hypertension in children is a growing concern with potential long-term cardiovascular consequences.
  • Aortic dilatation, common in hypertensive adults, has not been well-studied in pediatric populations.
  • Early detection of end-organ damage in hypertensive children is crucial for management.

Purpose of the Study:

  • To determine the prevalence of aortic dilatation in untreated hypertensive children.
  • To assess the association between aortic dilatation and other cardiovascular parameters in this cohort.
  • To evaluate aortic size using echocardiography in hypertensive pediatric patients.

Main Methods:

  • Prospective enrollment of multiethnic children with confirmed hypertension.
  • Echocardiographic measurements of the aorta at the sinus of Valsalva, supra-tubular junction, and ascending aorta.
  • Hypertension defined by Fourth Working Group criteria and 24-hour ambulatory blood pressure monitoring; aortic dilatation by z-score >2.

Main Results:

  • Aortic dilatation was detected in 2.8% of 142 hypertensive children.
  • Children with aortic dilatation showed significantly higher rates of aortic valve insufficiency (P=.005) and left ventricular hypertrophy (P=.018).
  • The prevalence of aortic dilatation was 2.8% (95% CI, 1%-7%) in this pediatric cohort.

Conclusions:

  • Aortic dilatation is present in a small but significant percentage of hypertensive children.
  • Hypertensive children with aortic dilatation exhibit more aortic insufficiency and left ventricular hypertrophy.
  • Echocardiography is valuable for assessing aortic size and end-organ damage in pediatric hypertension.

Keywords:
Echocardiogramaortic insufficiencyessential hypertensionleft ventricular hypertrophy

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