Aortic dilatation in children with systemic 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.