Assessment of Early Cardiovascular Risk in Children and Adolescents with Essential Hypertension

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Andreja Stelcar1, Evgenija Homsak2, Natasa Marcun Varda1

  • 1Pediatrics, Univerzitetni Klinicni Center Maribor, Maribor, Slovenia.

Klinische Padiatrie
|April 25, 2017
PubMed

Insights

Essential hypertension in children shows early target organ damage, including increased left ventricular mass and intima-media thickness. These changes, along with metabolic syndrome, highlight the need for early detection and intervention in pediatric hypertension.

Area of Science:

  • Pediatric Cardiology
  • Hypertension Research
  • Cardiovascular Risk Factors

Background:

  • Essential hypertension (EH) in children and adolescents is a growing concern.
  • Early detection of target organ damage is crucial for long-term cardiovascular health.
  • Identifying reliable early markers in pediatric hypertension is essential.

Purpose of the Study:

  • To investigate early markers of hypertensive target organ damage in children and adolescents.
  • To determine the clinical significance of these early markers.
  • To assess the prevalence of metabolic syndrome in hypertensive youth.

Main Methods:

  • Study included 100 hypertensive children and 50 controls.
  • Evaluated left ventricular mass (LVM), intima-media thickness (IMT), pulse wave velocity (PWV), microalbuminuria, biochemical parameters, and adipokines.
  • Assessed aortic systolic pressure (AoSP), aortic pulse pressure (AoPP), and augmentation index (AIx@75).

Main Results:

  • Hypertensive children showed significant differences in HDL-cholesterol, LDL-cholesterol, triglycerides, insulin, uric acid, glucose, apolipoprotein A1, and total adiponectin compared to controls.
  • Increased IMT and LVM were significant early markers in hypertensive children.
  • Hypertensive children exhibited higher AoSP, AoPP, and AIx@75; metabolic syndrome was diagnosed in 31%.

Conclusions:

  • A significant proportion of children with EH exhibit early target organ changes and risk factors like metabolic syndrome, particularly those who are obese.
  • Intima-media thickness (IMT), left ventricular mass (LVM), and arterial stiffness parameters are significant early markers in both obese and non-obese hypertensive children.
  • Adipokines and coagulation factors may play a role in obese hypertensive children.

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