Left ventricular cardiac geometry and ambulatory blood pressure in children

Limited information is available regarding the relationship between ambulatory blood pressure monitoring (ABPM) and cardiac geometry in hypertensive children. ABPM and 2D-echocardiography were retrospectively reviewed in children and adolescents <21 years old with primary hypertension. A total of 119 participants (median age 15.0 [IQR 12, 16] years) with hypertension were included. Left ventricular hypertrophy was diagnosed in 39.5% of participants. Normal geometry was found in 47.1%, concentric remodeling (CR) in 13.4%, concentric hypertrophy (CH) in 15.1%, and eccentric hypertrophy (EH) in 24.4% of children. After adjustment for age, sex, and body mass index z-score, awake systolic blood pressure (BP) index (BPi) (OR 1.07, 95% CI: 1.001-1.14, P = 0.045), awake diastolic BPi (OR 1.04, 95% CI: 1.00-1.09, P = 0.048), awake systolic BP load (OR 1.02, 95% CI: 1.000-1.04, P = 0.047), and sleep systolic BP load (OR 1.02, 95% CI: 1.001-1.04, P = 0.03) were directly associated with CH. No ABPM parameters were significant predictors of EH. In conclusion, ABPM parameters were found to be independent predictors of cardiac geometry, specifically CH.