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Isolated nocturnal hypertension is associated with increased left ventricular mass index in children

Tomáš Seeman1,2, Ondřej Hradský3, Jiří Gilík4

  • 1Department of Pediatrics, University Hospital Motol, Charles University Prague, Second Faculty of Medicine, V Úvalu 84, 15006, Prague, Czech Republic. tomas.seeman@lfmotol.cuni.cz.

Pediatric Nephrology (Berlin, Germany)
|January 7, 2021
PubMed

Insights

Isolated nocturnal hypertension (INH) in children is linked to a higher left ventricular mass index (LVMI) compared to normotensive children. This suggests potential cardiac effects of INH in pediatric populations.

Area of Science:

  • Pediatric Cardiology
  • Hypertension Research
  • Cardiovascular Physiology

Background:

  • Isolated nocturnal hypertension (INH) is a known risk factor for left ventricular hypertrophy (LVH) and cardiovascular disease in adults.
  • Limited data exists on the association between INH and cardiac target organ damage in children.
  • This study addresses the gap in understanding INH's impact on pediatric cardiac structure.

Purpose of the Study:

  • To investigate the association between isolated nocturnal hypertension (INH) and left ventricular mass index (LVMI) in children.
  • To determine if INH is linked to increased LVMI and LVH in pediatric patients.
  • To compare cardiac structural parameters in children with INH versus normotensive controls.

Main Methods:

  • Retrospective review of untreated children with confirmed ambulatory hypertension (HT).
  • Concurrent ambulatory blood pressure monitoring (ABPM) and echocardiography.
  • Definition of LVH as LVMI ≥ 95th percentile; comparison with ambulatory normotensive children.

Main Results:

  • Children with INH showed a significantly higher age-adjusted LVMI compared to normotensive children (0.83 ± 0.03 vs. 0.74 ± 0.03, p = 0.03).
  • Left ventricular hypertrophy (LVH) was present in 11% of children with INH, a rate not significantly different from normotensive children (0%, p = 0.23).
  • Age-adjusted LVMI in INH children was similar to that in children with isolated daytime HT.

Conclusions:

  • Isolated nocturnal hypertension (INH) in children is associated with elevated age-adjusted left ventricular mass index (LVMI) compared to normotensive peers.
  • While LVH prevalence was not significantly higher, the increased LVMI suggests potential early cardiac structural changes in pediatric INH.
  • Further research is warranted to understand the long-term cardiovascular implications of INH in children.
Abstract

Keywords:
Ambulatory blood pressure monitoringChildrenEchocardiographyIsolated nocturnal hypertensionLVMILeft ventricular hypertrophy

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