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Could arterial stiffness be early reversible target organ damage test in childhood hypertension?

Duygu Övünç Hacıhamdioğlu1, Özben Ceylan2, Aytül Hande Yardımcı3

  • 1Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Bahçeşehir University, Medical Park Göztepe Hospital; İstanbul-Turkey;Division of Pediatric Nephrology, Department of Pediatrics, University of Health Sciences, Süleymaniye Women Maternity and Child Diseases Training and Research Hospital; İstanbul-Turkey.

Anatolian Journal of Cardiology
|July 8, 2021
PubMed

Insights

Pediatric hypertension treatment improved arterial stiffness markers, including central systolic blood pressure and pulse wave velocity, in children. However, left ventricular mass index did not regress, indicating a need for further research on long-term cardiovascular effects.

Area of Science:

  • Pediatric Cardiology
  • Hypertension Management
  • Cardiovascular Health

Background:

  • Recent revisions in pediatric hypertension (HTN) treatment guidelines necessitate evaluating their impact on target organ damage (TOD) and arterial stiffness.
  • Primary HTN in children requires careful monitoring for early signs of cardiovascular complications.

Purpose of the Study:

  • To assess changes in TOD and arterial stiffness parameters in children with primary HTN following treatment aligned with the 2016 European Society of Hypertension Guidelines.
  • To evaluate the short-term cardiovascular effects of improved blood pressure control in pediatric HTN.

Main Methods:

  • Enrolled 32 newly diagnosed, untreated children with primary HTN, followed for at least 6 months.
  • Utilized 24-hour ambulatory blood pressure monitoring (ABPM) for HTN confirmation and measurements of central blood pressure (cBP) and pulse wave velocity (PWV).
  • Assessed anthropometrics (BMI), carotid intima-media thickness (cIMT), left ventricular mass index (LVMI), and various biochemical markers.

Main Results:

  • Following treatment, significant decreases were observed in creatinine, urea, systolic BP, diastolic BP, systolic load, diastolic load, central SBP (cSBP), cSBP z score, cDBP, and PWV z score.
  • Left ventricular mass index (LVMI) and BMI z scores remained unchanged.
  • Markers of arterial stiffness, specifically cSBP and PWV z scores, showed regression after blood pressure improvement.

Conclusions:

  • Blood pressure control in pediatric HTN led to regression of arterial stiffness markers, suggesting a short-term corrective effect on the cardiovascular system.
  • Left ventricular mass index did not regress, highlighting the need for longer-term studies.
  • Further longitudinal research is recommended to fully assess the impact of blood pressure management on arterial stiffness in children.
Abstract

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