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The Correlation Between ABPM Parameters and Left Ventricular Hypertrophy in Pediatric Essential Hypertension
Frontiers in Pediatrics
|June 20, 2022
Summary
Blood pressure load, especially 24-hour systolic blood pressure load, is a critical risk factor for left ventricular hypertrophy (LVH) in children with essential hypertension. Dipping patterns did not significantly differ, but elevated nighttime SBP was noted in the LVH group.
Area of Science:
- Pediatric Cardiology
- Hypertension Research
- Cardiovascular Physiology
Background:
- Pediatric essential hypertension is a growing concern with potential long-term cardiovascular consequences.
- Left ventricular hypertrophy (LVH) is a significant indicator of cardiac damage in hypertensive individuals.
- Understanding the factors contributing to LVH in children is crucial for early intervention.
Purpose of the Study:
- To investigate the association between blood pressure (BP) dipping patterns and BP load with LVH in pediatric essential hypertension.
- To identify specific BP parameters that predict LVH development in this population.
Main Methods:
- Echocardiography and ambulatory blood pressure monitoring (ABPM) were used in 425 untreated children and adolescents with essential hypertension.
- Patients were categorized into LVH (n=140) and non-LVH (n=285) groups.
- Multivariable logistic regression analysis was employed to assess the impact of BP load on LVH.
Main Results:
- No significant differences in systolic or diastolic BP dipping patterns were observed between LVH and non-LVH groups.
- The LVH group exhibited significantly elevated nighttime systolic blood pressure (SBP) and higher daytime/nighttime SBP loads, and nighttime diastolic blood pressure (DBP) load.
- A higher 24-hour SBP load was independently identified as a critical risk factor for LVH.
Conclusions:
- Blood pressure load, particularly 24-hour SBP load, is significantly correlated with LVH in pediatric hypertension.
- Elevated SBP load, rather than dipping patterns, appears to be a key driver of LVH progression in children.
- 24-hour SBP load serves as a critical early prognostic marker for LVH in pediatric essential hypertension.
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