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Risk of Target Organ Damage in Children With Primary Ambulatory Hypertension: A Systematic Review and Meta-Analysis

Jason Chung1, Cal H Robinson2, Andrew Yu3

  • 1University of Toronto, Temerty Faculty of Medicine, Ontario, Canada (J.C.).

Hypertension (Dallas, Tex. : 1979)
|February 21, 2023
PubMed

Insights

Children with ambulatory hypertension face higher risks of target organ damage, including left ventricular hypertrophy and elevated pulse wave velocity. Early blood pressure control and screening are crucial for preventing future cardiovascular disease in pediatric populations.

Area of Science:

  • Cardiology
  • Pediatrics
  • Hypertension Research

Background:

  • Target organ damage (TOD) is common in hypertensive adults, but its risk in children with ambulatory hypertension is not well understood.
  • This systematic review investigates TOD risks in pediatric populations with ambulatory hypertension compared to normotensive individuals.

Approach:

  • A comprehensive literature search identified studies from 1974 to 2021 involving 24-hour ambulatory blood pressure monitoring and TOD assessment.
  • Included studies compared TOD outcomes, such as left ventricular hypertrophy (LVH) and carotid intima-media thickness, between children with and without ambulatory hypertension.
  • Meta-regression analyzed the impact of body mass index on TOD development.

Key Points:

  • Children with ambulatory hypertension showed significantly increased risks of LVH (OR 4.69), elevated left ventricular mass index (5.13 g/m^2.7), increased pulse wave velocity (0.39 m/s), and thickened carotid intima-media (0.04 mm).
  • Body mass index positively correlated with left ventricular mass index and carotid intima-media thickness.
  • The findings underscore the adverse target organ damage profiles in pediatric hypertension.

Conclusions:

  • Pediatric ambulatory hypertension is linked to adverse target organ damage, potentially elevating future cardiovascular disease risk.
  • Optimizing blood pressure management and implementing TOD screening in children with ambulatory hypertension are essential.
  • This review emphasizes the need for proactive cardiovascular risk management in pediatric hypertension.
Abstract

Keywords:
blood pressurebody mass indexcarotid intima-media thicknesshypertensionhypertrophy

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