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Evaluation of endothelial dysfunction in hypertensive children and adolescents

Kenan Doğan1, Eviç Zeynep Başar2, Mehmet Baha Aytaç3

  • 1Department of Pediatric Nephrology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey. drdogankenan@gmail.com.

Pediatric Nephrology (Berlin, Germany)
|November 2, 2023
PubMed

Insights

Newly diagnosed children with hypertension show early signs of endothelial dysfunction, including increased carotid intima-media thickness and reduced flow-mediated dilatation. These vascular changes highlight the need for early hypertension detection and management in pediatric populations.

Area of Science:

  • Pediatric Cardiology
  • Vascular Biology
  • Hypertension Research

Background:

  • Hypertension in children can lead to early atherosclerotic changes due to endothelial damage.
  • Endothelial dysfunction is a key factor in the development of vascular complications.
  • Early identification of hypertension in children is crucial for preventing long-term cardiovascular issues.

Purpose of the Study:

  • To investigate the relationship between endothelial dysfunction and hypertension in newly diagnosed children.
  • To assess carotid intima-media thickness (CIMT), flow-mediated dilatation (FMD), and functional capillaroscopy in hypertensive children without end-organ damage.
  • To compare vascular parameters between dipper and non-dipper hypertensive patients.

Main Methods:

  • A cross-sectional study involving 20 newly diagnosed hypertensive children and 20 age/sex-matched healthy controls.
  • Measurements included CIMT, brachial artery FMD, and functional capillaroscopy performed before antihypertensive treatment.
  • Hypertensive patients were categorized into dipper and non-dipper groups.

Main Results:

  • Hypertensive children exhibited significantly increased CIMT, reduced brachial artery FMD, and lower functional capillary density compared to controls.
  • Significant differences were observed in CIMT (p=0.04), FMD (p=0.02), and capillary density (p<0.001).
  • No significant differences in vascular parameters were found between dipper and non-dipper hypertensive children.

Conclusions:

  • Newly diagnosed hypertensive children without target organ damage display significant endothelial changes.
  • These findings underscore the importance of early hypertension detection and management in children.
  • Analysis of CIMT, FMD, and capillaroscopy can identify early vascular consequences of pediatric hypertension.
Abstract

Keywords:
ChildrenEndothelial functionFunctional capillaroscopyHypertension

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