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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Body Mass Index (BMI) Is the Strongest Predictor of Systemic Hypertension and Cardiac Mass in a Cohort of Children
Marianna Fabi1, Matteo Meli2, Davide Leardini3
1Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Insights
Childhood hypertension is linked to cardiac damage, with body weight being a key factor. Weight management, not just blood pressure control, is crucial for reducing cardiovascular risk in children.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Risk Factors
- Pediatric Hypertension
Background:
- Hypertension (HTN) in children predicts adult HTN and increases cardiovascular (CV) risk.
- Early diagnosis and intervention are vital to prevent organ damage in pediatric hypertension.
- Understanding cardiac implications in childhood HTN is critical for long-term health outcomes.
Purpose of the Study:
- To investigate cardiac damage in children with hypertension.
- To identify risk factors associated with cardiac changes in pediatric hypertension.
- To analyze the evolution of cardiac morphology and function in relation to hypertension and its risk factors over time.
Main Methods:
- Prospective/retrospective study of children referred to a specialized Childhood Hypertension Outpatient Clinic.
- Clinical and echocardiographic assessments of cardiac morphology and function at three time points (enrollment and two follow-ups).
- Analysis of correlations between body mass index (BMI), blood pressure (BP), and left ventricular mass index (LVMI).
Main Results:
- Seventeen-point-nine percent of patients showed eccentric hypertrophy, and 9% had concentric hypertrophy.
- Overweight/obese children had higher systolic blood pressure (SBP) and BMI compared to those with chronic kidney disease (CKD).
- Body Mass Index (BMI) was a significant predictor of left ventricular mass index (LVMI) and correlated with SBP; weight variation impacted cardiac mass more than BP variation.
Conclusions:
- Body weight is strongly associated with hypertension and cardiac mass in children.
- Weight control interventions, alongside healthy lifestyle choices, are crucial for mitigating cardiovascular morbidity in pediatric hypertension.
- Addressing weight management early can significantly reduce the long-term burden of cardiovascular disease originating in childhood hypertension.
Background:
Hypertension (HTN) is a well-established cardiovascular (CV) risk factor in adults. The presence of HTN in children appears to predict its persistence into adulthood. Early diagnosis of HTN is crucial to reduce CV morbidity before the onset of organ damage.
Aim:
The aim of this study is to investigate cardiac damage in HTN, its risk factors (RFs), and evolution.
Methods:
We conducted a prospective/retrospective study involving children referred to the Childhood Hypertension Outpatient Clinic. This study included clinical and echocardiographic assessments of cardiac morphology and function at three time points: enrollment (T0) and follow-up (T1 and T2).
Results:
Ninety-two patients (mean age 11.4 ± 3 years) were enrolled. Cardiac eccentric and concentric hypertrophy were present in 17.9% and 9%, respectively, with remodeling in 10.5%. Overweight/obese subjects exhibited significantly higher systolic blood pressure (SBP), frequency of HTN, and body mass index (BMI) at T0 compared with patients with chronic kidney disease (CKD). SBP and BMI persisted more during follow-up. Normal-weight vs. overweight/obese patients were significantly more likely to have normal geometry. Positive correlations were found between BMI and left ventricular (LV) mass at T0, BMI and SBP at T0 and T1. Gender, BMI, SBP, and diastolic blood pressure (DBP) significantly predicted LV mass index (LVMI), but only BMI added significance to the prediction. During follow-up, the variation of BMI positively correlated with the variation of SBP, but not with LVMI.
Conclusions:
In our cohort, body weight is strongly associated with HTN and cardiac mass. Importantly, the variation in body weight has a more significant impact on the consensual variation of cardiac mass than blood pressure (BP) values. A strict intervention on weight control through diet and a healthy lifestyle from early ages might reduce the burden of CV morbidity in later years.
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