Ambulatory Blood Pressure Phenotype and Cardiovascular Risk in Youth: The SHIP-AHOY Study

Area of Science:

• Cardiology
• Pediatric Hypertension
• Vascular Biology

Background:

• Elevated blood pressure (BP) in youth is a growing concern.
• Understanding BP phenotypes and their link to target organ damage is crucial for early intervention.

Purpose of the Study:

• To investigate the association between specific blood pressure (BP) phenotypes, defined by clinic and 24-hour ambulatory BP (ABP) monitoring, and markers of target organ damage in healthy adolescents.

Main Methods:

• A cross-sectional study involving 373 adolescents.
• BP categorized into four phenotypes: normal, white coat hypertensive, ambulatory hypertensive, and masked hypertensive.
• Echocardiography and carotid-femoral pulse wave velocity used to assess cardiovascular risk markers.

Main Results:

• Adolescents with ambulatory or masked hypertension showed worse cardiac function and increased arterial stiffness compared to those with normal BP.
• BP phenotype was significantly associated with impaired diastolic and systolic function, and increased arterial stiffness, even after adjusting for BMI percentile.

Conclusions:

• Blood pressure phenotype in adolescents is independently linked to surrogate markers of cardiovascular risk, including compromised cardiac function and heightened vascular stiffness.
• Ambulatory blood pressure monitoring plays a vital role in comprehensive cardiovascular risk assessment in the pediatric population.