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Published on: December 14, 2020
Longitudinal Analysis of Gastroesophageal Reflux Disease and Its Impact on Cardiovascular Function and Development of
Ahmad Yar1, Sughra Chandio2, Kiramat Ullah3
1Pediatric Medicine, University of Child Health Sciences, The Children's Hospital, Lahore, PAK.
Insights
Pediatric gastroesophageal reflux disease (GERD) significantly impacts cardiovascular health, leading to hypertension and cardiac remodeling. Early detection and management are crucial for preventing long-term complications in children.
Area of Science:
- Pediatric Cardiology
- Gastroenterology
- Systemic Manifestations of GERD
Background:
- Gastroesophageal reflux disease (GERD) is increasingly recognized for its systemic effects beyond the gastrointestinal tract.
- Understanding these extra-intestinal manifestations is critical for comprehensive patient care.
Purpose of the Study:
- To investigate the long-term cardiovascular effects of GERD in children.
- To assess the development of hypertension and associated cardiac changes over one year.
Main Methods:
- A multi-center, one-year longitudinal study involving 285 children (aged 5-16) with confirmed GERD.
- Baseline and follow-up assessments included blood pressure, echocardiography, heart rate variability (HRV), and inflammatory biomarkers (CRP, IL-6, TNF-α).
Main Results:
- 16.8% of children developed hypertension, with higher incidence in severe GERD.
- Significant increases in systolic blood pressure, sympathetic nervous system predominance (reduced HRV), and left ventricular mass index were observed.
- Elevated CRP and severe GERD were independent predictors of hypertension.
Conclusions:
- GERD in children is linked to progressive cardiovascular changes, including hypertension, autonomic dysfunction, and cardiac remodeling.
- These findings highlight the systemic impact of GERD on pediatric cardiovascular health.
Background:
Gastroesophageal reflux disease (GERD) is increasingly recognized as a condition with systemic effects extending beyond the gastrointestinal tract.
Objective:
To evaluate the long-term impact of GERD on cardiovascular function and the development of hypertension in pediatric populations through a multi-center, one-year longitudinal analysis.
Methods:
This longitudinal study was conducted at The Children's Hospital, Lahore, and Allied Hospital, Faisalabad, from June 2024 to May 2025. A total of 285 children aged 5-16 years with confirmed GERD were enrolled from multiple tertiary care hospitals. Participants underwent baseline assessments including clinical evaluation, anthropometry, blood pressure measurement, echocardiography, heart rate variability (HRV) analysis, and inflammatory biomarkers (CRP, IL-6, TNF-α).
Results:
Over the three-year period, 48 children (16.8%) developed hypertension, with the highest incidence in the severe GERD group (30.7%). Systolic blood pressure increased significantly from 106.8 ± 8.9 mmHg at baseline to 114.7 ± 10.1 mmHg at 36 months (p < 0.001). Children with moderate and severe GERD showed marked reductions in HRV and increased low frequency/high frequency (LF/HF) ratios, indicating sympathetic predominance. Inflammatory biomarkers rose progressively, with CRP correlating positively with systolic blood pressure (r = 0.38, p < 0.01). Echocardiography revealed significant increases in left ventricular mass index over time, particularly in severe GERD cases. Multivariate analysis identified severe GERD (β = 0.31, p < 0.001), elevated CRP (β = 0.27, p = 0.002), and higher BMI (β = 0.22, p = 0.008) as independent predictors of hypertension.
Conclusion:
GERD in pediatric populations is associated with progressive cardiovascular alterations, including rising blood pressure, autonomic dysregulation, systemic inflammation, and early cardiac remodeling.
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