Isolated Nocturnal Hypertension and Target Organ Damage: A SHIP-AHOY Ancillary Study

Area of Science:

• Pediatric Cardiology
• Hypertension Research
• Cardiovascular Epidemiology

Background:

• Isolated nocturnal hypertension (INH) and its link to target organ damage (TOD) are understudied in pediatric populations.
• The Study of Hypertension in Pediatrics, Adult Hypertension Onset in Youth (SHIP-AHOY) cohort provides data to investigate INH prevalence and TOD.
• INH is hypothesized to correlate with an elevated risk of TOD in adolescents.

Purpose of the Study:

• To determine the prevalence of INH in the SHIP-AHOY cohort.
• To investigate the association between INH and target organ damage, specifically left ventricular hypertrophy (LVH).
• To evaluate the risk of TOD associated with INH in adolescents.

Main Methods:

• Utilized data from the SHIP-AHOY cohort.
• Defined primary exposure, INH, using static thresholds (wake < 130/80, sleep ≥ 110/65) and 95th percentile ambulatory BP.
• Assessed primary outcome, left ventricular hypertrophy (LVH), via left ventricular mass index (> 38.6 g/m^2.7) and employed logistic regression for analysis.

Main Results:

• INH was identified in 19.7% of adolescents using static thresholds, primarily due to systolic BP.
• Adolescents with INH exhibited higher age and height, and lower estimated glomerular filtration rate compared to normotensive individuals.
• A significant association was found between INH and LVH, with a 2.7-fold increased adjusted odds (95% CI [1.20,5.93], P = 0.016).

Conclusions:

• Isolated nocturnal hypertension (INH) is prevalent among adolescents and is linked to a 2.7-fold higher risk of left ventricular hypertrophy (LVH).
• Findings highlight the importance of monitoring nocturnal blood pressure in pediatric hypertension.
• Longitudinal studies are recommended to fully understand the long-term consequences of INH in youth.