Myocardial trophic effects of blood pressure in children with insulin-dependent diabetes mellitus.
To evaluate the effect of blood pressure (BP) on the left ventricular mass index (LVMI), 66 children with IDDM 13 +/- 3 years of age were studied and compared with 58 healthy age-matched siblings. The 24 h BP recordings disclosed that children with diabetes had higher DBP (68 vs. 65 mm Hg, P = 0.002), especially at night (60 vs. 55 mm Hg, P = 0.00007), with a minimisation of the normal nocturnal hypotension (-9.9 vs. -12.4 mm Hg, P = 0.04). Their LVMI was higher (79 vs. 71 g/m2, P = 0.02); it was independent of BP values and variability (P = NS), but it was positively correlated with heart rate (r = -0.46, P = 0.0005). In the control group, LVMI was significantly correlated with the mean SBP (r = 0.46, P = 0.0005); with its variability (r = 0.32, P = 0.02) and, to a lower extent, with heart rate (r = -0.29, P = 0.03). It is concluded that in children with diabetes mellitus the participation of BP in myocardial hypertrophy is not so obvious, although the BP load is increased. The increase of the LVMI occurs early in life and before the onset of hypertension.
Theochari
M A
MA
Department of Cardiology, University of Athens, Hippokratio General Hospital of Athens, Greece.
Vyssoulis
G P
GP
Giannakopoulou
A E
AE
Paleologos
A A
AA
Bartsocas
C S
CS
Toutouzas
P K
PK
D000293:Adolescent; D001795:Blood Pressure Determination; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D017379:Hypertrophy, Left Ventricular / Q000209:etiology*; D016014:Linear Models; D008297:Male; D016555:Matched-Pair Analysis; D009206:Myocardium / Q000473:pathology