The effects of obesity, gender, and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: a collaborative study of the International Pediatric Hypertension Association.
OBJECTIVE
To determine the prevalence of left ventricular hypertrophy (LVH) in a multiethnic group of children and adolescents with hypertension.


METHODS
Pooled data from 1998 to 2001 from 3 sites belonging to the International Pediatric Hypertension Association were reviewed. Patients undergoing echocardiography to detect LVH as part of the evaluation for hypertension were included for analysis. Left ventricular mass was calculated from 2-dimensional guided M-mode echocardiographic measurements of the left ventricle. Left ventricular mass index (LVMI) was calculated as left ventricular mass/height(2.7). LVH by adult criteria was defined as LVMI > 51 g/m(2.7) and by pediatric criteria as LVMI > 38.6 g/m(2.7). Left ventricle geometry was classified as concentric, concentric remodeling, eccentric, or normal.


RESULTS
Data on 129 patients with a mean age of 13.6 +/- 3.6 years were analyzed. The population was 67% male, 46.5% white, 38.0% African American, and 15.5% Hispanic. The prevalence of LVH was 15.5% using adult criteria and 41.1% using pediatric criteria. Increasing body mass index (BMI) was associated with a higher LVMI. Using either pediatric or adult criteria LVH was associated with BMI > or =95th percentile for age and gender. LVH and concentric hypertrophy were identified most frequently in Hispanic children.


CONCLUSIONS
LVH occurs commonly in children with hypertension and is associated with an increased BMI. LVH may be more prevalent in Hispanic children than in other ethnic groups. Prevention and treatment of obesity is important in reducing the cardiovascular risk for children with hypertension. Further evaluation of the frequency of LVH in multiethnic populations is needed.
Hanevold
Coral
C
Department of Pediatrics, Medical College of Georgia, Augusta, Georgia 30912-3795, USA. chanevol@mail.mcg.edu
Waller
Jennifer
J
Daniels
Stephen
S
Portman
Ronald
R
Sorof
Jonathan
J
D000293:Adolescent; D000328:Adult; D044383:Black People; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006630:Hispanic or Latino; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000208:ethnology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000208:ethnology / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D009765:Obesity / Q000150:complications*; D015995:Prevalence; D012189:Retrospective Studies; D012737:Sex Factors; D044465:White People; D001741:Black or African American