Left ventricular hypertrophy and arterial wall thickening in children with essential hypertension.
OBJECTIVE
Our aim was to determine the prevalence of left ventricular hypertrophy (LVH) and increased intima-media thickness (IMT) in Caucasian children with newly diagnosed, untreated essential hypertension (EH).


METHODS
Our study cohort consisted of 72 children with EH (mean age: 14.5 years; range: 5-18 years). The control groups consisted of 103 age-matched, healthy children.


METHODS
We evaluated the left ventricular mass (LVM), intima-media thickness in the carotid (cIMT) and superficial femoral (fIMT) arteries, 24-h ambulatory blood pressure, and biochemical cardiovascular risk factors.


RESULTS
Of the hypertensive children examined, 41.6% had LVM above the 95th percentile, and 13.2% had LVM above 51 g/m2.7. Of the hypertensive subjects, the cIMT was above 2 SDS of normal values in 38.8%, and the flMT was above 2 SDS of normal values in 17.5%. Patients with LVM above 51 g/m2.7 had a higher birth weight than other patients. LVM, cIMT, and fIMT correlated with 24-h SBP and pulse pressure; LVM also correlated with homocysteine and serum uric acid concentrations. fIMT correlated with low Aprotein A1 (ApoA1), higher ApoB and C reactive protein, and daily sodium excretion. Step-wise regression analysis revealed that serum uric acid and higher birth weight were predictors for LVM, pulse pressure was a predictor for cIMT, and ApoB was a predictor for fIMT.


CONCLUSIONS
A significant number of adolescents with EH already had cardiovascular damage at diagnosis. LVM and markers of arterial injury correlate with SBP, biochemical, and perinatal cardiovascular risk factors. Serum uric acid and higher birth weight are predictors of LVM.
Department of Nephrology, Division of Nephrology and Arterial Hypertension, The Children's Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland. m.litwin@czd.pl
Mieczysław
M
Litwin
Anna
A
Niemirska
Joanna
J
Sladowska
Jolanta
J
Antoniewicz
Joanna
J
Daszkowska
Aldona
A
Wierzbicka
Zbigniew T
ZT
Wawer
Ryszard
R
Grenda
D000293:Adolescent; D000818:Animals; D016632:Apolipoprotein A-I / Q000097:blood; D001724:Birth Weight; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006710:Homocysteine / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D011379:Prognosis; D012964:Sodium / Q000097:blood; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014527:Uric Acid / Q000097:blood
C505693:APOA1 protein, human; D016632:Apolipoprotein A-I; D006710:Homocysteine; D014527:Uric Acid; D012964:Sodium