Assessment of target-organ damage in adolescent white-coat and sustained hypertensives.
OBJECTIVE
The aim of the present study was to assess whether a difference exists between intima-media thickness and the left ventricular mass index in healthy nonhypertensive, white-coat hypertensive and sustained hypertensive adolescents.


METHODS
Fifty-nine normotensive and 120 hypertensive adolescents were enrolled in our study. Hypertensive patients were classified into white-coat hypertension (WCH) and sustained hypertension groups based on 24-h ambulatory blood pressure measurements. Both normotensive and hypertensive individuals underwent routine laboratory tests, intima-media thickness measurements on the common carotid arteries and transthoracic echocardiography to measure the left ventricular mass index (LVMI).


RESULTS
Intima-media thickness was higher both in WCH and sustained hypertension compared with healthy normotensive individuals (controls: 0.048 ± 0.01 cm, WCH: 0.056 ± 0.01 cm, sustained hypertension: 0.054 ± 0.012 cm, both P < 0.001 compared with controls, nonsignificant difference between the two hypertensive groups). There was no difference between the LVMI of control individuals and WCH (LVMI: 35.5 ± 10.3 g/m and 37.7 ± 11.2 g/m respectively, P = 0.87). LVMI in sustained hypertension group (LVMI: 44.1 ± 14.1 g/m) was significantly higher both compared with WCH (P < 0.05), and healthy adolescents (P < 0.001).


CONCLUSIONS
Target-organ damage develops in a stepwise fashion in adolescent hypertension. An increased intima-media thickness can be demonstrated not only in the sustained but also in the white-coat form of adolescent hypertension.
Páll
Dénes
D
First Department of Medicine, University of Debrecen, Debrecen, Hungary.
Juhász
Mária
M
Lengyel
Szabolcs
S
Molnár
Csilla
C
Paragh
György
G
Fülesdi
Béla
B
Katona
Eva
E
D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D009819:Office Visits; D015995:Prevalence; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*