title: Cardiac and vascular consequences of pre-hypertension in youth.
abstract: Hypertension is associated with increased left ventricular mass (LVM) and carotid intima-media thickness (cIMT), which predict cardiovascular (CV) events in adults. Whether target organ damage is found in pre-hypertensive youth is not known. The authors measured body mass index, blood pressure, fasting glucose, insulin, lipids and C-reactive protein, LVM/height(2.7) (LVM index), diastolic function, cIMT, carotid stiffness, augmentation index, brachial artery distensibility, and pulse wave velocity (PWV) in 723 patients aged 10 to 23 years (29% with type 2 diabetes mellitus). Patients were stratified by blood pressure level (normotensive: 531, pre-hypertensive: 65, hypertensive: 127). Adiposity and CV risk factors worsened across blood pressure group. There was a graded increase in cIMT, arterial stiffness, and LVM index and decrease in diastolic function from normotension to pre-hypertension to hypertension. In multivariable models adjusted for CV risk factors, status as pre-hypertension or hypertension remained an independent determinant of target organ damage for LVM, diastolic function, internal cIMT, and carotid and arterial stiffness. Pre-hypertension is associated with cardiovascular target organ damage in adolescents and young adults.
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center and the University of Cincinnati, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. elaine.urbina@cchmc.org
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Urbina
authors.forename: Philip R
authors.initials: PR
authors.lastname: Khoury
authors.forename: Connie
authors.initials: C
authors.lastname: McCoy
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Daniels
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kimball
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Dolan
mesh_terms: D000293:Adolescent; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000502:physiology*; D002648:Child; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004452:Echocardiography; D004548:Elasticity / Q000502:physiology*; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging*; D008297:Male; D009765:Obesity / Q000150:complications; D058246:Prehypertension / Q000150:complications* / Q000503:physiopathology; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014655:Vascular Resistance / Q000502:physiology; D055815:Young Adult