title: Effects of obesity and race on left ventricular geometry in hypertensive children.
abstract: BACKGROUND
  Like left ventricular hypertrophy (LVH), abnormal left ventricular (LV) geometry increases cardiovascular risk, but little data utilizing age and sex-specific norms are currently available on LV geometry in hypertensive children.
  
  
  METHODS
  This was a cross-sectional study of 141 hypertensive children aimed at determining the prevalence of LVH and abnormal LV geometry in the patient population and whether clinical characteristics associated with these findings differ by race. LVH was defined as an LV mass index of ≥95th percentile or cardiologist diagnosis. Abnormal geometry was defined as the presence of LVH or a relative wall thickness of >0.41.
  
  
  RESULTS
  The prevalence of LVH was 35 % overall. According to race, LVH prevalence was 49 % among African-Americans (AA) versus 30 % among non-AA (p < 0.05). Overweight/obesity was also highly prevalent among AA compared to non-AA (87 vs. 71 %, respectively; p = 0.03). After multivariable adjustment, the body mass index (BMI) z-score and 95 % diastolic blood pressure (BP) index were the sole independent predictors of LVH. Of the 141 hypertensive children, 40 % had abnormal LV geometry; 63 % among AA vs. 32 % among non-AA (p = 0.001). Multivariable analyses revealed a 3.8-fold increased odds of abnormal geometry among AA (p = 0.002).
  
  
  CONCLUSIONS
  While LVH, abnormal geometry and overweight/obesity are more prevalent among AA hypertensive children, after multivariable adjustment, BMI and race were independently associated with LVH and abnormal geometry, respectively. This result suggests that both race and obesity have important roles in the development of end-organ damage among children with primary hypertension.
authors.affiliation: Pediatrics, Johns Hopkins University, 200 N. Wolfe Street, Room 3055, Baltimore, MD 21287, USA. csouthe1@jhmi.edu
authors.forename: Cozumel S
authors.initials: CS
authors.lastname: Pruette
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Fivush
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Flynn
authors.forename: Tammy M
authors.initials: TM
authors.lastname: Brady
mesh_terms: D050154:Adiposity / Q000208:ethnology; D000293:Adolescent; D001741:Black or African American; D000367:Age Factors; D001794:Blood Pressure; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D063766:Pediatric Obesity / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D020257:Ventricular Remodeling