title: Left ventricular hypertrophy in hypertensive children and adolescents: predictors and prevalence.
abstract: Left ventricular hypertrophy is an independent predictor of cardiovascular morbidity and mortality in adults. In children, the primary correlate of left ventricular mass (LVM) is lean body mass, but fat mass, gender and systolic blood pressure are also contributors. LVM can be estimated from echocardiographic measurements, and by indexing this allometrically to height to the 2.7 power, the left ventricular mass index (LVMI) can be calculated. LVMI optimizes detection of left ventricular hypertrophy with established normal curves for children from birth to 18 years. In children with sustained hypertension, 8-41 % have LVMI above the 95th percentile and in 10-15.5 % of these, LVMI is elevated above levels associated with increased mortality in adults. The presence of obesity is associated with higher LVMI than is found in children with hypertension alone. In children with chronic kidney disease, left ventricular hypertrophy develops relatively early and becomes more prevalent as kidney function decreases. In summary, left ventricular hypertrophy is a sensitive marker of target organ damage in children with BP elevation, obesity and chronic kidney disease providing important management information.
authors.affiliation: Division of Pediatric Cardiology, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, 14692, USA, rae-ellen_kavey@urmc.rochester.edu.
authors.forename: Rae-Ellen W
authors.initials: RE
authors.lastname: Kavey
mesh_terms: D000293:Adolescent; D001794:Blood Pressure / Q000502:physiology; D018660:Blood Pressure Monitoring, Ambulatory; D002648:Child; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000453:epidemiology* / Q000209:etiology; D011237:Predictive Value of Tests; D015995:Prevalence
references.citation: J Pediatr. 2011 May;158(5):715-21
references.pmid: 21300369
references.citation: Circulation. 2004 Nov 30;110(22):3488-92
references.pmid: 15557363
references.citation: Am J Hypertens. 2010 Jan;23(1):24-9
references.pmid: 19851297
references.citation: Pediatr Nephrol. 2006 Jun;21(6):811-9
references.pmid: 16565870
references.citation: Circulation. 2003 Feb 18;107(6):864-8
references.pmid: 12591757
references.citation: Acta Paediatr. 2005 Aug;94(8):1055-9
references.pmid: 16188849
references.citation: Pediatrics. 1993 Nov;92(5):703-9
references.pmid: 8414859
references.citation: Circulation. 1995 Dec 1;92(11):3249-54
references.pmid: 7586311
references.citation: J Pediatr. 2008 Jan;152(1):73-8, 78.e1
references.pmid: 18154904
references.citation: Hypertension. 2002 Apr;39(4):903-8
references.pmid: 11967247
references.citation: Circulation. 1998 May 19;97(19):1907-11
references.pmid: 9609083
references.citation: J Am Soc Echocardiogr. 2009 Jun;22(6):709-14
references.pmid: 19423289
references.citation: Hypertens Res. 1999 Mar;22(1):1-9
references.pmid: 10221344
references.citation: Arch Intern Med. 1981 Jan;141(1):81-5
references.pmid: 7004372
references.citation: Circulation. 2006 Dec 12;114(24):2710-38
references.pmid: 17130340
references.citation: Circulation. 1995 May 1;91(9):2400-6
references.pmid: 7729027
references.citation: Kidney Int. 2003 Mar;63(3):1058-65
references.pmid: 12631088
references.citation: Circulation. 1998 May 19;97(19):1901-6
references.pmid: 9609082
references.citation: J Pediatr. 2002 Aug;141(2):191-7
references.pmid: 12183713
references.citation: Pediatr Res. 2008 Sep;64(3):303-7
references.pmid: 18458657
references.citation: J Am Soc Nephrol. 2012 Apr;23(4):578-85
references.pmid: 22383696
references.citation: Pediatrics. 2004 Aug;114(2 Suppl 4th Report):555-76
references.pmid: 15286277
references.citation: J Am Coll Cardiol. 1992 Nov 1;20(5):1251-60
references.pmid: 1401629
references.citation: N Engl J Med. 1990 May 31;322(22):1561-6
references.pmid: 2139921
references.citation: Am J Hypertens. 2012 Mar;25(3):389-95
references.pmid: 22089110
references.citation: Circulation. 2002 Jul 2;106(1):100-5
references.pmid: 12093777
references.citation: J Clin Hypertens (Greenwich). 2011 May;13(5):332-42
references.pmid: 21545394
references.citation: Am J Med. 2003 Jul;115(1):41-6
references.pmid: 12867233
references.citation: J Am Coll Cardiol. 2006 Jun 6;47(11):2267-73
references.pmid: 16750694
references.citation: J Am Soc Nephrol. 2002 Dec;13(12):2953-61
references.pmid: 12444214
references.citation: J Am Soc Hypertens. 2009 Nov-Dec;3(6):416-23
references.pmid: 20409984
references.citation: Pediatrics. 2004 Feb;113(2):328-33
references.pmid: 14754945
references.citation: J Pediatr. 2007 May;150(5):491-7
references.pmid: 17452222
references.citation: N Engl J Med. 2000 May 18;342(20):1478-83
references.pmid: 10816185
references.citation: Pediatr Nephrol. 2013 Oct;28(10):2015-22
references.pmid: 23703719
references.citation: Pediatr Nephrol. 2010 Aug;25(8):1513-8
references.pmid: 20393750
references.citation: N Engl J Med. 2004 Jun 24;350(26):2654-62
references.pmid: 15215481
references.citation: Hypertension. 2002 Jan;39(1):10-5
references.pmid: 11799071
references.citation: Am J Hypertens. 2003 Nov;16(11 Pt 1):895-9
references.pmid: 14573325
references.citation: J Hypertens. 1987 Feb;5(1):93-8
references.pmid: 3584967
references.citation: Pediatr Nephrol. 2010 Dec;25(12):2489-99
references.pmid: 20730452
references.citation: Kidney Int. 2004 Apr;65(4):1461-6
references.pmid: 15086489
references.citation: J Pediatr. 2006 Nov;149(5):671-5
references.pmid: 17095341
references.citation: Circulation. 2004 Jun 29;109(25 Suppl 1):IV22-30
references.pmid: 15226248
references.citation: Clin J Am Soc Nephrol. 2011 Sep;6(9):2132-40
references.pmid: 21841064
references.citation: Am J Hypertens. 2008 Oct;21(10):1144-51
references.pmid: 18756261
references.citation: J Am Coll Cardiol. 1995 Mar 15;25(4):879-84
references.pmid: 7884091
references.citation: Pediatr Nephrol. 2008 Jan;23(1):27-39
references.pmid: 17120060
references.citation: Pediatrics. 2003 Jan;111(1):61-6
references.pmid: 12509555
references.citation: Pediatr Transplant. 2001 Aug;5(4):279-84
references.pmid: 11472607
references.citation: Pediatr Nephrol. 2009 Aug;24(8):1545-51
references.pmid: 19444486
references.citation: Pediatr Nephrol. 2004 Jul;19(7):767-74
references.pmid: 15138871
references.citation: Hypertension. 2006 Jul;48(1):40-4
references.pmid: 16735644
references.citation: Pediatr Nephrol. 2012 May;27(5):835-41
references.pmid: 22105968
references.citation: Kidney Int. 1996 Sep;50(3):998-1006
references.pmid: 8872976
references.citation: J Am Coll Cardiol. 1997 Mar 1;29(3):641-7
references.pmid: 9060905
references.citation: Pediatr Nephrol. 2001 Apr;16(4):318-23
references.pmid: 11354774