title: Evidence of a hyperkinetic state in children with elevated blood pressure.
abstract: BACKGROUND
  Left ventricular hypertrophy (LVH) and elevated left ventricular mass index (LVMI) are important predictors of cardiovascular morbidity and mortality in adults. Children with hypertension and pre-hypertension demonstrate LVH and greater LVMI compared to normotensive children. The impact of blood pressure (BP) on early changes in left ventricular properties provides an opportunity to understand and identify cardiovascular risk early in childhood.
  
  
  OBJECTIVE
  The aim of this study was to assess left ventricular structural and functional properties in a sample of children across a wide range of BP values.
  
  
  METHODS
  Children aged 11-14-years were divided into BP groups: hypertensives (HTN; ≥95th percentile; n = 21) and normotensives (NTN; <90th percentile; n = 85) based on BP measures taken at two time points. Resting supine heart rate (HR), cardiac output (CO) and total peripheral resistance (TPR) were collected along with left ventricular structural and functional properties using ultrasound sonography.
  
  
  RESULTS
  LVMI and TPR were not different between groups. CO, HR and left ventricular end-diastolic and end-systolic volumes were elevated in the HTN group. Furthermore, HR and body mass index were found to be independent predictors of BP group status in children.
  
  
  CONCLUSIONS
  These findings show that children with elevated BP are characterized by high HR and CO and normal TPR. Also, the results identify HR as a predictor of BP group status in early childhood.
authors.affiliation: Faculty of Applied Health Sciences and.
authors.forename: Daniele
authors.initials: D
authors.lastname: Chirico
authors.forename: Terrance J
authors.initials: TJ
authors.lastname: Wade
authors.forename: John
authors.initials: J
authors.lastname: Cairney
authors.forename: Panagiota
authors.initials: P
authors.lastname: Klentrou
authors.forename: Deborah D
authors.initials: DD
authors.lastname: O'Leary
mesh_terms: D000293:Adolescent; D001794:Blood Pressure; D002302:Cardiac Output; D002648:Child; D005260:Female; D006352:Heart Ventricles / Q000033:anatomy & histology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology*; D008297:Male; D009864:Ontario; D013318:Stroke Volume; D016276:Ventricular Function
keywords: Blood pressure; children; hyperkinetic circulation; left ventricle mass