Left ventricular cardiac geometry and ambulatory blood pressure in children

J Clin Hypertens (Greenwich). 2019 May;21(5):566-571. doi: 10.1111/jch.13540. Epub 2019 Apr 13.

Abstract

Limited information is available regarding the relationship between ambulatory blood pressure monitoring (ABPM) and cardiac geometry in hypertensive children. ABPM and 2D-echocardiography were retrospectively reviewed in children and adolescents <21 years old with primary hypertension. A total of 119 participants (median age 15.0 [IQR 12, 16] years) with hypertension were included. Left ventricular hypertrophy was diagnosed in 39.5% of participants. Normal geometry was found in 47.1%, concentric remodeling (CR) in 13.4%, concentric hypertrophy (CH) in 15.1%, and eccentric hypertrophy (EH) in 24.4% of children. After adjustment for age, sex, and body mass index z-score, awake systolic blood pressure (BP) index (BPi) (OR 1.07, 95% CI: 1.001-1.14, P = 0.045), awake diastolic BPi (OR 1.04, 95% CI: 1.00-1.09, P = 0.048), awake systolic BP load (OR 1.02, 95% CI: 1.000-1.04, P = 0.047), and sleep systolic BP load (OR 1.02, 95% CI: 1.001-1.04, P = 0.03) were directly associated with CH. No ABPM parameters were significant predictors of EH. In conclusion, ABPM parameters were found to be independent predictors of cardiac geometry, specifically CH.

Keywords: concentric hypertrophy; eccentric hypertrophy; hypertension; left ventricular hypertrophy; pediatric.

MeSH terms

  • Adolescent
  • Blood Pressure Monitoring, Ambulatory / methods
  • Blood Pressure Monitoring, Ambulatory / trends*
  • Body Mass Index
  • Case-Control Studies
  • Child
  • Diastole
  • Echocardiography / methods
  • Female
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / physiopathology
  • Humans
  • Hypertension / drug therapy
  • Hypertension / ethnology
  • Hypertension / physiopathology*
  • Hypertrophy, Left Ventricular / diagnostic imaging*
  • Hypertrophy, Left Ventricular / epidemiology
  • Hypertrophy, Left Ventricular / physiopathology
  • Male
  • Retrospective Studies
  • Systole