Objective: To explore the association between blood pressure (BP) and the left ventricular mass (LVM) in children aged 6-8 years. Methods: The participants were from the community-based census-like design child cohort on sensitization, puberty, obesity and cardiovascular risk (PROC) conducted in six public non-boarding primary schools in Shunyi District, Beijing. Repeated three measurements on anthropometrical, M-mode and 2-dimensional (2D) echocardiographic imaging (2D/M ECHO) and blood biochemical assay, and BP measurements were carried out at baseline and follow-up from October 2018 to June 2019. A total of 1 659 children who had repeated BP measurements and cardiac structure information were included in this study. The average value of last two measurements of BP was determined as BP value for analysis. Formula recommended by Devereux was used to calculate the mass of left ventricle. Robust linear regression models were used to explore the association between BP and LVM in different groups. Results: The average age of all patients was (7.10±0.29) years old, including 832 boys (50.15%). Of all, 83.54% (1 386/1 659) were grouped as normal BP with average LVM (58.54±13.33) g, and 16.46% (273/1 659) as elevated BP group with LVM (63.84±15.78) g (P<0.001). The LVM of the normal BP group was lower than elevated BP group in overall participants, boys and girls (P<0.005). Univariate analysis showed that systolic BP was associated with LVM in overall, boys and girls (P<0.001) respectively. While diastolic BP was associated with LVM in overall and girls (P<0.03). Multivariable analysis indicated that the associations between systolic BP and LVM were observed in overall, boys and girls (P<0.05) with the β (95%CI)=0.14 (0.08, 0.21), 0.18 (0.08, 0.27) and 0.12 (0.03, 0.22), respectively. However, the associations of diastolic BP and LVM were not significant. Conclusion: Systolic BP is highly associated with LVM and elevated BP could increase the LVM in children. Boys with elevated BP present a larger LVM and might indicate higher risk of left ventricular hypertrophy in adulthood.
目的： 探讨6~8岁儿童血压与左心室质量的关系。 方法： 研究对象来自2018年10月至2019年6月在北京市顺义区开展的“儿童生长与健康队列”。采用人群普查的方法，最终纳入资料完整的1 659名6~8岁儿童为研究对象。通过体格检查、实验室检测和超声检查收集BMI、血压、血生化和心脏结构等信息，以重复测量血压后两次平均值进行血压分组，采用Devereux推荐公式计算左心室质量，采用稳健线性回归模型分析总体及男、女童血压与左心室质量的关系。 结果： 1 659名研究对象平均年龄为（7.10±0.29）岁，其中男童832名（50.15%）。6~8岁儿童中，血压正常和血压偏高检出率分别为83.54%（1386/1 659）和16.46%（273/1 659），左心室质量分别为（58.54±13.33）和（63.84±15.78）g，差异具有统计学意义（P<0.001）。总体、男童和女童正常血压组左心室质量均低于血压偏高组，差异具有统计学意义（P<0.005）。在单因素回归模型中，总体、男童和女童收缩压与左心室质量相关（P<0.001）；总体及女童舒张压与左心室质量相关（P<0.03）。在多因素回归模型中，总体、男童和女童的收缩压均与左心室质量相关（P<0.05），β（95%CI）值分别为0.14（0.08，0.21）、0.18（0.08，0.27）和0.12（0.03，0.22），总体、男童和女童的舒张压均与左心室质量无关。 结论： 收缩压与左心室质量密切相关，血压偏高会增加左心室质量，血压偏高的男童左心室质量更大，可能会预示其成年期左心室肥厚的发生风险更高。.
Keywords: Child; Cohort study; Hypertension; Left ventricular mass.