Aortic dilatation in children with systemic hypertension

J Am Soc Hypertens. 2014 Apr;8(4):239-45. doi: 10.1016/j.jash.2014.01.002. Epub 2014 Jan 9.

Abstract

The aim of the study was to determine the presence of aortic dilatation in hypertensive children, the prevalence of which is 4% to 10% in hypertensive adults. Prospectively enrolled multiethnic children, untreated for their hypertension, underwent an echocardiogram to exclude congenital heart disease and evaluate for end-organ damage and aortic size. The aorta was measured in the parasternal long-axis view at three levels: the sinus of Valsalva, supra-tubular junction, and the ascending aorta. Aortic dilatation was determined by z-score >2 at any one of the levels measured. Hypertension was defined as blood pressure above the 95th percentile based on the Fourth Working Group criteria confirmed by 24-hour ambulatory blood pressure monitoring. Among 142 consecutive hypertensive children (median age, 14 years; 45% females) aortic dilatation was detected in 2.8% (95% confidence interval, 1%-7%; median age, 16 years; 100% females). Children with aortic dilatation, when compared with those without, had significantly more aortic valve insufficiency (P = .005) and left ventricular hypertrophy (P = .018). Prevalence of aortic dilatation was 2.8% and was associated with significantly more aortic insufficiency and left ventricular hypertrophy in comparison to those without aortic dilatation.

Keywords: Echocardiogram; aortic insufficiency; essential hypertension; left ventricular hypertrophy.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Aortic Diseases / diagnostic imaging
  • Aortic Diseases / epidemiology
  • Aortic Diseases / etiology*
  • Aortic Diseases / physiopathology
  • Blood Pressure Monitoring, Ambulatory
  • Child
  • Child, Preschool
  • Dilatation, Pathologic
  • Echocardiography
  • Female
  • Humans
  • Hypertension / complications*
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Infant
  • Male
  • Prevalence
  • Prospective Studies
  • Texas / epidemiology