Blood pressure and left ventricular mass index in healthy adolescents

Abstract

Primary hypertension among children and adolescents is increasing in prevalence and has been associated with the sequela of left ventricular hypertrophy (LVH), defined by increased left ventricular mass index (LVMI). The association between high blood pressure (BP) and LVMI in an otherwise healthy pediatric population is not well understood. We evaluated the relationship between measures of BP and LVMI in a group of healthy adolescents. We conducted a retrospective review of 55 high school athletes who participated in a community health screen, which included collecting BP readings and limited echocardiograms. End points included prevalence of BP in the ranges of hypertension and prehypertension, prevalence of LVH, and relationship between BP indices and LVMI. No individuals were found to be in the hypertensive range, and there were 13 (24%) in the prehypertensive range. Only one (2%) adolescent met LVH criteria. In multivariable regression analysis, increasing systolic BP index was the only variable significantly associated with greater LVMI (P=0.028). In a healthy cohort of lean adolescents, BP in the prehypertensive range was common in the community health screen setting. Increasing systolic BP index was significantly associated with LVMI.

Recomendaciones para la prevención de la hipertensión arterial en niños y adolescentes: revisión sistemática de alcance

“…El interés que manifiestan en la actualidad investigadores y clínicos en el tema de la HTA en niños y adolescentes se debe a que la evidencia muestra que la PA elevada es mucho más prevalente de lo que se suponía (1,2) . Además, estudios han demostrado que la PA alterada en estas edades se traducen en HTA en la etapa adulta, así como cambios en órganos diana como: deterioro cognitivo, hipertrofia ventricular izquierda y marcadores subclínicos de enfermedad cardiovascular, por ejemplo, aumento del grosor de la íntima medio carotídea y síndrome metabólico a muy temprana edad (4) . Por lo que es importancia destacar la vigilancia de este fenómeno no solo a nivel clínico epidemiológico, considerando la prevención como herramienta primordial.…”

Research Gaps in Primary Pediatric Hypertension

“…1 Rates of elevated blood pressure (BP) in children may be underestimated on the basis of current practices and guidelines because of the increasing prevalence of obesity in young people. Hypertension in youth is a condition that has been associated with target-organ changes, such as impaired cognition, 2 left ventricular hypertrophy (LVH), 3 and subclinical markers of cardiovascular disease (CVD), for example, increased carotid intima thickness. 4 Observational studies in youth have demonstrated an association between BP values .90th percentile and alterations in cardiac and vascular structure.…”