Is Daytime Systolic Load an Important Risk Factor for Target Organ Damage in Pediatric Hypertension?

Abstract

The aim of this study was to compare ambulatory blood pressure (BP) monitoring (ABPM) data and determine which hypertension type is a risk factor in target organ damage. A total of 82 children (47 boys) with suspected hypertension based on office BP measurements and considered hypertensive by ABPM were studied. Target organ damage included the following: 35.3% hypertensive retinopathy, 25.6% microalbuminuria, 15.8% increased left ventricular mass index, 29.2% increased carotid intima-media thickness (cIMT), 24.3% high augmentation index (AIx), and 19.5% high pulse wave velocity (PWV). The association between BP load, PWV, and cIMT was statistically significant. There were significant correlations between daytime systolic BP load, PWV, AIx, and cIMT. A statistically significant difference was also detected between nighttime systolic BP load, PWV, and cIMT values and nighttime diastolic BP load levels and values of AIx and cIMT. There was also a statistically significant difference between the high level of nighttime diastolic BP load and cIMT. The authors found that target organ damage was seen more often in children with primary hypertension who had systolic loads.

Hypertension in Children: A Single Center Experience

“…In the study of Conkar, et al frequency of hypertensive retinopathy is found as 35.3% whereas Williams, et al mentioned it as 18% [20,21]. We found hypertensive retinopathy in 47 patients (20.3%).…”

The Use of Ambulatory Blood Pressure Monitoring As Standard of Care in Pediatrics

“…In adults, microalbuminuria has been shown to be a marker of HTN-induced renal injury (33). However, pediatric ABPM studies have not demonstrated ABPM parameters to independently predict presence of microalbuminuria in non-diabetic children and adolescents to date (34, 35). …”

Echocardiographic parameters of the heart with chronic kidney disease in children and adolescents

“…Поэтому с целью минимизировать влияние пола, возраста и ожирения у лиц моложе 18 лет для определения гипертрофии миокарда левого желудочка используют индекс массы миокарда ле-вого желудочка, индексированный по росту, возве-денному в степень 2,7. Гипертрофия миокарда левого желудочка диагностируется в случае, если средний уровень индекса массы миокарда левого желудочка равен или превышает 95-й перцентиль кривой рас-пределения этого индекса в популяции для соответ-ствующего возраста и пола [8].…”