Left ventricular mass of persistent masked hypertension in Hong Kong Chinese adolescents: a 4-year follow-up study

Yam, MC; So, Hung‐Kwan; Kwok, Sit-Yee; Lo, Fung-Cheung; Mok, C. K.; Leung, Chuk-Kwan; Yip, W. C. L.; Sung, Yn-Tz

doi:10.1017/s1047951118000434

Cited by 10 publications

(5 citation statements)

References 29 publications

(42 reference statements)

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“…High BP in children and adolescents is defined at or above the 95 th percentile of the distribution, and high normal BP is defined by the upper 10% of the distribution. In the future, long-term studies should be conducted to explore clinical markers for early cardiovascular disease that include increased carotid intimamedia thickness, left ventricular mass and pulse wave velocity, flow-mediated dilatation, retinal vascular narrowing, or increased cardiovascular biomarkers (interleukin-6, fibrinogen, and so on) [37][38][39], which would be useful for the establishment of HBP definition in children and adolescents.…”

Section: Discussionmentioning

confidence: 99%

Comparison of China Reference with Different National and International References: The Prevalence of High Blood Pressure in 695,302 Children and Adolescents in a Metropolis of Yangtze River Delta, China

Zhang¹,

Zhang

Zha³

et al. 2021

International Journal of Hypertension

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Objectives. This study aimed to compare performances of China reference and different national references on high blood pressure (HBP). Methods. A cross-sectional study including 695,302 children and adolescents aged 7 to 17 years in Suzhou, China, was conducted to determine the prevalence of HBP based on U.S., international, Europe, and China references in 2016. Results. Different percentiles of height and blood pressure were found among four references. Referring to U.S. reference, the prevalence of HBP was the highest with 26.0%, followed by International reference with 20.0%, Europe reference with 19.5%, and China reference with 19.2%. McNemar tests indicated statistically significant differences between HBP prevalence comparing China reference with the other 3 references ( P < 0.001 ). The area under the curve was 0.947, 0.851, and 0.949 for U.S., international, and Europe reference, respectively. U.S. reference showed the highest sensitivity (98.2%), but the lowest specificity (91.2%), and Europe reference showed the highest kappa value (0.893). Conclusions. The prevalence of HBP varied among these four references, and the appropriate choice of reference would be important to recognize high-risk children and judge the trends of HBP prevalence in the targeted population.

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Section: Discussionmentioning

confidence: 99%

Comparison of China Reference with Different National and International References: The Prevalence of High Blood Pressure in 695,302 Children and Adolescents in a Metropolis of Yangtze River Delta, China

Zhang¹,

Zhang

Zha³

et al. 2021

International Journal of Hypertension

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“…Two pediatric studies reported data on persistence of masked hypertension during 4 years of follow up. Both highlight the presence of masked hypertension as significant prognostic factor for higher LVMI during follow-up compared to normotensive children [ 3 , 77 ]. Lurbe et al found that LVH at the end of follow-up period was only present in the persistent masked hypertension group or in patients with masked hypertension who progressed to sustained (true, ambulatory) hypertension (30% versus 0%; P = 0.01) compared to normotensive controls [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Masked Hypertension in Healthy Children and Adolescents: Who Should Be Screened?

Seeman,

Šuláková,

Stabouli

2023

Curr Hypertens Rep

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Purpose of Review The goal is to review masked hypertension (MH) as a relatively new phenomenon when patients have normal office BP but elevated out-of-office BP. Firstly, it was described in children in 2004. It has received increased attention in the past decade. Recent Findings The prevalence of MH in different pediatric populations differs widely between 0 and 60% based on the population studied, definition of MH, or method of out-of-office BP measurement. The highest prevalence of MH has been demonstrated in children with chronic kidney disease (CKD), obesity, diabetes, and after heart transplantation. In healthy children but with risk factors for hypertension such as prematurity, overweight/obesity, diabetes, chronic kidney disease, or positive family history of hypertension, the prevalence of MH is 9%. In healthy children without risk factors for hypertension, the prevalence of MH is very low ranging 0–3%. Summary In healthy children, only patients with the following clinical conditions should be screened for MH: high-normal/elevated office BP, positive family history of hypertension, and those referred for suspected hypertension who have normal office BP in the secondary/tertiary center.

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“…Twelve studies reported differences in LVMI between MH (n=480) and normotensive (n=1301) children. 37–48 In all studies, LVMI was greater in MH (pooled mean=35.77 g/m 2.7 ; [95% CI, 31.96–39.57]) versus normotensive participants (pooled mean=31.28 g/m 2.7 ; [95% CI, 28.09–34.47]), with a mean difference of 3.86 g/m 2.7 ([95% CI, 2.51–5.22]; grade certainty: moderate; Figure 2). In the 6 studies analyzing the general pediatric population, LVMI of the MH participants (n=154; pooled mean=30.91 g/m 2.7 ) was greater than the normotensive participants (n=797; pooled mean=28.12 g/m 2.7 ) with a mean difference of 2.79 g/m 2.7 ([95% CI, 2.21–3.37]).…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies reported differences in LVMI between MH (n=480) and normotensive (n=1301) children. [37][38][39][40][41][42][43][44][45][46][47][48] In all 2). In the 6 studies analyzing the general pediatric population, LVMI of the MH participants (n=154; pooled mean=30.91 g/m 2.7 ) was greater than the normotensive participants (n=797; pooled mean=28.12 g/m 2.7 ) with a mean difference of 2.79 g/m 2.7 ([95% CI, 2.21-3.37]).…”

Section: Subclinical Cardiovascular Outcomesmentioning

confidence: 99%

“…Eleven studies reported differences in LVH prevalence between MH (n=436) and normotensive (n=612) children. 39,41,42,44,45,[48][49][50][51] In all studies, LVH was more common in MH (pooled prevalence: 19.0%) versus normotensive participants (pooled prevalence: 11.1%), with an odds ratio 2.44 ([95% CI, 1.50-3.96]; grade certainty: low; Figure 3). Eight studies used the age-specific reference intervals by Khoury et al 52 to define LVH; 1 study used the established pediatric cutoff of 38 g/m 2.7 to define LVH; 1 study used the established adult cutoff of 51 g/ m 2.7 to define LVH; 2 studies did not specify the definition of LVH used to diagnose participants.…”

Section: Subclinical Cardiovascular Outcomesmentioning

confidence: 99%

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Prevalence of Pediatric Masked Hypertension and Risk of Subclinical Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

Chung,

Robinson,

Sheffield

et al. 2023

Hypertension

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Masked hypertension (MH) occurs when office blood pressure is normal, but hypertension is confirmed using out-of-office blood pressure measures. Hypertension is a risk factor for subclinical cardiovascular outcomes, including left ventricular hypertrophy, increased left ventricular mass index, carotid intima media thickness, and pulse wave velocity. However, the risk factors for ambulatory blood pressure monitoring defined MH and its association with subclinical cardiovascular outcomes are unclear. A systematic literature search on 9 databases included English publications from 1974 to 2023. Pediatric MH prevalence was stratified by disease comorbidities and compared with the general pediatric population. We also compared the prevalence of left ventricular hypertrophy, and mean differences in left ventricular mass index, carotid intima media thickness, and pulse wave velocity between MH versus normotensive pediatric patients. Of 2199 screened studies, 136 studies (n=28 612; ages 4–25 years) were included. The prevalence of MH in the general pediatric population was 10.4% (95% CI, 8.00–12.80). Compared with the general pediatric population, the risk ratio (RR) of MH was significantly greater in children with coarctation of the aorta (RR, 1.91), solid-organ or stem-cell transplant (RR, 2.34), chronic kidney disease (RR, 2.44), and sickle cell disease (RR, 1.33). MH patients had increased risk of subclinical cardiovascular outcomes compared with normotensive patients, including higher left ventricular mass index (mean difference, 3.86 g/m 2.7 [95% CI, 2.51–5.22]), left ventricular hypertrophy (odds ratio, 2.44 [95% CI, 1.50–3.96]), and higher pulse wave velocity (mean difference, 0.30 m/s [95% CI, 0.14–0.45]). The prevalence of MH is significantly elevated among children with various comorbidities. Children with MH have evidence of subclinical cardiovascular outcomes, which increases their risk of long-term cardiovascular disease.

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Left ventricular mass of persistent masked hypertension in Hong Kong Chinese adolescents: a 4-year follow-up study

Abstract: Persistent masked hypertension in adolescents is associated with elevated left ventricular mass index.

Cited by 10 publications

References 29 publications

Comparison of China Reference with Different National and International References: The Prevalence of High Blood Pressure in 695,302 Children and Adolescents in a Metropolis of Yangtze River Delta, China

Comparison of China Reference with Different National and International References: The Prevalence of High Blood Pressure in 695,302 Children and Adolescents in a Metropolis of Yangtze River Delta, China

Masked Hypertension in Healthy Children and Adolescents: Who Should Be Screened?

Prevalence of Pediatric Masked Hypertension and Risk of Subclinical Cardiovascular Outcomes: A Systematic Review and Meta-Analysis

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