Cardiovascular functional and structural changes in children with primary hypertension

Minerva Pediatr. 2016 Feb;68(1):27-35. Epub 2014 Nov 20.

Abstract

Background: Primary hypertension in children is not a benign condition because of end-organ damage. Early investigations of cardiovascular effects rely on vascular structural and functional changes. We aimed to determine presence of early cardiovascular involvement in children with primary hypertension. For this purposes, we investigated functional and morphological changes in vascular system.

Methods: Seventy-five consecutive patients with primary hypertension and 35 healthy children comparable for age and gender were studied. Patients were classified according to the stages of blood pressure. Intima-media thickness of the carotid arteries (cIMT), carotid-femoral pulse wave velocity (PWVcf) and Pulse Wave Augmentation Index (AIx) and Left Ventricular Mass Index (LVMi) were investigated.

Results: PWVcf and AIx were higher in patients (5.87±0.87 m/s vs. 5.29±0.67 m/s, P=0.02; 9.41±8.54% vs. 8.36±3.59%, P=0.04, respectively) than in controls. cIMT was evaluated significantly higher in study group than controls (0.46±0.06 mm vs. 0.35±0.12 mm, respectively, P=0.01). The mean LVMi was higher in patients (32.9±11.5 vs. 28.8±1.55, P=0.01).

Conclusion: Our results demonstrated that vascular findings were more sensitive for target organ changes than the more frequently utilized LVMi in patients with pre-hypertension.

MeSH terms

  • Adolescent
  • Blood Pressure / physiology*
  • Cardiovascular System / physiopathology*
  • Carotid Arteries / pathology*
  • Carotid Intima-Media Thickness
  • Case-Control Studies
  • Child
  • Female
  • Heart Ventricles / pathology
  • Humans
  • Hypertension / physiopathology*
  • Male
  • Pulse Wave Analysis