Document Detail


Left ventricular geometry in children and adolescents with primary hypertension.
MedLine Citation:
PMID:  19851297     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Children with hypertension (HTN) are at increased risk for left ventricular hypertrophy (LVH). Increased left ventricular (LV) mass (LVM) by the process of remodeling in response to volume or pressure loading may be eccentric (increased LV diameter) or concentric (increased wall thickness). Our objective was to classify LV geometry among children with primary HTN and examine differences in ambulatory blood pressure (ABP).
METHODS: Subjects aged 7-18 years with suspected HTN were enrolled in this cross-sectional study. ABP and LVM index (LVMI) were measured within the same 24-h period. LV geometry was classified as normal, concentric remodeling, concentric LVH, or eccentric LVH.
RESULTS: Children with LVH had significantly higher ambulatory systolic BP (SBP) and diastolic blood pressure (BP) (DBP) levels and body mass index (BMI) Z-score. Sixty-eight children had HTN based upon ABP monitoring (ABPM). Thirty-eight percent of the hypertensive subjects had LVH, with equal distribution in the concentric and eccentric groups. There were significant differences in the 24-h DBP parameters when the eccentric LVH group was compared to the normal geometry and concentric LVH groups. Relative wall thickness (RWT) was inversely associated with night time DBP parameters. These relationships persisted after controlling for BMI Z-score.
CONCLUSIONS: Although the risk for LVH is associated with increased SBP and BMI Z-score, those with eccentric LVH had significantly higher DBP.
Authors:
Phyllis A Richey; Thomas G Disessa; Grant W Somes; Bruce S Alpert; Deborah P Jones
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-10-22
Journal Detail:
Title:  American journal of hypertension     Volume:  23     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-17     Completed Date:  2010-03-23     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  24-9     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Child
Cross-Sectional Studies
Diastole
Echocardiography*
Female
Heart Ventricles / ultrasonography*
Humans
Hypertension / complications,  physiopathology*,  ultrasonography*
Hypertrophy, Left Ventricular / etiology
Male
Risk Assessment
Systole
Grant Support
ID/Acronym/Agency:
5K23 HL 83910-02/HL/NHLBI NIH HHS; K23 HL083910-04/HL/NHLBI NIH HHS; M01 RR-00211/RR/NCRR NIH HHS
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