Circulation, Vol 82, 1243-1248, Copyright © 1990 by American Heart Association
SD Daniels, RA Meyer and JM Loggie
Left ventricular hypertrophy is often found in association with systemic
hypertension and may be an independent risk factor for cardiovascular
disease morbidity and mortality. Few studies have investigated the
determinants of left ventricular mass (LVM) in young patients with
essential hypertension. Therefore, we studied 104 children and adolescents
with blood pressure persistently greater than the 90th percentile for age
and sex and with no known cause of blood pressure elevation. LVM was
determined by echocardiography and was indexed by height to account for
body size. The mean LVM index was 90.2 +/- 26.0 g/m. Using the
gender-specific 95th percentile from normal children, 40 subjects (38.5%)
had left ventricular hypertrophy. Using multiple regression analysis, the
significant independent direct correlates of LVM index were male sex, body
mass index, dietary sodium intake, age at diagnosis, and systolic blood
pressure at maximum exercise. The significant independent inverse correlate
of LVM index was resting heart rate (p less than 0.05). These variables
accounted for a substantial portion of the LVM index variance in this
population (multiple R2 = 0.56, p less than 0.001). The results indicate
that left ventricular hypertrophy is prevalent in children and adolescents
with essential hypertension. The direct association of LVM index with body
mass index and dietary sodium intake suggests weight reduction and dietary
salt restriction might be useful to prevent or treat the development of
left ventricular hypertrophy in pediatric patients with essential
hypertension.
ARTICLES
Determinants of cardiac involvement in children and adolescents with essential hypertension
Division of Cardiology, University of Cincinnati College of Medicine, Ohio.
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