From the Divisions of Cardiology (S.R.D., P.K., T.R.K.) and Clinical
Pharmacology (J.M.H.L.), Department of Pediatrics, University of Cincinnati
College of Medicine and Children's Hospital Medical Center, Cincinnati,
Ohio.
Background—Left
ventricular (LV) hypertrophy has been
established as an independent risk factor for
cardiovascular disease in adults. Recent research has
refined this relationship by determining a cutpoint of 51
g/m2.7 for LV mass index indicative of increased risk and
defining LV geometric patterns that are associated with increased risk.
The purpose of this study was to evaluate severe LV
hypertrophy and LV geometry in children and adolescents
with essential hypertension.
Methods and Results—A cross-sectional study of young patients
(n=130) with persistent blood pressure elevation above the 90th
percentile was conducted. Nineteen patients (14%) had LV mass greater
than the 99th percentile; 11 of these were also above the adult
cutpoint of 51 g/m2.7. Males, subjects with greater body
mass index, and those who had lower heart rate at maximum exercise were
at significantly (P<.05) higher risk of severe LV
hypertrophy. In addition, 22 patients (17%) had concentric
LV hypertrophy, a geometric pattern that is associated with
increased risk of cardiovascular disease in adults.
Seven patients had LV mass index above the cutpoint and concentric
hypertrophy. No consistent significant determinants
of LV geometry were identified in these children and adolescents with
hypertension.
Conclusions—Severe LV hypertrophy and abnormal LV
geometry are relatively prevalent in young patients with essential
hypertension. These findings suggest that these patients may be at risk
for future cardiovascular disease and underscore the
importance of recognition and treatment of blood pressure elevation in
children and adolescents. Weight loss is an important component of
therapy in young patients with essential hypertension who are
overweight.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Left Ventricular Geometry and Severe Left Ventricular Hypertrophy in Children and Adolescents With Essential Hypertension
Key Words: ventricles • hypertrophy • hypertension • pediatrics
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