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
This article has been cited by other articles:
 |
|
 |
|
  S. S. Gidding Measuring Children's Blood Pressure Matters Circulation, June 24, 2008; 117(25): 3163 - 3164. [Full Text] [PDF]
|
|
|
|
|
|
B. J. Foster, A. S. Mackie, M. Mitsnefes, H. Ali, S. Mamber, and S. D. Colan A Novel Method of Expressing Left Ventricular Mass Relative to Body Size in Children Circulation, May 27, 2008; 117(21): 2769 - 2775. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. M. Ippisch, T. H. Inge, S. R. Daniels, B. Wang, P. R. Khoury, S. A. Witt, B. J. Glascock, V. F. Garcia, and T. R. Kimball Reversibility of Cardiac Abnormalities in Morbidly Obese Adolescents J. Am. Coll. Cardiol., April 8, 2008; 51(14): 1342 - 1348. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. G. Feld and H. Corey Hypertension in Childhood Pediatr. Rev., August 1, 2007; 28(8): 283 - 298. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Mitchell, N. Cheung, K. de Haseth, B. Taylor, E. Rochtchina, F. M. A. Islam, J. J. Wang, S. M. Saw, and T. Y. Wong Blood Pressure and Retinal Arteriolar Narrowing in Children Hypertension, May 1, 2007; 49(5): 1156 - 1162. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Drukteinis, M. J. Roman, R. R. Fabsitz, E. T. Lee, L. G. Best, M. Russell, and R. B. Devereux Cardiac and Systemic Hemodynamic Characteristics of Hypertension and Prehypertension in Adolescents and Young Adults: The Strong Heart Study Circulation, January 16, 2007; 115(2): 221 - 227. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. B. Lande, N. L. Carson, J. Roy, and C. C. Meagher Effects of Childhood Primary Hypertension on Carotid Intima Media Thickness: A Matched Controlled Study Hypertension, July 1, 2006; 48(1): 40 - 44. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. Srinivasan, L. Myers, and G. S. Berenson Changes in Metabolic Syndrome Variables Since Childhood in Prehypertensive and Hypertensive Subjects: The Bogalusa Heart Study Hypertension, July 1, 2006; 48(1): 33 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. Daniels, D. K. Arnett, R. H. Eckel, S. S. Gidding, L. L. Hayman, S. Kumanyika, T. N. Robinson, B. J. Scott, S. St. Jeor, and C. L. Williams Overweight in Children and Adolescents: Pathophysiology, Consequences, Prevention, and Treatment Circulation, April 19, 2005; 111(15): 1999 - 2012. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 National High Blood Pressure Education Program Wor The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents Pediatrics, August 1, 2004; 114(2/S2): 555 - 576. [Full Text] [PDF]
|
|
|
|
 |
|
 S. C. Couch and S. R. Daniels Diet and Blood Pressure Elevation in Children and Adolescents Arch Pediatr Adolesc Med, May 1, 2004; 158(5): 418 - 419. [Full Text] [PDF]
|
|
|
|
|
|
C. Hanevold, J. Waller, S. Daniels, R. Portman, and J. Sorof The Effects of Obesity, Gender, and Ethnic Group on Left Ventricular Hypertrophy and Geometry in Hypertensive Children: A Collaborative Study of the International Pediatric Hypertension Association Pediatrics, February 1, 2004; 113(2): 328 - 333. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Sorof, J. Turner, D. S. Martin, K. Garcia, Z. Garami, A. V. Alexandrov, F. Wan, and R. J. Portman Cardiovascular Risk Factors and Sequelae in Hypertensive Children Identified by Referral Versus School-Based Screening Hypertension, February 1, 2004; 43(2): 214 - 218. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Lorber, S. S. Gidding, M. L. Daviglus, L. A. Colangelo, K. Liu, and J. M. Gardin Influence of systolic blood pressure and body mass index on left ventricular structure in healthy African-American and white young adults: the CARDIA study J. Am. Coll. Cardiol., March 19, 2003; 41(6): 955 - 960. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Sorof, A. V. Alexandrov, G. Cardwell, and R. J. Portman Carotid Artery Intimal-Medial Thickness and Left Ventricular Hypertrophy in Children With Elevated Blood Pressure Pediatrics, January 1, 2003; 111(1): 61 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Sorof and S. Daniels Obesity Hypertension in Children: A Problem of Epidemic Proportions Hypertension, October 1, 2002; 40(4): 441 - 447. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Sorof, G. Cardwell, K. Franco, and R. J. Portman Ambulatory Blood Pressure and Left Ventricular Mass Index in Hypertensive Children Hypertension, April 1, 2002; 39(4): 903 - 908. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. S. Gidding Clinical and Epidemiological Significance of Left Ventricular Mass Assessed in Children and Adolescents Circulation, May 19, 1998; 97(19): 1893 - 1894. [Full Text] [PDF]
|
|