Skip to main content
SpringerLink
Log in

Carotid ultrasonography for detection of vascular abnormalities in hypertensive children

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract.

To determine whether hypertension and overweight status are associated with increased carotid intimal-medial thickness (cIMT) in children, vascular ultrasonography was performed in newly diagnosed hypertensive patients (n=53) and normotensive controls (n=33). Hypertensive subjects were identified either by referral or by systematic school-based hypertension screening. Hypertension was defined as blood pressure above the 95th percentile based on current Task Force criteria, and overweight was defined as body mass index (BMI) >25 kg/m2. cIMT was assessed by high-resolution vascular ultrasonography of the distal common carotid artery. Hypertensive subjects had a higher cIMT than normotensive subjects (0.62 vs. 0.53 mm, P<0.00001). This difference remained significant after controlling for the effects of gender, race, age, height, weight, and BMI. Similarly, overweight subjects had a higher cIMT than normal-weight subjects (0.63 vs. 0.54 mm, P<0.0001). Subjects with both systolic and diastolic hypertension had higher cIMT than those with isolated systolic hypertension (0.67 vs. 0.60, P<0.05). cIMT showed significant positive pairwise correlation with age, height, weight, BMI, and systolic blood pressure. Among all clinical variables analyzed, cIMT was most strongly correlated with BMI (r=0.53, P<0.001). These results provide further evidence that vasculopathy occurs in association with known cardiovascular risk factors such as hypertension and obesity during childhood.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.
Fig. 3.

Similar content being viewed by others

References

  1. Johnson MC, Bergersen LJ, Beck A, Dick G, Cole BR (1999) Diastolic function and tachycardia in hypertensive children. Am J Hypertens 12:1009–1014

    Article  CAS  PubMed  Google Scholar 

  2. Daniels SR, Loggie JM, Khoury P, Kimball TR (1998) Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation 97:1907–1911

    CAS  PubMed  Google Scholar 

  3. Laird WP, Fixler DE (1981) Left ventricular hypertrophy in adolescents with elevated blood pressure: assessment by chest roentgenography, electrocardiography, and echocardiography. Pediatrics 67:255–259

    CAS  PubMed  Google Scholar 

  4. Goldring D, Hernandez A, Choi S, Lee JY, Londe S, Lindgren FT, Burton RM (1979) Blood pressure in a high school population. II. Clinical profile of the juvenile hypertensive. J Pediatr 95:298–304

    CAS  PubMed  Google Scholar 

  5. Culpepper WS (1983) Cardiac anatomy and function in juvenile hypertension. Current understanding and future concerns. Am J Med 75:57–61

    CAS  Google Scholar 

  6. Culpepper WS, Sodt PC, Messerli FH, Ruschhaupt DG, Arcilla RA (1983) Cardiac status in juvenile borderline hypertension. Ann Intern Med 98:1–7

    PubMed  Google Scholar 

  7. Schieken RM, Clarke WR, Lauer RM (1981) Left ventricular hypertrophy in children with blood pressures in the upper quintile of the distribution. The Muscatine Study. Hypertension 3:669–675

    CAS  PubMed  Google Scholar 

  8. Daniels SR, Meyer RA, Loggie JM (1990) Determinants of cardiac involvement in children and adolescents with essential hypertension. Circulation 82:1243–1248

    CAS  PubMed  Google Scholar 

  9. Belsha CW, Wells TG, McNiece KL, Seib PM, Plummer JK, Berry PL (1998) Influence of diurnal blood pressure variations on target organ abnormalities in adolescents with mild essential hypertension. Am J Hypertens 11:410–417

    CAS  PubMed  Google Scholar 

  10. Heiss G, Sharrett AR, Barnes R, Chambless LE, Szklo M, Alzola C (1991) Carotid atherosclerosis measured by B-mode ultrasound in populations: associations with cardiovascular risk factors in the ARIC study. Am J Epidemiol 134:250–256

    CAS  PubMed  Google Scholar 

  11. O'Leary DH, Polak JF, Kronmal RA, Kittner SJ, Bond MG, Wolfson SKJ, Bommer W, Price TR, Gardin JM, Savage PJ (1992) Distribution and correlates of sonographically detected carotid artery disease in the Cardiovascular Health Study. The CHS Collaborative Research Group. Stroke 23:1752–1760

    CAS  PubMed  Google Scholar 

  12. Salonen JT, Salonen R (1993) Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation 87:1156–1165

    Google Scholar 

  13. Sorof JM, Alexandrov AV, Cardwell G, Portman RJ (2003) Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure. Pediatrics 111:61–66

    PubMed  Google Scholar 

  14. Jarvisalo MJ, Jartti L, Nanto-Salonen K, Irjala K, Ronnemaa T, Hartiala JJ, Celermajer DS, Raitakari OT (2001) Increased aortic intima-media thickness: a marker of preclinical atherosclerosis in high-risk children. Circulation 104:2943–2947

    CAS  PubMed  Google Scholar 

  15. Peppa-Patrikiou M, Scordili M, Antoniou A, Giannaki M, Dracopoulou M, Dacou-Voutetakis C (1998) Carotid atherosclerosis in adolescents and young adults with IDDM. Relation to urinary endothelin, albumin, free cortisol, and other factors. Diabetes Care 21:1004–1007

    CAS  PubMed  Google Scholar 

  16. Jarvisalo MJ, Putto-Laurila A, Jartti L, Lehtimaki T, Solakivi T, Ronnemaa T, Raitakari OT (2002) Carotid artery intima-media thickness in children with type 1 diabetes. Diabetes 51:493–498

    CAS  PubMed  Google Scholar 

  17. Virkola K, Pesonen E, Akerblom HK, Siimes MA (1997) Cholesterol and carotid artery wall in children and adolescents with familial hypercholesterolaemia: a controlled study by ultrasound. Acta Paediatr 86:1203–1207

    CAS  PubMed  Google Scholar 

  18. Sorof JM, Poffenbarger T, Franco K, Bernard L, Portman RJ (2002) Isolated systolic hypertension, obesity, and hyperkinetic hemodynamic states in children. J Pediatr 140:660–666

    Article  PubMed  Google Scholar 

  19. Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents (1996) Pediatrics 98:649–658

    Google Scholar 

  20. American Society of Hypertension (1992) Recommendations for routine blood pressure measurement by indirect cuff sphygmomanometry. Am J Hypertens 5:207–209

    PubMed  Google Scholar 

  21. Oalmann MC, Strong JP, Tracy RE, Malcom GT (1997) Atherosclerosis in youth: are hypertension and other coronary heart disease risk factors already at work? Pediatr Nephrol 11:99–107

    Google Scholar 

  22. Enos WF, Holmes RH, Beyer J (1953) Coronary disease among United States soldiers killed in action in Korea. Preliminary report. JAMA 152:1090–1093

    Google Scholar 

  23. McNamara JJ, Molot MA, Stremple JF, Cutting RT (1971) Coronary artery disease in combat casualties in Vietnam. JAMA 216:1185–1187

    Article  CAS  PubMed  Google Scholar 

  24. Strong JP, Malcom GT, Oalmann MC (1995) Environmental and genetic risk factors in early human atherogenesis: lessons from the PDAY study. Pathol Int 45:403–408

    CAS  PubMed  Google Scholar 

  25. Berenson GS, Srinivasan SR, Bao W, Newman WP, Tracy RE, Wattigney WA (1998) Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 338:1650–1656

    CAS  PubMed  Google Scholar 

  26. Tonstad S, Joakimsen O, Stensland-Bugge E, Leren TP, Ose L, Russell D, Bonaa KH (1996) Risk factors related to carotid intima-media thickness and plaque in children with familial hypercholesterolemia and control subjects. Arterioscler Thromb Vasc Biol 16:984–991

    CAS  PubMed  Google Scholar 

  27. Sorof JM, Poffenbarger T, Franco K, Portman R (2001) Evaluation of white coat hypertension in children: importance of the definitions of normal ambulatory blood pressure and the severity of casual hypertension. Am J Hypertens 14:855–860

    Article  CAS  PubMed  Google Scholar 

  28. Sass C, Herbeth B, Chapet O, Siest G, Visvikis S, Zannad F (1998) Intima-media thickness and diameter of carotid and femoral arteries in children, adolescents and adults from the Stanislas cohort: effect of age, sex, anthropometry and blood pressure. J Hypertens 16:1593–1602

    Article  CAS  PubMed  Google Scholar 

  29. Sorof J, Daniels S (2002) Obesity hypertension in children: a problem of epidemic proportions. Hypertension 40:441–447

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements.

The research was supported by a grant from NHLBI K23 HL04217–01A1.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Nephrology and Hypertension, University of Texas Health Science Center at Houston, Houston, Texas, USA

    Jonathan M. Sorof, Jennifer L. Turner, Robert E. Grafe & Ronald J. Portman

  2. Department of Neurology, University of Texas Health Science Center at Houston, Houston, Texas, USA

    Andrei V. Alexandrov & Zsolt Garami

  3. School of Public Health, Department of Biometry, University of Texas Health Science Center at Houston, Houston, Texas, USA

    Dejian Lai

  4. Division of Pediatric Nephrology and Hypertension, University of Texas Houston Medical School, 6431 Fannin Street, Room 3.124, Houston, TX 77030, USA

    Jonathan M. Sorof

Authors
  1. Jonathan M. Sorof
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrei V. Alexandrov
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zsolt Garami
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jennifer L. Turner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Robert E. Grafe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dejian Lai
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ronald J. Portman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jonathan M. Sorof.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sorof, J.M., Alexandrov, A.V., Garami, Z. et al. Carotid ultrasonography for detection of vascular abnormalities in hypertensive children. Pediatr Nephrol 18, 1020–1024 (2003). https://doi.org/10.1007/s00467-003-1187-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-003-1187-0

Keywords

Search

Navigation