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Left ventricular hypertrophy and arterial wall thickening in children with essential hypertension

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Abstract

Objective

Our aim was to determine the prevalence of left ventricular hypertrophy (LVH) and increased intima-media thickness (IMT) in Caucasian children with newly diagnosed, untreated essential hypertension (EH).

Participants

Our study cohort consisted of 72 children with EH (mean age: 14.5 years; range: 5–18 years). The control groups consisted of 103 age-matched, healthy children.

Methods

We evaluated the left ventricular mass (LVM), intima-media thickness in the carotid (cIMT) and superficial femoral (fIMT) arteries, 24-h ambulatory blood pressure, and biochemical cardiovascular risk factors.

Results

Of the hypertensive children examined, 41.6% had LVM above the 95th percentile, and 13.2% had LVM above 51 g/m2.7. Of the hypertensive subjects, the cIMT was above 2 SDS of normal values in 38.8%, and the flMT was above 2 SDS of normal values in 17.5%. Patients with LVM above 51 g/m2.7 had a higher birth weight than other patients. LVM, cIMT, and fIMT correlated with 24-h SBP and pulse pressure; LVM also correlated with homocysteine and serum uric acid concentrations. fIMT correlated with low Aprotein A1 (ApoA1), higher ApoB and C reactive protein, and daily sodium excretion. Step-wise regression analysis revealed that serum uric acid and higher birth weight were predictors for LVM, pulse pressure was a predictor for cIMT, and ApoB was a predictor for fIMT.

Conclusions

A significant number of adolescents with EH already had cardiovascular damage at diagnosis. LVM and markers of arterial injury correlate with SBP, biochemical, and perinatal cardiovascular risk factors. Serum uric acid and higher birth weight are predictors of LVM.

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Authors and Affiliations

  1. Department of Nephrology, Division of Nephrology and Arterial Hypertension, The Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland

    Mieczysław Litwin, Anna Niemirska, Joanna Śladowska, Jolanta Antoniewicz & Ryszard Grenda

  2. Department of Cardiology, Division of Echocardiography, The Children’s Memorial Health Institute, Warsaw, Poland

    Joanna Daszkowska

  3. Department of Laboratory Diagnostics, The Children’s Memorial Health Institute, Warsaw, Poland

    Aldona Wierzbicka & Zbigniew T. Wawer

Authors
  1. Mieczysław Litwin
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  2. Anna Niemirska
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  3. Joanna Śladowska
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  4. Jolanta Antoniewicz
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  7. Zbigniew T. Wawer
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  8. Ryszard Grenda
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Correspondence to Mieczysław Litwin.

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Litwin, M., Niemirska, A., Śladowska, J. et al. Left ventricular hypertrophy and arterial wall thickening in children with essential hypertension. Pediatr Nephrol 21, 811–819 (2006). https://doi.org/10.1007/s00467-006-0068-8

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  • DOI: https://doi.org/10.1007/s00467-006-0068-8

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