Pediatric Nephrology

, Volume 21, Issue 6, pp 811–819 | Cite as

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

  • Mieczysław Litwin
  • Anna Niemirska
  • Joanna Śladowska
  • Jolanta Antoniewicz
  • Joanna Daszkowska
  • Aldona Wierzbicka
  • Zbigniew T. Wawer
  • Ryszard Grenda
Original Article

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.

Keywords

Children Essential hypertension Intima-media thickness Left ventricular hypertrophy Target organ damage 

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Copyright information

© IPNA 2006

Authors and Affiliations

  • Mieczysław Litwin
    • 1
  • Anna Niemirska
    • 1
  • Joanna Śladowska
    • 1
  • Jolanta Antoniewicz
    • 1
  • Joanna Daszkowska
    • 2
  • Aldona Wierzbicka
    • 3
  • Zbigniew T. Wawer
    • 3
  • Ryszard Grenda
    • 1
  1. 1.Department of Nephrology, Division of Nephrology and Arterial HypertensionThe Children’s Memorial Health InstituteWarsawPoland
  2. 2.Department of Cardiology, Division of EchocardiographyThe Children’s Memorial Health InstituteWarsawPoland
  3. 3.Department of Laboratory DiagnosticsThe Children’s Memorial Health InstituteWarsawPoland

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