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The Role of Obesity in the Development of Left Ventricular Hypertrophy Among Children and Adolescents

Abstract

Both obesity and hypertension have increased substantially among children over the last several decades. At the same time, mounting evidence has pointed to the role of these and other cardiovascular disease risk factors on the development of end organ damage such as left ventricular hypertrophy in children. While traditionally thought to occur in response to an increased afterload as in systemic hypertension, evidence demonstrates that obesity is associated with left ventricular hypertrophy independent of blood pressure. Both hemodynamic and non-hemodynamic factors contribute to the pathogenesis of obesity-related left ventricular remodeling. However, more contemporary research suggests that adiposity and blood pressure have a greater effect on left ventricular geometry when present together than when present alone. Normalization of left ventricular mass in obese hypertensive individuals requires achievement of both normotension and weight loss. Additional strategies are needed to promote the cardiovascular health of children, with greater emphasis placed on obesity prevention.

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Abbreviations

BMI:

Body mass index

BP:

Blood pressure

CV:

Cardiovascular

CVD:

Cardiovascular disease

LV:

Left ventricular

LVH:

Left ventricular hypertrophy

LVM:

Left ventricular mass

LVMI:

Left ventricular mass index

RWT:

Relative wall thickness

SD:

Standard deviation

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Acknowledgments

None of the sponsors had any role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript. The first draft of this manuscript was written by Tammy M. Brady, and there was no honorarium, grant, or other form of payment given to anyone to produce the manuscript.

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Correspondence to Tammy M. Brady.

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Dr. Brady declares no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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TMB is funded by the NIH/NHLBI (1K23 HL119622-01).

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This article is part of the Topical Collection on Pediatric Hypertension

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Brady, T.M. The Role of Obesity in the Development of Left Ventricular Hypertrophy Among Children and Adolescents. Curr Hypertens Rep 18, 3 (2016). https://doi.org/10.1007/s11906-015-0608-3

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  • DOI: https://doi.org/10.1007/s11906-015-0608-3

Keywords

  • Pediatrics
  • Blood pressure
  • Overweight
  • Youth
  • End organ damage
  • Cardiovascular disease