Changes of the Left Ventricular Geometry in Children and Adolescents with Primary Hypertension

Overview

Background.
Left ventricular hypertrophy is an independent risk factor of cardiovascular morbidity and mortalityin adults. The results of 24-hour ambulatory blood pressure monitoring (ABPM) correlate better with signs of organdamage than values of casual blood pressure. The objective of this study was to investigate the relationships betweenthe results of 24-hour ABPM and left ventricular geometry in school-aged children and adolescents with elevatedblood pressure.Methods and Results. 24-hour ABPM and echocardiographic assessment of left ventricle were performed in108 children and adolescents age 8-20 years (77 boys and 31 girls) with repeatedly elevated casual blood pressure(BP) values. Patients with secondary cause of hypertension were not included in this study. Based on ABPM results57 patients out of total 108 had hypertension, the rest of 51 subjects had their ambulatory BP values below 95.percentil and were labelled as white coat hypertensive (WCH). The left ventricular measurements in hypertensivesubject were higher when compared with WCH (left ventricle posterior wall thickness 8.4±1.0 mm in hypertensivevs. 8.0±1.1 mm in WHC (p=0.047) and supurscript left ventricular mass index 81.8±13.8 g/m2vs 74.3±12 g/m2respectively; p=0,003). No differences were found in anthropometric data including body mass index in both groups.There was a significant correlation between ambulatory BP and both left ventricle posterior wall thickness and leftventricular mass index. The strongest correlation was found between diurnal systolic ambulatory BP and left ventricleposterior wall thickness (r=0.42; p

Key words:
ambulatory blood pressure monitoring, hypertension, white coat hypertension, left ventricular