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. 2011 May;13(5):332-42.
doi: 10.1111/j.1751-7176.2011.00471.x. Epub 2011 Apr 21.

Cardiac and vascular consequences of pre-hypertension in youth

Elaine M Urbina  1 , Philip R Khoury, Connie McCoy, Stephen R Daniels, Thomas R Kimball, Lawrence M Dolan
Affiliations

Cardiac and vascular consequences of pre-hypertension in youth

Elaine M Urbina et al. J Clin Hypertens (Greenwich). 2011 May.

Abstract

Hypertension is associated with increased left ventricular mass (LVM) and carotid intima-media thickness (cIMT), which predict cardiovascular (CV) events in adults. Whether target organ damage is found in pre-hypertensive youth is not known. The authors measured body mass index, blood pressure, fasting glucose, insulin, lipids and C-reactive protein, LVM/height(2.7) (LVM index), diastolic function, cIMT, carotid stiffness, augmentation index, brachial artery distensibility, and pulse wave velocity (PWV) in 723 patients aged 10 to 23 years (29% with type 2 diabetes mellitus). Patients were stratified by blood pressure level (normotensive: 531, pre-hypertensive: 65, hypertensive: 127). Adiposity and CV risk factors worsened across blood pressure group. There was a graded increase in cIMT, arterial stiffness, and LVM index and decrease in diastolic function from normotension to pre-hypertension to hypertension. In multivariable models adjusted for CV risk factors, status as pre-hypertension or hypertension remained an independent determinant of target organ damage for LVM, diastolic function, internal cIMT, and carotid and arterial stiffness. Pre-hypertension is associated with cardiovascular target organ damage in adolescents and young adults.

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Figures

Figure 1
Figure 1
Cardiac structure and function by blood pressure group. LVMI indicates left ventricular mass index. P<.05 for *normotension (NT)<pre‐hypertension (pre‐HTN)<HTN; †NT<pre‐HTN and HTN; §NT and pre‐HTN<HTN; ‡‡NT>pre‐HTN; §§NT>pre‐HTN and HTN.
Figure 2
Figure 2
Carotid intima‐media thickness (cIMT) by blood pressure group. P<.05 for ‡‡normotension (NT)<hypertension (HTN); *NT<pre‐HTN and HTN.
Figure 3
Figure 3
Arterial stiffness by blood pressure group. YEM indicates Young’s elastic modulus; AIx, augmentation index; BrachD, brachial artery distensibility; PWV, pulse wave velocity. P<.05 for mean differences by analysis of variance. *Normotension (NT)<pre‐hypertension (pre‐HTN) and HTN; ‡NT<pre‐HTN<HTN; §§HT<pre‐HTN<HTN.
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