Left Ventricular Hypertrophy Phenotype in Childhood-Onset Essential Hypertension

Abstract

The aim of this study was to determine the risk factors associated with left ventricular (LV) hypertrophy (LVH) among 89 untreated children with primary hypertension. Clinic hypertension was confirmed by 24-hour ambulatory blood pressure (BP) monitoring. LV mass (LVM) index was calculated as LVM (g)/height (m)(2.7) and LVH was defined as LVM index >95th percentile. Children with (n=32) and without (n=57) LVH were compared. Both obesity and systolic BP were independently associated with LVH, with a higher contribution by body mass index. Obesity contributed significantly, with a nearly nine-fold increased risk of LVH. There was evidence of effect modification by the presence or absence of obesity on the relationship between systolic BP and LVH, whereby the relationship existed mainly in nonobese rather than obese children. Hence, to achieve reversal of LVH, clinicians should take into account both BP control and weight management.

Figure 1

Box plots showing the distribution of body mass index (BMI) z scores in hypertensive children with and without left ventricular hypertrophy (LVH) (P=.0002).

Figure 2

Box plots showing the association of systolic blood pressure with distribution of body mass index (BMI) z scores in obese and nonobese hypertensive children with and without left ventricular hypertrophy (LVH).