Lande Marc B, Meagher Cecilia C, Fisher Susan Gross, Belani Puneet, Wang Hongyue, Rashid Megan
Division of Pediatric Nephrourology, University of Rochester Medical Center, Rochester, NY, USA.
J Pediatr. 2008 Jul;153(1):50-4. doi: 10.1016/j.jpeds.2008.01.025. Epub 2008 Mar 19.
To determine whether children with white coat hypertension (WCH) have evidence of target-organ damage by comparing the left ventricular mass index (LVMI) of subjects with WCH with that of matched normotensive and hypertensive controls.
Each subject in the WCH group was matched by body mass index (BMI; +/- 10%), age (+/- 1 year), and sex to a normotensive control and a hypertensive control. Echocardiograms were reviewed to determine the LVMI for each subject. These triple matches were analyzed using repeated-measures analysis of variance to detect differences in LVMI among the 3 groups.
A total of 27 matched triplets were established. The groups were comparable for sex, age, and BMI. Mean LVMI was 29.2 g/m(2.7) for the normotensive group, 32.3 g/m(2.7) for the WCH group, and 35.1 g/m(2.7) for the sustained hypertensive group (normotensive vs WCH, P = .028; WCH vs sustained hypertension, P = .07). Left ventricular hypertrophy was not present in any subject in the normotensive or WCH groups, but was found in 26% of the sustained hypertensive subjects (P < .001).
After controlling closely for BMI, the LVMI in the subjects with WCH was between that of the normotensives and sustained hypertensives, suggesting that WCH may be associated with hypertensive end-organ effects.
通过比较白大衣高血压(WCH)患儿与匹配的血压正常及高血压对照组的左心室质量指数(LVMI),确定WCH患儿是否存在靶器官损害的证据。
WCH组的每个受试者按体重指数(BMI;±10%)、年龄(±1岁)和性别与血压正常对照组及高血压对照组进行匹配。回顾超声心动图以确定每个受试者的LVMI。使用重复测量方差分析对这些三重匹配进行分析,以检测三组之间LVMI的差异。
共建立了27个匹配的三联组。三组在性别、年龄和BMI方面具有可比性。血压正常组的平均LVMI为29.2g/m².⁷,WCH组为32.3g/m².⁷,持续性高血压组为35.1g/m².⁷(血压正常组与WCH组比较,P = 0.028;WCH组与持续性高血压组比较,P = 0.07)。血压正常组或WCH组的任何受试者均未出现左心室肥厚,但持续性高血压受试者中有26%出现左心室肥厚(P < 0.001)。
在严格控制BMI后,WCH受试者的LVMI介于血压正常者和持续性高血压者之间,提示WCH可能与高血压终末器官效应有关。