Yildirim Ali, Kosger Pelin, Ozdemir Gokmen, Sahin Fezan Mutlu, Ucar Birsen, Kilic Zubeyir
Medical Faculty, Department of Pediatric Cardiology, Eskisehir Osmangazi University, Eskisehir, Turkey.
Department Of Biostatistics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
Hypertens Res. 2015 Sep;38(9):621-6. doi: 10.1038/hr.2015.49. Epub 2015 May 14.
A significant correlation between hypertension history and high blood pressure has been observed with regard to age, race and gender. Investigating carotid intima-media thickness and aortic stiffness prior to the development of hypertension in children of hypertensive parents enabled us to evaluate these patients for subclinical atherosclerosis. We compared carotid intima-media thickness, aortic strain, distensibility, stiffness indices and elastic modulus in 67 normotensive children whose parents had a diagnosis of essential hypertension and 39 normotensive children with no parental history of hypertension. Although there were no significant differences between the two groups in terms of systolic blood pressure, diastolic blood pressure, average blood pressure and pulse pressure (P>0.05), systolic blood pressures were higher among patients 15 years and older in the study group. No significant differences were noted between the control and study groups regarding interventricular septal thickness, left-ventricular posterior wall thickness, left-ventricular systolic and diastolic diameter and aortic annulus diameter (P>0.05). The left atrium diameter was larger in the study group compared with that in the control group, mainly because of the values of the 15-year-old and older children (P=0.01). The mean, maximum and minimum values of carotid intima-media thickness were significantly different in the study group compared with the control group among all age groups (P<0.001, P<0.001, P=0.006, respectively). Aortic systolic and diastolic diameters were larger in normotensive children of hypertensive parents compared with the control group (P=0.014, P=0.001, respectively). Although there were no differences between the study and control groups regarding aortic strain, aortic distensibility, elastic modulus and stiffness indices (P>0.05), aortic distensibility was lower, and aortic stiffness indices were higher among children 15 years and older in the study group. An increase in the carotid intima-media thickness in all age groups and a decrease in aortic elastic properties in 15-year-old and older children of hypertensive parents may indicate subclinical atherosclerosis in these apparently healthy children.
在年龄、种族和性别方面,已观察到高血压病史与高血压之间存在显著相关性。在高血压患者的子女出现高血压之前,对其颈动脉内膜中层厚度和主动脉僵硬度进行研究,使我们能够对这些患者进行亚临床动脉粥样硬化评估。我们比较了67名父母被诊断为原发性高血压的血压正常儿童和39名无高血压家族史的血压正常儿童的颈动脉内膜中层厚度、主动脉应变、扩张性、僵硬度指数和弹性模量。虽然两组在收缩压、舒张压、平均血压和脉压方面无显著差异(P>0.05),但研究组中15岁及以上患者的收缩压较高。在室间隔厚度、左心室后壁厚度、左心室收缩和舒张直径以及主动脉环直径方面,对照组和研究组之间未观察到显著差异(P>0.05)。研究组的左心房直径大于对照组,主要是因为15岁及以上儿童的值(P=0.01)。在所有年龄组中,研究组的颈动脉内膜中层厚度的平均值、最大值和最小值与对照组相比均有显著差异(分别为P<0.001、P<0.001、P=0.006)。与对照组相比,高血压患者的血压正常子女的主动脉收缩和舒张直径更大(分别为P=0.014、P=0.001)。虽然研究组和对照组在主动脉应变、主动脉扩张性、弹性模量和僵硬度指数方面无差异(P>0.05),但研究组中15岁及以上儿童的主动脉扩张性较低,主动脉僵硬度指数较高。所有年龄组的颈动脉内膜中层厚度增加以及高血压患者15岁及以上子女的主动脉弹性特性降低,可能表明这些看似健康的儿童存在亚临床动脉粥样硬化。