Gupta-Malhotra Monesha, Hashmi Syed Shahrukh, Poffenbarger Tim, McNiece-Redwine Karen
Division of Pediatric Cardiology, Department of Pediatrics, Children's Memorial Hermann Hospital, The University of Texas Health Science Center, Houston, TX.
Division of Pediatric Nephrology, Department of Pediatrics, Children's Memorial Hermann Hospital, The University of Texas Health Science Center, Houston, TX.
J Clin Hypertens (Greenwich). 2016 May;18(5):449-55. doi: 10.1111/jch.12708. Epub 2015 Oct 5.
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.
本研究旨在确定89例未经治疗的原发性高血压儿童左心室(LV)肥厚(LVH)的相关危险因素。通过24小时动态血压(BP)监测确诊临床高血压。左心室质量(LVM)指数计算为LVM(克)/身高(米)(2.7),LVH定义为LVM指数>第95百分位数。比较了有(n = 32)和无(n = 57)LVH的儿童。肥胖和收缩压均与LVH独立相关,体重指数的贡献更大。肥胖的影响显著,LVH风险增加近9倍。有证据表明肥胖的存在与否对收缩压与LVH之间的关系有效应修正作用,即这种关系主要存在于非肥胖儿童而非肥胖儿童中。因此,为了实现LVH的逆转,临床医生应同时考虑血压控制和体重管理。