Department of Pediatrics, Division of Pediatric Nephrology, Cohen Children's Medical Center, New Hyde Park, New York.
J Clin Hypertens (Greenwich). 2019 May;21(5):566-571. doi: 10.1111/jch.13540. Epub 2019 Apr 13.
Limited information is available regarding the relationship between ambulatory blood pressure monitoring (ABPM) and cardiac geometry in hypertensive children. ABPM and 2D-echocardiography were retrospectively reviewed in children and adolescents <21 years old with primary hypertension. A total of 119 participants (median age 15.0 [IQR 12, 16] years) with hypertension were included. Left ventricular hypertrophy was diagnosed in 39.5% of participants. Normal geometry was found in 47.1%, concentric remodeling (CR) in 13.4%, concentric hypertrophy (CH) in 15.1%, and eccentric hypertrophy (EH) in 24.4% of children. After adjustment for age, sex, and body mass index z-score, awake systolic blood pressure (BP) index (BPi) (OR 1.07, 95% CI: 1.001-1.14, P = 0.045), awake diastolic BPi (OR 1.04, 95% CI: 1.00-1.09, P = 0.048), awake systolic BP load (OR 1.02, 95% CI: 1.000-1.04, P = 0.047), and sleep systolic BP load (OR 1.02, 95% CI: 1.001-1.04, P = 0.03) were directly associated with CH. No ABPM parameters were significant predictors of EH. In conclusion, ABPM parameters were found to be independent predictors of cardiac geometry, specifically CH.
关于动态血压监测(ABPM)与高血压儿童心脏结构之间的关系,相关信息有限。对年龄<21 岁的原发性高血压儿童和青少年进行了 ABPM 和二维超声心动图回顾性分析。共纳入 119 名高血压参与者(中位数年龄 15.0 [IQR 12, 16] 岁)。39.5%的参与者被诊断为左心室肥厚。47.1%的儿童心脏结构正常,13.4%为向心性重构,15.1%为向心性肥厚,24.4%为离心性肥厚。校正年龄、性别和体重指数 z 评分后,清醒收缩压指数(BPi)(OR 1.07,95%CI:1.001-1.14,P=0.045)、清醒舒张压 BPi(OR 1.04,95%CI:1.00-1.09,P=0.048)、清醒收缩压负荷(OR 1.02,95%CI:1.000-1.04,P=0.047)和睡眠收缩压负荷(OR 1.02,95%CI:1.001-1.04,P=0.03)与 CH 呈直接相关。ABPM 指标与 EH 无显著相关性。结论:ABPM 指标是心脏结构的独立预测因子,尤其是 CH。