Division of Pediatric Nephrology, Department of Pediatrics, University of Health Sciences, Izmir Tepecik Training and Research Hospital.
Division of Pediatric Nephrology and Rheumatology, Department of Pediatrics, Izmir Katip Çelebi University Medical Faculty, İzmir, Turkey.
Blood Press Monit. 2022 Aug 1;27(4):213-219. doi: 10.1097/MBP.0000000000000589. Epub 2022 Mar 7.
We aimed to evaluate the effects of blood pressure (BP) values obtained by 24-h ambulatory BP monitoring (ABPM) of hypertensive children and adolescents on left ventricular mass index (LVMI).
Patients diagnosed with HT with BP measurements confirmed with ABPM and evaluated with echocardiography for LVMI were included. The patients were divided into two groups according to their BMI as obese and nonobese. SDSs of ABPM parameters were compared between the groups.
A total of 158 children with HT were included in the study. Ninety of these patients were obese. In obese and nonobese cases, mean SDS levels were similar in ABPM parameters, whereas LVMI was significantly higher in obese patients ( P = 0.049). There was a significant correlation between LVMI and 24-h SBP SDS, daytime SBP SDS, 24-h SBP load and daytime BP load. In obese cases, there was a statistically significant correlation between LVMI and 24-h SBP SDS, daytime SBP SDS, 24-h SBP load, daytime SBP load as well as nighttime SBP SDS and nighttime SBP load. When the whole group was evaluated, 24-h SBP SDS was the most effective parameter influencing LVMI ( P = 0.001). Similarly, the most effective ABPM parameter on LVMI in obese patients was 24-h SBP SDS ( P = 0.001).
A significantly higher rate of LVMI in obese patients suggests that obesity itself is an effective factor on LVMI. In addition, systolic hypertension is more effective on cardiac functions compared with DBP measurements and systolic-DBP dipping ratios.
评估通过 24 小时动态血压监测（ABPM）获得的高血压儿童和青少年血压值对左心室质量指数（LVMI）的影响。
纳入经 ABPM 证实血压升高且经超声心动图评估 LVMI 的 HT 患者。根据 BMI 将患者分为肥胖和非肥胖两组。比较两组 ABPM 参数的 SDS。
共纳入 158 例 HT 患儿，其中 90 例肥胖。肥胖和非肥胖患者的 ABPM 参数的平均 SDS 水平相似，而肥胖患者的 LVMI 显著更高（P=0.049）。LVMI 与 24 小时 SBP SDS、白天 SBP SDS、24 小时 SBP 负荷和白天 BP 负荷呈显著相关。在肥胖患者中，LVMI 与 24 小时 SBP SDS、白天 SBP SDS、24 小时 SBP 负荷、白天 SBP 负荷以及夜间 SBP SDS 和夜间 SBP 负荷之间存在统计学显著相关性。当评估整个组时，24 小时 SBP SDS 是影响 LVMI 的最有效参数（P=0.001）。同样，肥胖患者中对 LVMI 最有效的 ABPM 参数也是 24 小时 SBP SDS（P=0.001）。
肥胖患者的 LVMI 发生率明显更高，提示肥胖本身是影响 LVMI 的有效因素。此外，与 DBP 测量和收缩压-舒张压下降率相比，收缩压高血压对心脏功能的影响更大。
