Department of Pediatric Nephrology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
Department of Pediatric Cardiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
Pediatr Nephrol. 2024 Apr;39(4):1193-1199. doi: 10.1007/s00467-023-06205-4. Epub 2023 Nov 2.
Atherosclerotic changes can be attributed to early endothelial damage in individuals with hypertension. We aimed to explore the relationship between endothelial dysfunction and hypertension in newly diagnosed children without end-organ damage, considering carotid intima-media thickness (CIMT), flow-mediated dilatation (FMD), and functional capillaroscopy parameters. We also analyzed the differences between dipper and non-dipper patients.
In this cross-sectional study, 20 patients diagnosed with essential hypertension with no target organ damage, and 20 age and sex-matched healthy volunteers were enrolled. The patient group comprised newly diagnosed individuals not receiving antihypertensive treatment. Hypertensive patients were divided into two groups (dipper and non-dipper patients). The measurements of CIMT, brachial FMD, and functional capillaroscopy were performed before starting treatment.
Among the patients, 11 were boys, and 9 were girls, with a median age of 16.0 (2.13) years. Of 20 hypertensive patients, 10 were dipper and 10 were non-dipper. Significant differences were observed between the hypertensive patients and controls in terms of CIMT (p = 0.04), brachial artery FMD (p = 0.02), and functional capillary density (p < 0.001). Hypertensive patients exhibited increased CIMT, reduced brachial artery FMD, and lower capillary density. However, there were no differences between dippers and non-dippers regarding age, sex, height SDS, weight SDS, CIMT SDS, brachial artery FMD, and capillary density.
Understanding the vascular consequences associated with essential hypertension emphasizes the importance of early detection and management of hypertension. Herein, we have effectively highlighted significant endothelial changes through the analysis of three parameters in newly diagnosed children without apparent target organ damage.
动脉粥样硬化变化可归因于高血压个体的早期内皮损伤。我们旨在探讨无靶器官损伤的新诊断儿童中内皮功能障碍与高血压之间的关系，考虑颈动脉内膜中层厚度（CIMT）、血流介导的扩张（FMD）和功能毛细血管镜参数。我们还分析了杓型和非杓型患者之间的差异。
在这项横断面研究中，纳入了 20 名新诊断为无靶器官损伤的原发性高血压患者和 20 名年龄和性别匹配的健康志愿者。患者组包括未接受抗高血压治疗的新诊断个体。将高血压患者分为两组（杓型和非杓型患者）。在开始治疗前测量 CIMT、肱动脉 FMD 和功能毛细血管镜。
患者中，11 名男性，9 名女性，中位年龄为 16.0（2.13）岁。20 名高血压患者中，10 名是杓型，10 名是非杓型。高血压患者与对照组在 CIMT（p=0.04）、肱动脉 FMD（p=0.02）和功能毛细血管密度（p<0.001）方面存在显著差异。高血压患者的 CIMT 增加，肱动脉 FMD 降低，毛细血管密度降低。然而，杓型和非杓型患者在年龄、性别、身高 SDS、体重 SDS、CIMT SDS、肱动脉 FMD 和毛细血管密度方面无差异。
了解与原发性高血压相关的血管后果强调了早期发现和管理高血压的重要性。在此，我们通过分析无明显靶器官损伤的新诊断儿童的三个参数，有效地突出了显著的内皮变化。
