Walsh Aaron T, Hor Kan N, Eisner Mariah, Alvarado Chance, Kallash Mahmoud, Spencer John David, Tran Andrew H
The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.
Am J Prev Cardiol. 2025 Apr 18;22:101001. doi: 10.1016/j.ajpc.2025.101001. eCollection 2025 Jun.
Left ventricular hypertrophy (LVH) secondary to hypertension is associated with cardiovascular events in adulthood. Prevalence of abnormal blood pressure and LVH in youths with congenital heart disease (CHD) is understudied despite childhood hypertension predicting adult hypertension. This study aimed to describe the prevalence of hypertension and LVH in adolescents with CHD and factors associated with LVH in this population.
This was a retrospective analysis of echocardiogram reports from patients with CHD aged 13-17 years with documented systolic blood pressure (SBP), height, weight, and left ventricular mass (LVM) indexed to body size (LVMI-ht). Patients were stratified by SBP and CHD type. Hypertension and LVH prevalence were calculated; linear regression models assessed factors associated with LVH.
Of 853 patients (mean age 15.5 ± 1.5 years, 57.1 % male), 25.1 % had elevated SBP, whereas 11.6 % and 5.7 % had stage 1 and stage 2 hypertension, respectively. LVH was more prevalent with higher SBP (37.4 % elevated, 32.3 % stage 1 hypertension, and 40.7 % stage 2 hypertension) versus 19.6 % normotensive. BMI percentile and SBP were significantly associated with LVMI-ht; for 10 % BMI percentile and 10 mmHg SBP increases, LVMI-ht increased by 1.2 g/m and 0.93 g/m, respectively, after adjustment for age, sex, race, SBP, BMI, and CHD lesion.
Adolescents with CHD have a high prevalence of abnormal SBP and LVH. BMI percentile and SBP were associated with LVMI-ht. Findings support screening for BMI and hypertension in youths with CHD as this population has increased baseline cardiovascular risk that may be compounded by obesity and chronic hypertension.
高血压继发的左心室肥厚（LVH）与成年人心血管事件相关。尽管儿童期高血压可预测成人高血压，但先天性心脏病（CHD）青少年的血压异常和LVH患病率尚未得到充分研究。本研究旨在描述CHD青少年中高血压和LVH的患病率以及该人群中与LVH相关的因素。
这是一项对年龄在13 - 17岁、有记录的收缩压（SBP）、身高、体重以及根据体型指数化的左心室质量（LVM）（LVMI-ht）的CHD患者的超声心动图报告进行的回顾性分析。患者按SBP和CHD类型分层。计算高血压和LVH患病率；线性回归模型评估与LVH相关的因素。
在853例患者（平均年龄15.5±1.5岁，57.1%为男性）中，25.1%的患者SBP升高，而分别有11.6%和5.7%的患者患有1级和2级高血压。与正常血压者的19.6%相比，SBP越高，LVH越普遍（SBP升高者为37.4%，1级高血压者为32.3%，2级高血压者为40.7%）。BMI百分位数和SBP与LVMI-ht显著相关；在调整年龄、性别、种族、SBP、BMI和CHD病变后，BMI百分位数每增加10%和SBP每升高10 mmHg，LVMI-ht分别增加1.2 g/m和0.93 g/m。
CHD青少年中SBP异常和LVH的患病率较高。BMI百分位数和SBP与LVMI-ht相关。研究结果支持对CHD青少年进行BMI和高血压筛查，因为该人群的基线心血管风险增加，肥胖和慢性高血压可能会使其风险进一步增加。
