Assessment of central blood pressure as a predictor of target organ damage in children with primary hypertension
Journal Title: Postępy Nauk Medycznych - Year 2015, Vol 28, Issue 11
Abstract
Introduction. Central systolic blood pressure (cSBP) is assumed to be the best indicatorof cardiovascular risk caused by elevated blood pressure. However, there are no dataon the usefulness of cSBP measurments in the assessment of the risk of target organdamage (TOD) in hypertensive children.Aim. The aim of study was to evaluate the usefulness of noninvasive measurements ofcSBP, AugP and AugInd as predictors of increased left ventricular hypertrophy (LVH) andincreased carotid intima-media thickness (cIMT) in children with primary hypertension.Material and methods. 114 children (25 girls), mean age 15.2 ± 2.5 years, referredbecause of elevated blood pressure and with excluded secondary hypertension, wereincluded in the study. In all patients, 24h ambulatory blood pressure monitoring (ABPM),cSBP, central pulse pressure (cPP), AugP, AugInd, cardiac index (CI), total peripheralresistance (TPR), pulse wave velocity (PWV), LVMI and cIMT were measured.Results. In 62 patients white coat hypertension was diagnosed, 9 had ambulatory hypertensionand 43 had severe ambulatory hypertension. Children with severe ambulatoryhypertension had greater AugP, CI and carotid wall cross sectional area (WCSA) and lowerTPR. cSBP correlated with WCSA (p = 0.015; r = 0.255) and AugP with LVMI (p = 0.02;r = 0.220).ABPM had greater sensitivity and lower specificity for predicting LVH than cSBP. ABPMand cSBP had similar sensitivity and specificity as predictors of cIMT and WCSA.Conclusions. Although sensitivity and specificity of cSBP and ABPM as predictors ofarterial injury were similar, ABPM performed better as a predictor of LVH. The results of ourstudy indicate a much higher risk of TOD in children with severe ambulatory hypertensionand show that the assessment of cSBP, which is also a predictor of LVH, may be a newcriterion for drug therapy implementation.
Authors and Affiliations
Łukasz Obrycki, Jędrzej Sarnecki, Anna Niemirska, Mieczysław Litwin
Keywords
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