Ambulatory blood pressure and increased left ventricular mass in children at risk for hypertension

J Pediatr. 2008 Mar;152(3):343-8. doi: 10.1016/j.jpeds.2007.07.014. Epub 2007 Oct 22.


Objective: To relate ambulatory blood pressure (ABP) to cardiac target organ measurement in children at risk for primary hypertension (HTN).

Study design: Left ventricular mass index (LVMI) and ABP were measured concomitantly in children (6 to 18 years) at risk for hypertension using a cross-sectional study design.

Results: LVMI showed a significant positive correlation with 24-hour systolic blood pressure (SBP) load, SBP index (SBPI), and standard deviation score (SDS). When subjects were stratified by LVMI percentile, there were significant differences in SBP load, 24-hour SBPI, and 24-hour SSDS. The odds ratio (OR) of having elevated LVMI increased by 54% for each incremental increase of SDS in 24-hour SSDS after controlling for race and BMI (OR = 1.54, unit = 1 SDS, CI = 1.1, 2.15, P = .011) and increased by 88% for each increase of 0.1 in BPI (OR = 1.88, CI = 1.03, 3.45, P = .04). Subjects with stage 3 HTN had significantly greater mean LVMI compared with normal subjects (P = .002 by ANOVA; LMVI, 31.6 +/- 7.9 versus 39.5 +/- 10.4).

Conclusions: As systolic ABP variables increase, there is greater likelihood for increased LVMI. Staging based on ABPM allows assessment of cardiovascular risk in children with primary hypertension.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Distribution
  • Analysis of Variance
  • Blood Pressure Monitoring, Ambulatory*
  • Body Mass Index
  • Child
  • Cohort Studies
  • Echocardiography, Doppler
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / epidemiology*
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / epidemiology*
  • Incidence
  • Logistic Models
  • Male
  • Odds Ratio
  • Predictive Value of Tests
  • Probability
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution