Cardiac and vascular consequences of pre-hypertension in youth

J Clin Hypertens (Greenwich). 2011 May;13(5):332-42. doi: 10.1111/j.1751-7176.2011.00471.x. Epub 2011 Apr 21.

Abstract

Hypertension is associated with increased left ventricular mass (LVM) and carotid intima-media thickness (cIMT), which predict cardiovascular (CV) events in adults. Whether target organ damage is found in pre-hypertensive youth is not known. The authors measured body mass index, blood pressure, fasting glucose, insulin, lipids and C-reactive protein, LVM/height(2.7) (LVM index), diastolic function, cIMT, carotid stiffness, augmentation index, brachial artery distensibility, and pulse wave velocity (PWV) in 723 patients aged 10 to 23 years (29% with type 2 diabetes mellitus). Patients were stratified by blood pressure level (normotensive: 531, pre-hypertensive: 65, hypertensive: 127). Adiposity and CV risk factors worsened across blood pressure group. There was a graded increase in cIMT, arterial stiffness, and LVM index and decrease in diastolic function from normotension to pre-hypertension to hypertension. In multivariable models adjusted for CV risk factors, status as pre-hypertension or hypertension remained an independent determinant of target organ damage for LVM, diastolic function, internal cIMT, and carotid and arterial stiffness. Pre-hypertension is associated with cardiovascular target organ damage in adolescents and young adults.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Blood Flow Velocity / physiology
  • Blood Pressure / physiology
  • Carotid Arteries / diagnostic imaging*
  • Carotid Arteries / physiology*
  • Child
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / complications
  • Echocardiography
  • Elasticity / physiology*
  • Female
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging*
  • Male
  • Obesity / complications
  • Prehypertension / complications*
  • Prehypertension / physiopathology
  • Tunica Intima / diagnostic imaging*
  • Tunica Media / diagnostic imaging*
  • Ultrasonography
  • Vascular Resistance / physiology
  • Young Adult