Association of Blood Pressure Level With Left Ventricular Mass in Adolescents.
Hypertension
; 74(3): 590-596, 2019 09.
Article
de En
| MEDLINE
| ID: mdl-31327264
ABSTRACT
Hypertension is associated with left ventricular hypertrophy (LVH), a risk factor for cardiovascular events. Since cardiovascular events in youth are rare, hypertension has historically been defined by the 95th percentile of the normal blood pressure (BP) distribution in healthy children. The optimal BP percentile associated with LVH in youth is unknown. We aimed to determine the association of systolic BP (SBP) percentile, independent of obesity, on left ventricular mass index (LVMI), and to estimate which SBP percentile best predicts LVH in youth. We evaluated SBP, anthropometrics, and echocardiogram in 303 adolescents (mean age 15.6 years, 63% white, 55% male) classified by SBP as low-risk (L=141, <80th percentile), mid-risk (M=71, 80-<90th percentile), or high-risk (H=91, ≥90th percentile) using the mean of 6 measurements at 2 visits according to the 2017 guidelines. Logistic regression was used to determine the sensitivity and specificity of various SBP percentiles associated with LVH. Results:
BP groups did not differ by age or demographics but differed slightly by body mass index. Mean BP, LVMI, and prevalence of LVH increased across groups (BP L=111/75, M=125/82, and H=133/92 mm Hg; LVMI L=31.2, M=34.2, and H=34.9 g/m2.7; LVH L=13%, M=21%, H=27%, all P<0.03). SBP percentile remained a significant determinant of LVMI after adjusting for covariates. The 90th percentile for SBP resulted in the best balance between sensitivity and specificity for predicting LVH (LVMI≥38.6 g/m2.7). Abnormalities in cardiac structure in youth can be found at BP levels below those used to define hypertension.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Pression sanguine
/
Indice de masse corporelle
/
Hypertrophie ventriculaire gauche
/
Hypertension artérielle
Type d'étude:
Clinical_trials
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Adolescent
/
Child
/
Female
/
Humans
/
Male
Langue:
En
Journal:
Hypertension
Année:
2019
Type de document:
Article