BLOOD PRESSURE VARIABILITY AND LEFT VENTRICULAR MASS INDEX ION CHILDREN WITH TRUE AMBULATORY HYPERTENSION

Authors

  • Bojko Bjelaković Clinic of Pediatrics, Clinical Center, Niš, Faculty of Medicine, University of Niš, Serbia
  • Vladislav Vukomanović Mother and Child Health Institute, "Dr Vukan Čupić," Belgrade, Faculty of Medicine, University of Belgrade, Serbia
  • Ljiljana Šaranac Clinic of Pediatrics, Clinical Center Niš, Niš, Faculty of Medicine, University of Niš, Serbia
  • Miloš Krstić Faculty of Medicine, University of Niš, Serbia
  • Marko Jović Faculty of Medicine, University of Niš, Serbia
  • Vanja Petrovski Health Centre of Niš, Serbia

DOI:

https://doi.org/10.46793/PP160829009B

Keywords:

blood pressure, hypertension, variability, children

Abstract

This study sought to evaluate the relationship between blood pressure variability and left ventricular mass index (LVMI) in children with true ambulatory hypertension. We conducted a cross-sectional survey among 115 children who were consecutively referred for evaluation of hypertension to our University Children’s Hospital. The calculated blood pressure variability (BPV) measures were 24-h average real variability (ARV) and 24-hour weighted SD (wSD).  LVMI was estimated by M-mode echocardiography using Devereux’s formula and indexed for height.

A total of 35 children had true ambulatory hypertension. We found no correlation between 24-hour ARV and wSD with LVMI. On the other hand, partial correlation analysis revealed statistically significant and inverse correlation between 24-hour ARV and LVMI, controlling for body mass index (r = -0,516; P = 0.002).

Contrary to previous studies, our results indicate inverse association of LVMI and BPV as expressed by ARV in a population of true hypertensive children.

References

McNiece KL, Gupta-Malhotra M, Samuels J, Bell C, Garcia K, Poffenbarger T, et al. Left ventricular hypertrophy in hypertensive adolescents: analysis of risk by 2004 National High Blood Pressure Education Program Working Group staging criteria. Hypertension [Internet]. 2007 Aug [cited 2015 Jan 3];50(2):392–5. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3582191&tool=pmcentrez&rendertype=abstract

Sorof JM, Cardwell G, Franco K, Portman RJ. Ambulatory Blood Pressure and Left Ventricular Mass Index in Hypertensive Children. Hypertension [Internet]. 2002 Apr 1 [cited 2015 Jan 3];39(4):903–8. Available from: http://hyper.ahajournals.org/cgi/doi/10.1161/01.HYP.0000013266.40320.3B

Target H, Damage O. Large Blood Pressure Variability and Hypertensive Cardiac Remodeling. 2009;73(December):2198–203.

Shah R V, Abbasi S a, Neilan TG, Hulten E, Coelho-Filho O, Hoppin A, et al. Myocardial tissue remodeling in adolescent obesity. J Am Heart Assoc [Internet]. 2013 Aug [cited 2015 Jan 3];2(4):e000279. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3828806&tool=pmcentrez&rendertype=abstract

Nadruz W. Myocardial remodeling in hypertension. J Hum Hypertens [Internet]. 2015 Jan [cited 2015 Aug 30];29(1):1–6. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24804791

Mangner N, Scheuermann K, Winzer E, Wagner I, Hoellriegel R, Sandri M, et al. Childhood obesity: impact on cardiac geometry and function. JACC Cardiovasc Imaging [Internet]. 2014 Dec [cited 2015 Aug 30];7(12):1198–205. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25306542

de Simone G, Izzo R, De Luca N, Gerdts E. Left ventricular geometry in obesity: Is it what we expect? Nutr Metab Cardiovasc Dis [Internet]. 2013 Oct [cited 2015 Aug 28];23(10):905–12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24095148

Chen W-K, Yeh Y-L, Lin Y-M, Lin J-Y, Tzang B-S, Lin JA, et al. Cardiac hypertrophy-related pathways in obesity. Chin J Physiol [Internet]. 2014 Jun 30 [cited 2015 Aug 30];57(3):111–20. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24826779

Murakami K, Shigematsu Y, Hamada M, Higaki J. Insulin Resistance in Patients With Hypertrophic Cardiomyopthy. 2004;68(July):650–5.

Martinka P, Fielitz J, Patzak A, Regitz-Zagrosek V, Persson PB, Stauss HM. Mechanisms of blood pressure variability-induced cardiac hypertrophy and dysfunction in mice with impaired baroreflex. Am J Physiol Regul Integr Comp Physiol [Internet]. 2005 Mar [cited 2015 Jan 3];288(3):R767–76. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15563577

Flynn JT, Daniels SR, Hayman LL, Maahs DM, McCrindle BW, Mitsnefes M, et al. Update: ambulatory blood pressure monitoring in children and adolescents: a scientific statement from the American Heart Association. [Internet]. Hypertension. 2014 [cited 2014 Dec 3]. 1116-35 p. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24591341

Soergel M, Kirschstein M, Busch C, Danne T, Gellermann J, Hall R, et al. Oscillometric twenty-four-hour ambulatory blood pressure values in healthy children and adolescents : A multicenter trial including 1141 subjects. 1997;

Pierdomenico SD, Di Nicola M, Esposito AL, Di Mascio R, Ballone E, Lapenna D, et al. Prognostic value of different indices of blood pressure variability in hypertensive patients. Am J Hypertens [Internet]. Nature Publishing Group; 2009 Aug [cited 2015 Jan 3];22(8):842–7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19498342

Agabiti-Rosei E, Muiesan ML, Salvetti M. Evaluation of subclinical target organ damage for risk assessment and treatment in the hypertensive patients: left ventricular hypertrophy. J Am Soc Nephrol [Internet]. 2006 Apr [cited 2015 Jan 3];17(4 Suppl 2):S104–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16565230

Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, et al. CDC growth charts: United States. Adv Data. 2000;(314):1–27.

Stolarz-Skrzypek K, Thijs L, Richart T, Li Y, Hansen TW, Boggia J, et al. Blood pressure variability in relation to outcome in the International Database of Ambulatory blood pressure in relation to Cardiovascular Outcome. Hypertens Res [Internet]. 2010 Aug [cited 2015 Sep 16];33(8):757–66. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20613762

Calcaterra I, Costanzo M, Geraci G, Guarino L, Foraci AC. Relationship Between Short-Term Blood Pressure Variability and Subclinical Renal Damage in Essential Hypertensive Patients Relationship Between Short-Term Blood Pressure Variability and Subclinical Renal Damage in Essential Hypertensive Patients. 2015;(MARCH).

Stauss HM, Bjelakovic B. Re: Pediatric Hypertension and Cardiac Hypertrophy. Curr Hypertens Rep [Internet]. 2016 Jan [cited 2016 Jan 17];18(1):5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26739585

Vishram JKK, Dahlöf B, Devereux RB, Ibsen H, Kjeldsen SE, Lindholm LH, et al. Blood pressure variability predicts cardiovascular events independently of traditional cardiovascular risk factors and target organ damage: a LIFE substudy. J Hypertens [Internet]. 2015 Dec [cited 2016 Jan 17];33(12):2422–30. Available from: http://www.ncbi.nlm.nih.gov/pubmed/26378687

Mena L, Pintos S, Queipo N V, Aizpúrua JA, Maestre G, Sulbarán T. A reliable index for the prognostic significance of blood pressure variability. J Hypertens [Internet]. 2005 Mar [cited 2015 Sep 16];23(3):505–11. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15716690

Li Z, Snieder H, Su S, Harshfield GA, Treiber FA, Wang X. A longitudinal study of blood pressure variability in African-American and European American youth. J Hypertens. 2010;28(4):715–22.

Höcht C, Bertera FM, Taira CA. Importance of blood pressure variability in the assessment of cardiovascular risk and benefits of antihypertensive therapy. Expert Rev Clin Pharmacol [Internet]. 2010 Sep [cited 2015 Sep 22];3(5):617–21. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22111743

Boggia J, Asayama K, Li Y, Hansen TW, Mena L, Schutte R. Cardiovascular risk stratification and blood pressure variability on ambulatory and home blood pressure measurement. Curr Hypertens Rep [Internet]. 2014 Sep [cited 2015 Sep 16];16(9):470. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25097109

Rowland T, Unnithan V. Stroke volume dynamics during progressive exercise in healthy adolescents. Pediatr Exerc Sci [Internet]. 2013 May [cited 2015 Sep 22];25(2):173–85. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23504977

Hansen TW, Thijs L, Li Y, Boggia J, Kikuya M, Björklund-Bodegård K, et al. Prognostic value of reading-to-reading blood pressure variability over 24 hours in 8938 subjects from 11 populations. Hypertension [Internet]. 2010 Apr [cited 2015 Sep 16];55(4):1049–57. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20212270

Krzesiński P, Stańczyk A, Gielerak G, Piotrowicz K. The hemodynamic patterns in hypertensive men and women of different age. J Hum Hypertens [Internet]. 2015 Jul 2 [cited 2015 Jul 22]; Available from: http://www.ncbi.nlm.nih.gov/pubmed/26134620

Bristow M. Antiadrenergic Therapy of Chronic Heart Failure: Surprises and New Opportunities. Circulation [Internet]. 2003 Mar 4 [cited 2015 Sep 16];107(8):1100–2. Available from: http://circ.ahajournals.org/content/107/8/1100.full

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Published

10/28/2016

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