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Pediatric Nephrology

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Open Access 01-04-2019 | Original Article

Central systolic blood pressure and central pulse pressure predict left ventricular hypertrophy in hypertensive children

Authors: Mieczysław Litwin, Łukasz Obrycki, Anna Niemirska, Jędrzej Sarnecki, Zbigniew Kułaga

Published in: Pediatric Nephrology | Issue 4/2019

Abstract

Background

Central systolic and pulse pressures are stronger predictors of cardiovascular risk and hypertensive organ damage than brachial blood pressure. It is suggested that isolated systolic hypertension typically seen in adolescents is associated with normal central blood pressure and does not lead to organ damage and this phenomenon is called spurious hypertension.

Methods

We assessed the prevalence of spurious hypertension and analyzed utility of pulse wave analysis as determinant of hypertensive organ damage in 294 children (62 girls; 15.0 ± 2.4 years) diagnosed as primary hypertension. White coat hypertension, ambulatory prehypertension, ambulatory hypertension, and severe ambulatory hypertension were diagnosed in 127, 29, 41, and 97 patients, respectively.

Results

Normal central blood pressure was found in 100% in patients with white coat hypertension, 93% in pre-hypertensives, 51.2% in those with ambulatory hypertension, and 27.8% with severe ambulatory hypertension (p = 0.0001). Children with severe ambulatory hypertension had higher central systolic and pulse pressure, pulse wave velocity, and greater prevalence of left ventricular hypertrophy than white coat and prehypertensive children (p < 0.05). Left ventricular mass index and carotid intima-media thickness correlated with central systolic and pulse pressure (p < 0.05 for all). Receiver operating curve area was similar for augmentation pressure (0.5836), 24-h ambulatory systolic blood pressure (0.5841), central systolic blood pressure (0.6090), and central pulse pressure (0.5611) as predictors of left ventricular hypertrophy.

Conclusions

These findings suggest that pulse wave analysis is complementary to ambulatory blood pressure monitoring in assessment of risk of organ damage in hypertensive adolescents.

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Title: Central systolic blood pressure and central pulse pressure predict left ventricular hypertrophy in hypertensive children
Authors: Mieczysław Litwin
Łukasz Obrycki
Anna Niemirska
Jędrzej Sarnecki
Zbigniew Kułaga
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 4/2019
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-018-4136-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Central systolic blood pressure and central pulse pressure predict left ventricular hypertrophy in hypertensive children

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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