In this study, Ambulatory BP parameters did not predict the LV hypertrophy (LVH) and the LVH was related to LV diastolic dysfunction; LV mass index was significantly correlated with body mass index in children and adolescents with essential hypertension.

Left ventricular hypertrophy (LVH) and diastolic dysfunction are the common type of cardiac damage that occurs in children and adolescents with hypertension and are clinically silent leading to underdiagnosed.

Hence the present study investigated the prevalence of LV hypertrophy and diastolic dysfunction in the children and adolescent subjects (n=38) diagnosed with essential hypertension in ambulatory blood pressure monitoring.

The observations were as follows:

Higher BMI or obesity increases the cardiac workload that causes adaptive hypertrophic changes in heart shown by increases  in cardiac mass.

Hypertensive Vs control subjects

  • Had significantly higher BP index and BP load than control subjects
  • Had significantly higher BMI than controls
  • Had significantly higher LVMI

  • But LV hypertrophy was not higher than controls
  • No difference in LV diastolic dysfunction compared to controls
  • Had no differences in nocturnal BP dip compared to controls

LV hypertrophy

  • 8% hypertension subjects had LV hypertrophy
  • LVMI had shown a significant quantitative linear relationship with only BMI
  • But ambulatory blood pressure monitoring parameters had no correlation with LV hypertrophy
  • Only BMI was found to be the significant risk factor of LV hypertrophy

LV diastolic dysfunction

  • 25 % hypertensives had LV dysfunction
  • Ambulatory blood pressure monitoring parameters and LVMI had no correlation with diastolic function
  • Subjects with LV hypertrophy had higher diastolic dysfunction (E/E’ ratio) compared to those without LV hypertrophy; there was no difference in their E/A ratio.

The findings of this study reveal that left ventricular mass index is significantly correlated with body mass index in children and adolescents with essential hypertension, and the diastolic dysfunction could be in higher risk in subjects with left ventricular hypertrophy.

Reference
Lee H et al. Left ventricular hypertrophy and diastolic function in children and adolescents with essential hypertension. Clinical Hypertension. 2015, 21:21.

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