The effects of obesity, gender, and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: A collaborative study of the international pediatric hypertension association
The effects of obesity, gender, and ethnic group on left ventricular hypertrophy and geometry in hypertensive children: A collaborative study of the international pediatric hypertension association
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DOI：
10.1542/peds.113.2.328
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发表时间：
2004-02-01
期刊：
影响因子：
8
通讯作者：
Sorof, J
中科院分区：
文献类型：
--
作者：
Hanevold, C;Waller, J;Sorof, J
目标。目的：确定多民族儿童和青少年高血压患者左心室肥厚（LVH）的患病率。从1998年到2001年来自国际儿童高血压协会3个站点的汇总数据进行了回顾。接受超声心动图检测LVH作为高血压评估的一部分的患者被纳入分析。左心室质量由二维引导m型超声心动图测量的左心室计算。左心室质量指数（LVMI）计算为左心室质量/高度（2.7）。按成人标准LVH定义为LVMI>51 g/m(2.7)，按儿童标准LVMI>38.6 g/m（2.7）。左心室几何形态分为同心、同心重构、偏心和正常。129例患者的平均年龄为13.6+/-3.6岁。男性占67%，白人占46.5%，非裔美国人占38.0%，西班牙裔占15.5%。按成人标准LVH患病率为15.5%，按儿童标准为41.1%。体重指数（BMI）升高与LVMI升高相关。使用儿童或成人标准LVH与BMI大于或等于年龄和性别的第95个百分位数相关。LVH和同心圆肥大在西班牙裔儿童中最常见。LVH常见于高血压患儿，并与BMI升高有关。LVH可能在西班牙裔儿童中比在其他种族群体中更为普遍。预防和治疗肥胖对于降低高血压儿童的心血管风险非常重要。需要进一步评估多民族人群LVH的频率。
Objective. To determine the prevalence of left ventricular hypertrophy (LVH) in a multiethnic group of children and adolescents with hypertension.Design/Methods. Pooled data from 1998 to 2001 from 3 sites belonging to the International Pediatric Hypertension Association were reviewed. Patients undergoing echocardiography to detect LVH as part of the evaluation for hypertension were included for analysis. Left ventricular mass was calculated from 2-dimensional guided M-mode echocardiographic measurements of the left ventricle. Left ventricular mass index (LVMI) was calculated as left ventricular mass/height(2.7). LVH by adult criteria was defined as LVMI>51 g/m(2.7) and by pediatric criteria as LVMI>38.6 g/m(2.7). Left ventricle geometry was classified as concentric, concentric remodeling, eccentric, or normal.Results. Data on 129 patients with a mean age of 13.6+/-3.6 years were analyzed. The population was 67% male, 46.5% white, 38.0% African American, and 15.5% Hispanic. The prevalence of LVH was 15.5% using adult criteria and 41.1% using pediatric criteria. Increasing body mass index (BMI) was associated with a higher LVMI. Using either pediatric or adult criteria LVH was associated with BMI greater than or equal to95th percentile for age and gender. LVH and concentric hypertrophy were identified most frequently in Hispanic children.Conclusions. LVH occurs commonly in children with hypertension and is associated with an increased BMI. LVH may be more prevalent in Hispanic children than in other ethnic groups. Prevention and treatment of obesity is important in reducing the cardiovascular risk for children with hypertension. Further evaluation of the frequency of LVH in multiethnic populations is needed.