Ambulatory blood pressure and increased left ventricular mass in children at risk for hypertension
Ambulatory blood pressure and increased left ventricular mass in children at risk for hypertension
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DOI：
10.1016/j.jpeds.2007.07.014
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发表时间：
2008-03-01
影响因子：
5.1
通讯作者：
Jones, Deborah P.
中科院分区：
文献类型：
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作者：
Richey, Phyllis A.;DiSessa, Thomas G.;Jones, Deborah P.
目的 将动态血压 (ABP) 与有原发性高血压 (HTN) 风险的儿童的心脏靶器官测量联系起来。研究设计 采用横断面研究设计，同时测量有高血压风险的儿童（6 至 18 岁）的左心室质量指数 (LVMI) 和 ABP。结果 LVMI 显示与 24 小时收缩压 (SBP) 负荷、SBP 指数 (SBPI) 和标准差评分呈显着正相关（安全数据表）。当受试者按 LVM1 百分位数分层时，SBP 负荷、24 小时 SBPI 和 24 小时 SSDS 存在显着差异。在控制种族和 BMI 后，24 小时 SSDS 中 SDS 每增加 1 倍，LVMI 升高的优势比 (OR) 就会增加 54%（OR = 1.54，单位 = I SDS，CI = 1.1, 2.15，P = .011），BPI 每增加 0.1，则 LVMI 升高的优势比 (OR) 就会增加 88%（OR = 1.88，CI = 1.03， 3.45，P =.04）。与正常受试者相比，3 期 HTN 受试者的平均 LVMI 显着更高（方差分析 P = 0.002；LMVI，31.6 +/- 7.9 与 39.5 +/- 10.4）。 结论 随着收缩压 ABP 变量增加，LVMI 增加的可能性更大。基于 ABPM 的分期可以评估原发性高血压儿童的心血管风险。
Objective To relate ambulatory blood pressure (ABP) to cardiac target organ measurement in children at risk for primary hypertension (HTN).Study design Left ventricular mass index (LVMI) and ABP were measured concomitantly in children (6 to 18 years) at risk for hypertension using a cross-sectional study design.Results LVMI showed a significant positive correlation with 24-hour systolic blood pressure (SBP) load, SBP index (SBPI), and standard deviation score (SDS). When subjects were stratified by LVMl percentile, there were significant differences in SBP load, 24-hour SBPI, and 24-hour SSDS. The odds ratio (OR) of having elevated LVMI increased by 54% for each incremental increase of SDS in 24-hour SSDS after controlling for race and BMI (OR = 1.54, unit = I SDS, CI = 1.1, 2.15, P = .011) and increased by 88% for each increase of 0.1 in BPI (OR = 1.88, CI = 1.03, 3.45, P =.04). Subjects with stage 3 HTN had significantly greater mean LVMI compared with normal subjects (P = .002 by ANOVA; LMVI, 31.6 +/- 7.9 versus 39.5 +/- 10.4).Conclusions As systolic ABP variables increase, there is greater likelihood for increased LVMI. Staging based on ABPM allows assessment of cardiovascular risk in children with primary hypertension.